Caring & Treating Since 2005
Knee Osteoarthritis (OA)
What is Knee Osteoarthritis (OA)
Arthritis refers to inflammation of the joints. Osteoarthritis (OA), also known as degenerative arthritis or “wear and tear” arthritis, is the most common form of arthritis. OA can affect almost any joint in the body, but it occurs most frequently in the knees, fingers, hips and spine.
In normal joints, a layer of firm, rubbery material called cartilage lines the ends of each bone. This reduces friction and allows the bones to glide over each other smoothly.
In Osteoarthritis (OA), the cartilage begins to break down, leading to joint pain and decreased range of motion. As Osteoarthritis (OA) worsens over time, bits of bone, in turn, begin breaking down, leading to the development of growths called bone spurs, or osteophytes. Small fragments of bone or cartilage may chip off and float around in the joint space, causing locking or “jamming” of the joint.
In the late stages of Osteoarthritis (OA), the joint space is greatly reduced and bone rubs against bone, resulting in severe joint pain and stiffness.
Knee Osteoarthritis (OA)
This article will focus primarily on knee Osteoarthritis (OA)
The stages of knee OA are outlined in the diagram below:
These degenerative changes usually develop slowly over time. Osteoarthritis (OA) can affect people of all ages but tends to occur most commonly in people aged 50 or older.
A pre-existing injury such as ligament or meniscal tears and previous fracture can accelerate the rate of Osteoarthritis (OA) development.
Symptoms of Knee Osteoarthritis (OA)
Symptoms of Knee Osteoarthritis (OA) vary based on the severity:
- Pain and stiffness. These are the most common symptoms and are typically worse on waking up in the morning or after an extended period of inactivity.
- Swelling after a period of overuse
- A “grating” or “crunching” sensation can be heard or felt when moving the knee
- Decreased range of motion
- Locking or “jamming” of the joint
- Joint instability
- Joint deformity
The quality of life for patients with Knee Osteoarthritis (OA) can be very debilitating in the late stages.
They may find it increasingly difficult to enjoy the sports or activities that they normally enjoy doing.
Even simple daily tasks that are usually taken for granted, like walking up and down the stairs, become seemingly impossible.
Knee Osteoarthritis (OA) can also impact one’s work significantly and result in having to switch jobs or even stop working.
What are the Risk Factors of Knee Osteoarthritis (OA)?
There are a number of risk factors that contribute to OA. Here are some of them:
1) The risk of Knee Osteoarthritis (OA) occurs with increasing age.
2) Females are more likely to develop Knee Osteoarthritis (OA) than males, especially after menopause.
3) Being overweight puts extra pressure and stress on the weight-bearing joints, causing the cartilage to break down faster. Excess adipose tissue also produces inflammatory proteins known as cytokines that cause further damage to joints.
4) There are certain inherited genetic traits that predispose some people to develop Knee Osteoarthritis (OA)
5) Joint injury. Injuries such as fractures, ligament or meniscal tears, or previous septic arthritis, can lead to the development of Knee Osteoarthritis (OA). The orthopaedic operations performed to treat such injuries are also risk factors themselves to developing OA.
6) Certain jobs that regularly require manual labour, climbing tasks, long duration of walking or are physically demanding to predispose to Knee Osteoarthritis (OA).
7) Underlying medical conditions. Diabetes, rheumatoid arthritis and gout are just some of the many medical conditions that can contribute to Knee Osteoarthritis (OA) development.
How to Diagnose Knee Osteoarthritis (OA)?
After a detailed consultation, your doctor will perform a physical examination of the knee joint. Blood tests are usually not necessary in confirming a diagnosis of Knee Osteoarthritis (OA). However, the following tests may be necessary:
Arthrocentesis, or knee joint aspiration.
A needle is inserted into the knee joint in order to withdraw some joint fluid. This sample is sent to the lab and examined for evidence of inflammation. It is also useful for ruling out other possible diagnoses.
The images can reveal joint space narrowing, which is an indication of cartilage degeneration, and bone spurs or osteophytes. Your doctor may need to X-ray the unaffected joint as well for comparison.
Magnetic resonance imaging (MRI) scan
MRI is not usually required to diagnose Knee Osteoarthritis (OA), but may be performed in complex cases, as it can provide highly detailed images of the knee joint including the soft tissue structures.
How to Treat Knee Osteoarthritis (OA)?
OA is a chronic degenerative condition which cannot be cured. It is important to implement some lifestyle changes such as maintaining a healthy weight, continuing to be physically active, and muscle strengthening exercises to ease the burden on the knee joints. One can also consider joint support or braces, and walking aids.
Numerous treatments are available to help manage the symptoms:
- Oral/topical analgesics eg. nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol or opioids
- Oral supplements containing natural products that help to reduce inflammation, slow down cartilage degeneration and promote collagen formation
- Corticosteroid injection. Steroids have powerful anti-inflammatory effects and are useful for the short term, immediate pain relief.
- Hyaluronic acid (HA) injection. HA is a natural component of joint synovial fluid and is broken down in OA. HA injections can help to improve joint lubrication and movement and provide medium-term relief.
In the late stages of OA when joints are severely damaged, surgery may be indicated. Surgical options include arthroscopy, knee osteotomy, partial or total knee replacement.