Definition
Knee osteoarthritis, often simply referred to as knee OA, is a degenerative joint disorder that primarily affects the knee joint. It is a form of osteoarthritis, which is the most common type of arthritis. Osteoarthritis is characterised by the gradual breakdown of cartilage in the joints, leading to pain, stiffness, and reduced joint function.
In the case of knee osteoarthritis, the cartilage within the knee joint undergoes wear and tear over time, causing it to thin and lose its smooth surface. As a result, the bones in the knee may rub against each other, leading to pain, swelling, and reduced mobility. In addition to cartilage damage, other structures within the knee, such as ligaments and synovial fluid, may also be affected.
Knee osteoarthritis is more common in older adults, but it can also develop due to factors such as joint injury, overuse, obesity, and genetic predisposition. The symptoms of knee osteoarthritis often include pain, stiffness, swelling, and a gradual loss of joint flexibility.
Clinical Presentation
The clinical presentation of knee osteoarthritis (OA) can vary among individuals, but common symptoms and signs include:
- Pain: Pain is a hallmark symptom of knee osteoarthritis. It is often described as aching or throbbing and is typically localised to the knee joint. Pain may be more pronounced during weight-bearing activities such as walking, standing, or climbing stairs. It can also be present at rest and at night, especially in advanced stages of the condition.
- Stiffness: Individuals with knee OA may experience stiffness, particularly after periods of inactivity such as waking up in the morning or sitting for an extended period. This stiffness usually improves with movement but may return after prolonged rest.
- Swelling: Swelling in the knee joint may occur due to inflammation caused by the breakdown of cartilage. This swelling may contribute to a feeling of fullness or tightness in the joint.
- Limited Range of Motion: As knee osteoarthritis progresses, the range of motion in the affected joint may decrease. This can lead to difficulty bending or straightening the knee fully.
- Crepitus: A grating or cracking sensation, known as crepitus, may be felt or heard when the knee is moved. This noise is often a result of the roughening of the joint surfaces due to cartilage loss.
- Joint Deformities: In advanced cases, changes in the shape and alignment of the knee joint may occur, leading to visible deformities.
- Weakness and Instability: The surrounding muscles may weaken due to disuse or pain, leading to a sense of instability in the knee.
It’s important to note that the severity and progression of knee osteoarthritis can vary. Some individuals may have mild symptoms that can be managed with lifestyle modifications and conservative treatments, while others may experience more significant pain and functional limitations requiring more aggressive interventions, such as medications or surgery.
Treatment Options
The management of knee osteoarthritis (OA) aims to relieve symptoms, improve joint function, and enhance the overall quality of life. Treatment options for knee osteoarthritis can be categorised into several approaches, including lifestyle changes, non-pharmacological interventions, medications, and surgical options. The specific treatment plan may vary based on the severity of symptoms, the individual’s overall health, and other factors. Here are some common treatment options:
- Lifestyle Modifications:
- Weight Management: Maintaining a healthy weight is crucial as excess weight puts additional stress on the knee joints. Weight loss can help reduce symptoms and slow down the progression of knee osteoarthritis.
- Exercise: Regular, low-impact exercises, such as walking, swimming, or cycling, can help improve joint flexibility, strengthen muscles around the knee, and reduce pain. Physiotherapy may be recommended to develop a personalised exercise program.
- Joint Protection: Using assistive devices, such as walking aids or braces, can help reduce stress on the knee joint and improve stability.
- Non-Pharmacological Interventions:
- Physiotherapy: Therapeutic exercises, manual therapy, and other modalities can be prescribed by a physiotherapist to improve joint function and reduce pain. The GLAD physiotherapy program is an excellent example of this.
- Occupational Therapy: Occupational therapists can provide guidance on adaptive strategies and assistive devices to make daily activities easier for individuals with knee osteoarthritis.
- Medications:
- Pain Relief: Over-the-counter pain relievers such as Paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation. Prescription-strength NSAIDs may be recommended in some cases.
- Corticosteroid Injections: Injections of corticosteroids into the knee joint can provide temporary relief from flare-ups of pain and inflammation.
- Joint Injections:
- Hyaluronic Acid Injections: Also known as visco-supplementation, these injections involve injecting a gel-like substance into the knee joint to improve lubrication and reduce pain.
- Platelet Rich Plasma (PRP) injections: these blood derived injections can often provide symptomatic relief for patients with mild to moderate arthritis
- Surgical Options
- Arthroscopy: In some cases, arthroscopic surgery may be performed to remove loose particles or unstable cartilage to minimise mechanical symptoms associated with OA.
- Partial or Total Knee Replacement: For severe cases where conservative measures are ineffective, partial or total knee replacement surgery may be recommended to replace the damaged joint surfaces with artificial implants.
It’s essential for individuals with knee osteoarthritis to work closely with healthcare professionals to develop a comprehensive treatment plan tailored to their specific needs. Treatment may involve a combination of these approaches, and the goal is to improve function, reduce pain, and enhance overall well-being.
To schedule an appointment with Dr Matthew Evans to discuss your Knee Injury, please contact us by phone – (03) 9529 3820, or email evansadmin@mog.com.au
