Knee Osteoarthritis

 

Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease, but it is particularly common in the knee. Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. The most common types of arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 different forms. Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep people staying active.

 

Knee Anatomy

The knee is the largest and strongest joint in your body. It is made up of the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap). The ends of the three bones where they touch are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones as you bend and straighten your knee. Two wedge-shaped pieces of cartilage called meniscus act as "shock absorbers" between your thighbone and shinbone. They are tough and rubbery to help cushion the joint and keep it stable. The knee joint is surrounded by a thin lining called the synovial membrane. This membrane releases a fluid that lubricates the cartilage and reduces friction

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Osteoarthritis vs. Rheumatoid Arthritis

Osteoarthritis (OA) is the most common form of arthritis in the knee. It is a degenerative,"wear-and-tear" type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too. In osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone, and produce painful bone spurs. Osteoarthritis develops slowly and the pain it causes worsens over time.

Rheumatoid arthritis (RA) is a chronic disease that attacks multiple joints throughout the body, including the knee joint. It is symmetrical, meaning that it usually affects the same joint on both sides of the body. In rheumatoid arthritis the synovial membrane that covers the knee joint begins to swell, this results in knee pain and stiffness. Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues (such as cartilage and ligaments) and softens the bone. The cause of RA is unknown, but it’s believed that genetic as well as environmental factors like air pollution and smoke can start an autoimmune response in the body. Inflammation may start in the joints, but can spread into other body systems such as skin, blood vessels, lungs, saliva and tear glands, heart membrane and the muscles.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Left -Normal joint space between the femur and the tibia. Right- Decreased joint space due to damaged cartilage and bone spurs.

 

Symptoms

A knee joint affected by arthritis may be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There are other symptoms, as well:

  • The joint may become stiff and swollen, making it difficult to bend and straighten the knee.

  • Pain and swelling may be worse in the morning, or after sitting or resting.

  • Vigorous activity may cause pain to flare up.

  • Pain may cause a feeling of weakness or buckling in the knee.

  • Many people with arthritis note increased joint pain with rainy weather.

 

Treatment options

Non-surgical conservative treatment

Lifestyle modifications. Some changes in your daily life can protect your knee joint and slow the progress of arthritis.

  • Minimize activities that aggravate the condition, such as climbing stairs.

  • Switching from high impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your knee.

  • Losing weight can reduce stress on the knee joint, resulting in less pain and increased function.
     

Physical therapy 
Specific exercises can help increase range of motion and flexibility, as well as help strengthen the muscles in your leg.
Your physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.

Assistive devices. Using devices such as a cane, a walker or crutches or wearing a brace or knee sleeve can be helpful.
A brace assists with stability and function, and may be especially helpful if the arthritis is centered on one side of the knee.

 

Surgical intervention

After a thorough interview and examination, your orthopedic surgeon will discuss your options. There are various techniques from minimal invasive procedures to a total knee joint replacement. Regardless of the surgical procedure you undergo, the knee will be swollen, painful and limited in motion. It is extremely important you start rehabilitation right after the surgery to avoid complications such as muscles shortening, limping, thrombus formation and overall deconditioning.