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Knee Arthritis

When you are in your 50s, it is common to experience cracking or popping sounds from your knees and difficulty doing simple activities like walking and kneeling down. These symptoms may be due to knee arthritis.

What is knee arthritis?

Knee arthritis is inflammation of the knee joint that causes pain, swelling, and tenderness in the knee.

Our knee is the largest and strongest joint, made of three main bones: the thighbone (femur), shinbone (tibia), and kneecap (patella). The end of each bone is covered with cartilage, which acts as a shock absorber to protect the bones and helps in the smooth movement of the knee joint. Any damage to this cartilage will increase the friction between these bones, resulting in pain and restricted knee movements.

What are the symptoms associated with knee arthritis?

The symptoms that are linked to knee arthritis are:

Pain and swelling of the knee, especially in the morning or after sitting for a while
Stiffness of joint, which causes difficulty in bending or straightening of the joint
Pain that gets worse with little activity
Reduced movement of the joint
Creaking and crackly sound from the joint while walking

What are the causes and risk factors associated with knee arthritis?

The following are the major types of arthritis that affect the knee joint:

Osteoarthritis is a degenerative, wear-and-tear type of arthritis that occurs when the cartilage in the knee joint wears away, exposing the underlying bone. As a result, the bones begin to rub together, resulting in knee pain and restricted movement.
Rheumatoid arthritis: Rheumatoid arthritis is an autoimmune disease in which the body's immune system tricks the body tissue into attacking the smooth lining of the knee joint.
Post-traumatic arthritis: This form of arthritis develops following an injury to the knee and can occur years after the existing knee injury, like a ligament injury or knee fracture. The new knee injury will increase the instability and pressure on the knee joint, which leads to arthritis.

The risk of having knee arthritis is more for:

Elderly people (late 40's or older): The risk of getting knee arthritis increases as you get older as the cartilages will become more brittle and has less repair capacity.
Obese individuals: Extra weight gives more pressure to the weight bearing body joints like knee joint and causes inflammation.
Females: Women have wider hips than men. The angle formed by the hip bones being wider puts more stress on the outside of the knees. Moreover, female hormones like estrogen also trigger the condition.
Family history: If you have a parent or sibling who has knee arthritis, the chances are greater that you will get it too.
Previous joint injuries: Old injuries in knee like fracture, ligament tear etc. can increase the risk of developing arthritis in that joint.

How knee arthritis is diagnosed?

To determine whether a person has arthritis in the knee, your physician will ask you for a complete medical history, including family history, previous knee injuries, etc. A physical examination may be performed to check for symptoms such as tenderness, swelling, redness, and tenderness in the affected knee area.

Imaging tests like X-ray or MRI are used to confirm the diagnosis, its location and severity.

In certain cases, your doctor may also recommend lab tests like blood tests and joint fluid analysis to identify the type of arthritis and find out whether the pain is due to an infection or other conditions like gout.

What are the treatment options available for knee arthritis?

Although there is no cure for knee arthritis, treatment is done to relieve symptoms, improve strength and mobility of the joint, and prevent further knee damage.

The non-surgical treatment options for knee arthritis will include the combination of the following:

Lifestyle modification: Certain lifestyle changes can relieve the symptoms and prevent worsening of the condition. This includes:
- Reducing body weight
- Minimizing the activities that cause pain
- Proper rest
Medications: As the severity and cause of the condition differs, your doctor will determine the correct medications and dosages that are safe and effective for you.
- Painkillers and non-steroidal anti-inflammatory drugs are prescribed to relieve mild to moderate pain.
- Corticosteroid injections given into the joint may help relieve pain.
- Antidepressant medications may be prescribed for relieving chronic pain.
- Disease-modifying anti-rheumatic drugs (DMARDs) may help slow down the progression of knee arthritis especially rheumatoid arthritis.

Surgical treatment is recommended only when the pain due to knee arthritis is severe, causing any disability, or when the patient is not relieved with nonsurgical treatment. The surgery options include:

Knee arthroscopy: This is a minimally invasive surgical procedure where thin instruments are inserted through small incisions on the knee to diagnose and treat knee joint injuries.
Knee Osteotomy: A knee osteotomy is used for early-stage osteoarthritis where only one side of the knee joint is damaged. In this procedure, either the thigh bone (femur) or shinbone (tibia) is cut and reshaped to reduce the pressure on the knee joint.
Knee replacement: In this surgical procedure, the damaged joint is removed and replaced with an artificial joint made of metal or plastic. Knee replacement is of two types: partial knee replacement (which involves replacement of only one part of the knee) and total knee replacement (which involves replacement of the whole knee joint).

Physical therapy: These are the specific exercises done under the guidance of a physiotherapist to strengthen the muscles around the knee joints, relieve symptoms, restore mobility, and prevent disability.

Assistive devices: Devices such as a cane, or shoe inserts, and shock-absorbing shoes can be used to provide support to the knee.

Alternative therapies: Alternative therapies to treat pain include the use of acupuncture and magnetic pulse therapy, which may help by relieving pain or temporarily numb an area.

What are the preventive measures for knee arthritis?

Risk factors like age, family history, and gender cannot be modified. However, modifying some lifestyle habits may slow down the knee joint damage and prevent further complications.