Knee Arthritis

What is Arthritis

The term ‘arthritis’ refers to inflammation of the joint but there are several forms of arthritis, as described below. The disease causes pain that may be mild, moderate or severe.

The vast majority of patients who manage their knee arthritis properly never require surgery.

Orthopaedic surgeons who specialise in arthritis generally treat patients who have advanced arthritis with progressive loss of the bearing surface of the joint and ultimately destruction of the joint with pain, stiffness and loss of function. Surgery may be required to relieve pain, stiffness and to improve function.

Common Types of Arthritis in the Knee

Osteoarthritis

This is the most common form of knee arthritis and arises due to wear and tear in which the bearing surface of the joint wears thin. It is not truly hereditary but does run in families with evidence of a genetic component.Osteoarthritis cutaway of knee

This may be due to abnormal loading of a joint such as shallow sockets in the hip or it may be a defect in the bearing surface of the joint (articular cartilage).

It usually affects the larger weight bearing joints. Moderate to severe osteoarthritis occurs in 8% of people aged more than 60 years. There is currently no proven medication or method to reverse or halt the progression of osteoarthritis.

Rheumatoid Arthritis

Rheumatoid arthritis cutaway of knee
Rheumatoid arthritis is one of the inflammatory types of arthritis that affects many joints in the body. It is a systemic disease affecting the whole body but focusing in the lining of all of the joints. The joints are swollen and inflamed, and the bearing surface of the knee becomes eroded.

Post-Traumatic Arthritis

Following a serious injury to a joint such as a fracture or previous surgery around the joint, arthritis may develop due to irregularities in the joint surface or alterations in the underlying bone structure or alignment of the joint.

Basic Treatment Program

The initial management of osteoarthritis does not involve surgery in most cases. This program is a starting point in caring for your arthritis and will vary with the severity of your symptoms and disease.

Please ask your surgeon to develop an individualised plan for your specific arthritis, which will take into consideration the following:

  • Exercise
  • Weight loss
  • General medical health
  • Modify activity
  • Medication and supplements

Exercise

  • Daily exercise is very important to keep the knee joints moving, strengthen muscles around joints and improve general fitness.
  • Low impact aerobic type activities like walking, swimming and bike riding are best.
  • You should avoid high impact activities like jogging, singles tennis and contact sports.
  • Hydrotherapy and supervised physiotherapy can be helpful.

Weight Loss

Excessive weight can be a major factor in the knee joints failing as they are not capable of handling the excess weight. Having body weight that is within the normal healthy range will help protect the joint. even a small amount of weight loss will be beneficial.

Diet

A healthy balanced diet will assist you to lead a normal life and keep your weight controlled. There are no proven diets that will greatly alter your arthritis, however diets that are high in fish oils have been suggested for people with rheumatoid arthritis.

General Medical Health

Medical diseases such as heart disease and diabetes can interfere with your arthritis care. Increased control of your chronic diseases can allow increased stamina and vitality.

Work and activity Modification

Modification to your work activities may be suggested if they result in excess loading and damage to the joints. This will depend on the individual activity and severity of arthritis. High impact and prolonged repetitive activities should be avoided.

Walking aids and Orthotics

  • A walking stick will reduce the load that is placed on damaged knee cartilage and joints. In general, the stick should be used in the opposite hand. The stick is placed forward when the opposite painful limb is moved forward and placed on the ground.
  • Occasionally shoe orthotics are beneficial for knee arthritis. Although unpredictable, orthotics can be considered if the knees are not unduly deformed.

Medications and Supplements

The goals of medical therapy and supplements are to decrease inflammation and decrease the pain in the joint.

There is always a new pill, injection or therapy that promises much, but usually delivers little.

Our recommendation:

  1. Start with simple analgesics such as paracetamol.
  2. Next, introduce a non-steroidal anti-inflammatory (perhaps new Cox-2 Inhibitors).
  3. Thirdly, introduce a joint supplement.

Other possible Medication and Supplementation treatments include:

  • Cortisone injections into the joint to reduce inflammation though relief is only temporary and not guaranteed.
  • Visco-supplementation (Synvisc™) is an artificial lubricant produced and promoted to relieve pain and increase function for those with mild to moderate osteoarthritis.

For information on these and more treatments, please contact us to discuss your individual circumstances.

Surgery

Surgery is usually recommended when patients have severe pain and significant loss of function. The decision to proceed with surgery is completely individual and subjective. There is no “One Size Fits All” scenario.

Please Contact Us so we can discuss more about your individual knee arthritis condition and needs.

Download our information sheet to learn more about Arthritis and treatment options.