During your life, your knees go through a lot, these joints cushion your movements and help support your weight. Over time, this natural wear and tear process can lead to osteoarthritis (OA) in the knee.
While age is a major risk factor for osteoarthritis of the knee, young people can get it, too. For some individuals, it may be hereditary. For others, osteoarthritis of the knee can result from injury or infection or even from being overweight.
What Is Osteoarthritis?
Osteoarthritis, commonly known as wear-and-tear arthritis, is a condition in which the natural cushioning between joints and cartilage wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, decreased ability to move.
Who Gets Osteoarthritis of the Knee?
Osteoarthritis is the most common type of arthritis. While it can occur even in young people, the chance of developing osteoarthritis rises after age 45. Women are more likely to have osteoarthritis than men
What Causes Knee Osteoarthritis?
The most common cause of osteoarthritis of the knee is age. Almost everyone will eventually develop some degree of osteoarthritis. However, several factors increase the risk of developing significant arthritis at an earlier age.
- Age: The ability of cartilage to heal decreases as a person gets older.
- Weight: Weight increases pressure on all the joints, especially the knees. Every pound of weight you gain adds 3 to 4 pounds of extra weight on your knees.
- Heredity: This includes genetic mutations that might make a person more likely to develop osteoarthritis of the knee. It may also be due to inherited abnormalities in the shape of the bones that surround the knee joint.
- Gender: Women ages 55 and older are more likely than men to develop osteoarthritis of the knee.
- Repetitive stress injuries: These are usually a result of the type of job a person has. People with certain occupations that include a lot of activity that can stress the joint, such as kneeling, squatting, or lifting heavy weights (55 pounds or more), are more likely to develop osteoarthritis of the knee because of the constant pressure on the joint.
- Athletics: Athletes involved in soccer, tennis, or long-distance running may be at higher risk for developing osteoarthritis of the knee. That means athletes should take precautions to avoid injury. However, it’s important to note that regular moderate exercise strengthens joints and can decrease the risk of osteoarthritis. In fact, weak muscles around the knee can lead to osteoarthritis.
- Other illnesses: People with rheumatoid arthritis, the second most common type of arthritis, are also more likely to develop osteoarthritis. People with certain metabolic disorders, such as iron overload or excess growth hormone, also run a higher risk of osteoarthritis.
What Are the Symptoms of Knee Osteoarthritis?
Symptoms of osteoarthritis of the knee may include:
- pain that increases when you are active, but gets a little better with rest
- feeling of warmth in the joint
- stiffness in the knee, especially in the morning or when you have been sitting for a while
- decrease in mobility of the knee, making it difficult to get in and out of chairs or cars, use the stairs, or walk
- creaking, crackly sound that is heard when the knee moves
How Is Osteoarthritis of the Knee Diagnosed?
The diagnosis of knee osteoarthritis will begin with a physical exam by your doctor. Your doctor will also take your medical history and note any symptoms. Make sure to note what makes the pain worse or better to help your doctor determine if osteoarthritis, or something else, may be causing your pain. Also find out if anyone else in your family has arthritis. Your doctor may order additional testing, including:
- X-rays, which can show bone and cartilage damage as well as the presence of bone spurs
- Magnetic resonance imaging (MRI) scans…sometimes
MRI scans may be ordered when X-rays do not give a clear reason for joint pain or when the X-rays suggest that other types of joint tissue could be damaged.
How Is Osteoarthritis of the Knee Treated?
The primary goals of treating osteoarthritis of the knee are to relieve the pain and return mobility. The treatment plan will typically include a combination of the following:
Non-Surgical Treatments for Knee Osteoarthritis
Weight loss. Losing even a small amount of weight, if needed, can significantly decrease knee pain from osteoarthritis.
Exercise. Strengthening the muscles around the knee makes the joint more stable and decreases pain. Stretching exercises help keep the knee joint mobile and flexible.
Pain relievers and anti-inflammatory drugs. This includes over-the-counter choices such as acetaminophen, ibuprofen. Don’t take over-the-counter medications for more than 10 days without checking with your doctor. Taking them for longer increases the chance of side effects.
Injections of corticosteroids or hyaluronic acid into the knee. Steroids are powerful anti-inflammatory drugs. Hyaluronic acid is normally present in joints as a type of lubricating fluid.
Alternative therapies. Some alternative therapies that may be effective include topical creams with capsaicin, acupuncture, or supplements, including glucosamine and chondroitin..
Using devices such as braces.support braces provide support for the knee and thus relieve pain to some extent.
Physical and occupational therapy. If you are having trouble with daily activities, physical or occupational therapy can help. Physical therapists teach you ways to strengthen muscles and increase flexibility in your joint. Occupational therapists teach you ways to perform regular, daily activities, such as housework, with less pain.
Warm or cold compress
Using a warming pad can loosen a stiff knee joint making activity easier. Icing the knee joint for 15 or 20 minutes after activity can decrease swelling and provide some immediate pain relief. Heating or icing a joint is focused on improving symptoms temporarily: it does not alleviate the underlying causes of knee pain and will not improve long-term joint function by itself.
Supportive devices and orthotics
certain orthopedic products may be used to help stabilize or take pressure off the knee. Some examples include:
- Cushioning shoe inserts can lessen the pressure put on the knee joint when walking
- Elastic knee braces can support the knee joint
- Using a cane on the opposite side of the affected knee can provide extra stability and reduce pressure on the knee
2) Surgery. When other treatments don’t work, surgery is a good option
Is Surgery Used to Treat Knee Osteoarthritis?
If your doctor wants to treat the osteoarthritis in the knee with surgery, the options are arthroscopy, osteotomy, and arthroplasty.
- Arthroscopy uses a small telescope (arthroscope) and other small instruments. The surgery is performed through small incisions. The surgeon uses the arthroscope to see into the joint space. Once there, the surgeon can remove damaged cartilage or loose particles, clean the bone surface, and repair other types of tissue if those damages are discovered. The procedure is often used on younger patients (ages 55 and younger) in order to delay more serious surgery.
- An osteotomy is a procedure that aims to make the knee alignment better by changing the shape of the bones. This type of surgery may be recommended if you have damage primarily in one area of the knee. It might also be recommended if you have broken your knee and it has not healed well. An osteotomy is not permanent, and further surgery may be necessary later on.
- Joint replacement surgery, or arthroplasty, is a surgical procedure in which joints are replaced with artificial parts made from metals or plastic. The replacement could involve one side of the knee or the entire knee. Joint replacement surgery is usually reserved for people over age 50 with severe osteoarthritis. The surgery may need to be repeated later if the joint wears out again after several years, but with today’s modern advancements most new joints will last over 20 years.