Knee Arthritis

Three main types of arthritis can affect the knee joint:

• Osteoarthritis (OA) : This is the most common of the three. It is a slowly progressive degenerative disease in which the joint cartilage gradually wears down.
• Rheumatoid Arthritis (RA) : This is an inflammatory disease that can destroy joint cartilage, can strike at any age and generally affects both knees.
• Post-traumatic arthritis : develops after a knee injury, is similar to osteoarthritis, and can develop years after a fracture, ligament or meniscal injury .

Symptoms

Pain associated with arthritis usually progresses gradually, but sudden onset is also possible.

The joint may become stiff and swollen, making it difficult for the knee to flex and extend. Pain and swelling are greatest in the morning or after a period of inactivity.

The pain may also increase after performing certain activities such as walking, climbing stairs, squatting. The pain can often cause a feeling of weakness in the knee, resulting in a “blockage” of the joint.

Many people experience a change in the level of arthritic pain even as the weather changes.

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Diagnosis

Your doctor will perform a physical exam focused on walking, limb range of motion, joint swelling, and tenderness.

Normal radiographs show a decrease in joint space in the affected knee.

Blood tests and other more specific radiological tests, such as MRI, may be necessary for the diagnosis of rheumatoid arthritis .

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Treatment

In the early stages, knee arthritis is treated with nonsurgical conservative measures.

• Lifestyle modifications that include: weight loss, switching from running to swimming or cycling, and minimizing activities that aggravate the situation, such as climbing stairs.
• Physiotherapy with exercises that increase the range of motion of the joint and strengthen the muscles of the leg.
• Using supportive tools such as walking sticks, wearing shock absorbing shoes, using braces can help.
• Other measures may include applications of heat or ice, water exercises, liniments, or elastic bandages.

Several types of medications can be used in the treatment of knee arthritis. Since all patients are different, and since not all people respond to the same medications, your doctor will develop a program for your specific condition.

• Anti-inflammatory drugs such as aspirin, ibuprofen etc. they can be helpful in reducing swelling.
• Glucosamine and chondroitin sulfate as oral supplements can relieve the pain of osteoarthritis.
• Corticosteroids, powerful anti-inflammatory agents that can be injected directly into the joint.
• Therapy with hyaluronic acid : consists of a series of infiltrations with the aim of changing the characteristics of the joint fluid.
• Special medical therapies for rheumatoid arthritis include the use of gold salts and other specific medications.

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Surgical Treatment

If arthritis does not respond to conservative treatments.

• Arthroscopic surgery: uses optical fibers to see inside the joint and remove fragments and / or repair cartilage damage
• Osteotomy of the tibia or femur to improve alignment of the knee joint.
• Total or partial knee replacement.
• Cartilage transplant. It is only possible for some knees, where cartilage damage is limited.

Orthopedic surgeons are continually searching for new avenues for treating knee arthritis. Research today is focused on new drugs, cartilage transplantation and other ways to slow the progression of arthritis.

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