Knee Arthritis

Osteoarthritis occurs when the protective cartilage that covers the ends of the bones wears down over time. When cartilage breaks down, bones rub against each other, causing pain, swelling, and stiffness. Osteoarthritis worsens over time and is more common in older adults, but younger people with a history of knee injuries or excessive joint stress might also develop this condition. Age, obesity, joint problems, and repetitive stress from work or hobbies put people at risk of getting osteoarthritis.

Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly attacks the synovium, the joint membrane lining. This causes inflammation, damaging the bone and tissue inside it. This condition affects both knees, leading to severe pain, swelling, and joint deformity. This type of arthritis is more common in women and can develop at any age. Early evaluation and treatment are important for controlling symptoms and preventing joint damage.

Post-traumatic arthritis can develop after a knee injury, such as a fracture, ligament tear, or meniscus tear. Even after healing, the injury can damage cartilage and lead to arthritis. Post-traumatic arthritis causes pain, swelling, and decreased joint function months or years after the injury. People of all ages can get this kind of arthritis, but people who have had serious knee accidents in the past are more likely to get it. Proper management and rehabilitation after knee injuries are important to reduce the risk of developing post-traumatic arthritis.

A detailed medical history is the first step in diagnosing knee arthritis. The knee specialist will ask about the onset and duration of symptoms, any history of knee injuries, and any other medical conditions. A family history of arthritis or other joint diseases may also be relevant.

During the physical examination, a knee specialist will assess the knee for signs of arthritis. This includes checking for:

• Swelling: The knee specialist will palpate or press the knees to detect areas of tenderness, swelling, discomfort, and inflammation.
• Knee’s Range of Motion: The knee specialist will evaluate the knee’s range of motion by moving it through its full range and noting any limitations or pain.
• Joint Stability: The knee specialist will perform certain manoeuvres to check the knee’s overall strength and the health of its ligaments. This may involve gently pushing or pulling on the leg to see if the knee remains stable or shows signs of weakness or instability.
• Gait Analysis: The knee specialist will observe the patient’s gait and how they walk. This can provide information about how their knees function and if they are in pain. Changes in how you walk could be a sign of serious joint damage.

Imaging tests are required to diagnose and assess the severity of knee arthritis. Common imaging tests include:

• X-rays: X-rays can reveal joint space narrowing, bone spurs, and other changes characteristic of osteoarthritis. In rheumatoid arthritis, X-rays can show joint erosion and other deformities.
• MRI (Magnetic Resonance Imaging): MRI scans provide detailed images of the knee’s soft tissues, including cartilage, tendons, and ligaments. MRI is particularly useful for detecting early-stage arthritis and assessing the extent of joint damage.

Laboratory tests can help identify the type of arthritis and rule out other conditions. Common tests include:

• Blood Tests: Blood tests can detect markers of inflammation, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Specific antibodies, like rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP), can indicate rheumatoid arthritis.
• Joint Fluid Analysis: Aspiration of joint fluid (arthrocentesis) involves drawing a small fluid sample from the knee joint. This fluid is analysed for signs of infection, inflammation, and crystals (which can indicate gout).

Non-surgical treatments are often the first line of management for knee arthritis. These include:

Medications

Medications can help manage pain and inflammation associated with knee arthritis. Pain relievers such as acetaminophen can help reduce pain but do not address inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can help reduce pain and inflammation.

Knee Injections

Pain and inflammation may be reduced by knee injections. Common injections include corticosteroids, which reduce inflammation, and hyaluronic acid, which lubricates joints and may alleviate arthritis pain. These injections may provide months of relief.

Joint Lubricant Injection for OA Knee

Knee osteoarthritis (OA) is treated by hyaluronic acid injections, often called joint lubricant injections. These injections lessen discomfort and increase the range of motion by lubricating and cushioning the knee joint. They especially benefit those who have not reacted well to previous therapies.

APS (Autologous Protein Solution) Injection

This injection is a non-surgical regenerative therapy designed to treat osteoarthritis and slow down joint and cartilage degeneration. It uses your own blood components—specifically white blood cells and platelet-rich plasma—to reduce inflammation and pain caused by degenerative changes.

Physical Therapy

Physical therapy is important for maintaining and improving knee function, focusing on the following:

• Strengthening Exercises: Exercises to strengthen the muscles around the knee help provide better support and reduce the load on the joint. Exercises such as calf raises and quadriceps or hamstring workouts can improve leg strength and knee function.
• Range of Motion Exercises: Exercises to maintain or improve flexibility and mobility of the knee joint, such as heel slides, knee extensions and hamstring stretches.
• Aerobic Exercises: Low-impact aerobic exercises, such as swimming or cycling, can help improve overall fitness without putting excessive strain on the knee.

Use of Assistive Devices

Assistive devices can relieve pain and improve mobility. Knee braces relieve discomfort and prevent injury by stabilising the knee. Canes or walkers reduce knee weight, making walking safer. These devices help people manage their condition and continue daily activities.

When non-surgical treatments are ineffective, surgical options may be considered.

• Arthroscopy: Arthroscopy is a procedure that uses a small camera inserted into the knee joint to remove or fix damaged tissue. This surgery is often performed on people with a torn meniscus, damaged cartilage, or loose bodies in the joint.
• Osteotomy: Osteotomy involves cutting and reshaping the bones to ease pressure on the knee joint. This procedure is typically recommended for younger patients with limited arthritis and aims to shift weight away from the damaged part of the knee.
• Partial Knee Replacement: Partial knee replacement involves replacing only the damaged part of the knee joint with a prosthesis, preserving as much of the natural knee as possible. This procedure is suitable for patients with arthritis limited to a single knee compartment.
• Total Knee Replacement: Total knee replacement involves replacing the entire knee joint with an artificial joint. This procedure is typically recommended for severe arthritis that affects the entire knee and aims to relieve pain and restore function.