Osteoarthritis is often referred to as ‘wear-and-tear arthritis’ as it arises when cartilage wears away. Cartilage is the natural cushioning structure that is found between the bones of a joint. Its role is to stop bones rubbing together by acting as a shock-absorber. With little or no cartilage in place, the bones are in direct contact and rub against each other. This can cause pain, a change of appearance in your knee, stiffness and difficulty moving the joint, and can also lead to the formation of bone spurs.
What causes osteoarthritis of the knee?
According to figures from Arthritis Research UK, around one in five adults over 45 years of age in England have osteoarthritis of the knee. Age can have an impact developing the condition, as cartilage doesn’t heal as well as you get older. Unfortunately, the chances of developing osteoarthritis rise sharply after the age of 45, and it is also more common in women than in men. It is so common that just about everyone will develop it to some degree.
There are some factors that can make it more likely that you will develop osteoarthritis at a younger age. If you are above your ideal weight, it will add to the pressure on your knees and this increases your risk of developing osteoarthritis. It also tends to run in families and previous injuries to the joint can also play a part.
Lifestyle factors also can have an impact on developing osteoarthritis of the knee. If your job involves a lot of kneeling, squatting or lifting heavy weights, it increases your risk. Playing sports that put a strain on the knees (such as football, tennis, or long-distance running) also increases the risk. Conversely, doing no exercise at all is a risk factor as well! One way to decrease your risk is by doing regular moderate exercise.
What are the symptoms of osteoarthritis and how is it diagnosed?
You may experience pain that increases with exercise and stiffness that is worse first thing in the morning. Your joint may become swollen, and it may feel hot or may make a crackly sound. Eventually, you may find it difficult to bend or move the knee, and struggle to get in and out of chairs and cars. Walking can become a challenge and using stairs could be especially hard.
It is advisable to go to your doctor as soon as you notice symptoms. You can expect to be physically examined and to be asked questions about your medical and personal history. Be prepared to discuss when the pain started and if you notice certain activities that make it worse or better. Depending on the outcome of the consultation, you may need an X-ray or magnetic resonance imaging (MRI) scan to confirm a diagnosis.
Will I need to have surgery?
Not everyone requires surgery, but depending on the severity of your diagnosis you may be offered arthroscopy, osteotomy or arthroplasty (partial or total knee replacement).
During arthroscopy, small incisions are made to allow a small telescope and small instruments to remove damaged cartilage and loose particles from the knee joint. An osteotomy involves changing the shape of the bones so that they align better for a period of time, but more surgery may be required down the line. Arthroplasty is when your knee joint is completely replaced with a new joint made from metals or plastic. It is possible to have a partial knee arthroplasty where only one side of the joint is replaced.
In general, we would try joint preservation procedure or biological agents before offering joint replacement surgery (either partial or total knee replacements). This is because the artificial joint can also wear out and will need to be replaced. These days, modern artificial knee joints can be expected to last at least 20 years. As with all surgery, there are risks, but these will be discussed with you prior to surgery.
Are there non-surgical treatment options?
The main aim of any treatment for osteoarthritis will be to relieve pain and improve mobility. Pain relievers and anti-inflammatory drugs may be prescribed temporarily, but they are not a long-term solution. Injections of corticosteroids or hyaluronic acid directly into the knee joint are also useful to lubricate and reduce inflammation. There is also a new treatment available called Platelet Rich Plasma Therapy (PRP), which involves a series of injections of platelets from your own blood directly into the joint.
Physiotherapy is very helpful as you will be given exercises to strengthen the muscles and increase flexibility. Also, occupational therapy can help to reduce the impact the condition has on your daily activities. Strengthening exercises can also be used to help the muscles around the knee secure the joint in place, which can reduce pain and improve movement. You may be advised to lose weight if this could be contributing to your symptoms. A knee brace, such as an “unloader” brace, can also help relieve symptoms as it offloads the weight on the side of the knee that is affected by arthritis.
Knee osteoarthritis can be a painful and debilitating condition, but there are many forms of modern treatments to help. If you think you may have osteoarthritis, don’t suffer in silence.
For more information or to book an appointment, contact us.