Knee Arthritis (Osteoarthritis)
What is arthritis?
Arthritis is a condition characterised by a degenerative process whereby there is gradual wear and tear to the cartilage and bone surfaces of a joint with subsequent inflammation. Arthritis of the knee may occur following a specific injury or due to repetitive impact through the knee joint, beyond what it can withstand over a period of time. In a normal knee, joint surfaces are smooth and there is cartilage between the bone ends which allows for efficient shock absorption and smooth movement (see healthy knee x-ray).
Knee Arthritis Anatomy
When the knee is damaged or overloaded, particularly with excessive weight-bearing or twisting forces, degeneration of the cartilage can occur, reducing the knee’s shock absorbing capacity. As the condition progresses, and the cartilage wears away, the joint space can narrow and there is eventual wearing down of the bone ends so that the surfaces are no longer smooth (see arthritic knee x-ray). The bone ends may also develop small bony processes (spurs) called ‘osteophytes’. When some or all of these changes occur, the condition is known as knee arthritis. Arthritis of the knee usually occurs after the age of 50 years and tends to affect females more frequently than males. It is more common in those patients who have a past history of injury, surgery or trauma to the knee.
Signs and symptoms of knee arthritis
Patients suffering with arthritis of the knee usually experience symptoms that develop gradually over time. In patients with minor cases of knee arthritis, little or no symptoms may be present. As the condition progresses, there may be increasing knee pain with weight bearing activity and joint stiffness (particularly after rest or first thing in the morning). Swelling, decreased flexibility (i.e. an inability to fully straighten or bend the knee), severe joint pain, pain at night and a grinding, clicking or locking sensation during certain movements may also be experienced. Symptoms can sometimes fluctuate from month to month with patients reporting an increase in symptoms with colder weather. In more severe cases, muscle wasting (especially of the quadriceps), a visible deformity of the knee joint, and a limp may also be present. Diagnosis of knee arthritis A thorough subjective and objective examination from a physiotherapist may be sufficient to diagnose knee arthritis. An X-ray is usually required to confirm diagnosis and may demonstrate signs of decreased joint space, irregularities of the bony ends and/or the presence of bony spurs (osteophytes). Sometimes an MRI may also be indicated to assist with diagnosis and rule out other pathologies.
Prognosis of knee arthritis
Because knee arthritis is a progressive condition, complete resolution of symptoms is often not possible. However, in mild to moderate cases, most patients, if managed well, can maintain an active lifestyle with little or no symptoms and delay or prevent the deterioration of the condition. In severe cases that have been unresponsive to appropriate physiotherapy management and where quality of life is significantly affected, knee joint replacement surgery is usually indicated with most patients subsequently experiencing a good outcome following the procedure.
Other intervention for knee arthritis
Although a knee brace cannot physically improve the symptoms of arthritis, it is advised that keeping the knee warm can help to reduce discomfort especially in the winter months, and keeping the knee compressed will help to keep swelling around the joint to a minimum. See our recommendations of braces and supports for arthritic knees. Or see our full range of Knee Supports and Knee Braces