Knee Osteoarthritis | Gleneagles Hospitals

Osteoarthritis is a condition where the natural cushioning between the joints faces wear and tear. It results in the joint bones rubbing against each other, causing pain, stiffness, swelling, and with time, development of contractures and bone spurs.

Knee osteoarthritis or osteoarthritis of the knee is also known as “degenerative joint disease of the knee.” It is the most commonly occurring form of arthritis.

While it is more commonly observed in people above 45 years of age, younger people may also sometimes suffer from this condition. It has also been observed through various studies that women are more likely to face this condition than men.

There are two types of knee osteoarthritis:

Primary - Articular degeneration happens without an underlying cause.
Secondary - Happens as a consequence of a trauma, abnormal application of force on the joint, or conditions like abnormal articular cartilage-like rheumatoid arthritis.

Stages of osteoarthritis knee

Doctors usually classify the stages of knee osteoarthritis as follows:

Stage	Description
0	The knee appears normal and shows no signs of damage.
1 (Minor)	Minor wear and tear of the knee joint. There may also be bone spur growths on the knee joint. Patient may not be experiencing joint pain. Treatment at this stage may only be in the form of lifestyle changes and supplements such as glucosamine.
2 (Mild)	Knee shows more bone spur growth. Patient may be experiencing some joint pain, stiffness around the joint, and a feeling of being uncomfortable when sitting for extended periods. The cartilage and soft tissues may still be healthy. However, some proteolytic breakdown of the cartilage matrix may be noted. Treatment involves plans to stop the progression of the disease. Pain-relieving therapies may be prescribed along with braces and knee supports and supplements such as glucosamine.
3 (Moderate)	The cartilage shows signs of erosion. The gap between the bones is narrowed, causing high levels of pain to the patient when walking. The synovial fluid may show proteoglycan and collagen fragments, and the joint may get rougher. The inflammation may result in frequent pain to the patient. There may also be popping sounds when walking. Treatment involves over-the-counter pain-relieving medications, therapies, weight loss. If the pain continues to worsen, the patient may be given hyaluronic acid injections in the knee joint to increase mobility. Bone osteotomy and / or realignment surgery may also be beneficial.
4 (Severe)	The space within the joint is considerably reduced, causing severe wear and tear of the cartilage. This leads to chronic inflammation, decreased synovial fluid, extreme friction between the joints, and inability to move without extreme pain. This stage also shows the development of more bone spurs which may cause severe pain to the patient when moving. The treatment may involve knee replacement surgery, bone osteotomy and / or bone realignment.

Knee osteoarthritis symptoms

Common symptoms include:

Knee pain that is mild at first but worsens with time
Knee pain increases in intensity with activity
Stiffness and swelling around the knee joint
Inability to move the joint after prolonged sitting/resting
The joint feels warm to touch
Decrease in mobility
Cracking sound in the knee while moving

Osteoarthritis is a progressive disease. It may develop from one stage to the next if left untreated. The final stages of the disease may leave a patient disabled with a complete inability to walk.

It is therefore advisable to consult your doctor when you notice the early signs of knee pain or other symptoms.

Knee osteoarthritis risk factors

These are the known risk factors for developing arthritis of the knee:

Age: Cartilage’s self-healing capacity decreases as a person gets older.
Heredity: Certain genes may make a person more prone to developing knee osteoarthritis.
Gender: Women above the age of 50 are more likely to get this condition than men.
Overweight: Being overweight/obese increases the pressure on joints.
Stress-related injuries: This is commonly observed in people involved in certain types of activities/ jobs such as weightlifting, and constant kneeling on the floor.
Sports: High-intensity sports like soccer, tennis, and running, may increase the chances of knee injury resulting in osteoarthritis.
Other conditions: Certain pre-existing diseases like rheumatoid arthritis, and metabolic disorders, may increase the chances of osteoarthritis.

Knee osteoarthritis diagnosis

Your doctor would first question your general health and symptoms before conducting a thorough physical examination.

Diagnosis is made based on your reported symptoms, physical examination, and investigations.

In addition to these, the orthopaedic specialist may order the following tests:

X-Rays to show damage to the bone and cartilage
MRI scans
Blood tests to rule out conditions like rheumatoid arthritis or other hormonal issues

Knee osteoarthritis treatment

The primary goal of treatment is pain management and restoring mobility. Treatment methodology hence begins with conservative techniques followed by surgical intervention if conservative treatment has become ineffective.

Conservative treatment options include:

Medications and topical creams containing nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
Corticosteroid injections may help relieve inflammation.
Hyaluronic acid injections for lubricating the joint.
Exercises to strengthen the muscles around the knee joint to make the joint more stable.
Supportive devices like knee braces.
Occupational and physiotherapy.

Surgery techniques include the following:

Arthroscopy: This minimally invasive surgery (MIS) procedure is performed by making small incisions and using a telescope-like instrument (called an arthroscope) to remove damaged cartilage and repair tissue damage. It is preferably done on patients younger than 55 years of age. Post-surgery recovery is fast.
Osteotomy: This procedure is done to remove knee alignment. It is recommended if the damage is limited to one area of the knee or if a broken knee has not healed well.
Arthroplasty (joint replacement surgery): The joint is replaced by artificial parts (made of metal or plastic). It is usually recommended for cases of severe osteoarthritis and for people above 55 years of age.

Make an appointment at Gleneagles Hospitals

If you are experiencing any of the symptoms of rheumatoid arthritis, get in touch with us to find out more about our Orthopaedic Services at your nearest Gleneagles Hospital.

Gleneagles Hospital works with orthopaedic specialists to assist patients through diagnosis and treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.

Knee Osteoarthritis: Symptoms, Diagnosis, Treatment