The knee is a hinge joint formed by the lower-end of the thigh bone and upper shin bone. A smooth covering of cartilage protects the bone surfaces and provides cushion as the joint moves freely. Knee arthritis is a condition characterized by cartilage deterioration and decreased knee joint spacing. Three types of arthritis can affect the knee:
- Osteoarthritis: The most common form of arthritis. This condition includes progressive wear and tear of the cartilage that typically affects middle-age and elderly people.
- Rheumatoid Arthritis: A chronic, inflammatory disease that causes swelling of the joint lining and damage to the cartilage. This condition occurs more frequently in middle-aged women. Systemic symptoms such as fever, loss of energy and appetite changes can occur. Patients with this condition often have flare ups where more than one joint becomes painful and stiff.
- Traumatic Arthritis: Can develop after an injury to the knee, such as a bad fall, fracture, or meniscus tear. Over time, the cartilage may wear away.
Symptoms include: progressive “aching” pain, knee swelling, stiffness, “grinding” or locking of the knee, difficulty going up and down stairs, and knee weakness.
In patients with arthritis, x-ray imaging can show bones spurs, joint deformity, and a decreasing joint space indicative of cartilage loss.
There are multiple treatment options for knee arthritis. You and your doctor can formulate a plan based on disease severity, symptoms, and overall function/health.
- Activity Modification: For early stages for arthritis, activity modification such as swimming and biking instead of running can reduce stress on the joint. Losing weight if overweight can be of benefit as it will decrease the pressure across your joints while weight-bearing. Using assistive devices such as a cane or knee brace can decrease pain and provide support.
- Medications: Anti-inflammatory medications reduce swelling and pain associated with arthritis. Glucosamine and chondroitin sulfate are natural substances found in and around cartilage in the knee. Oral supplementation of this is available over-the-counter and may help increase joint mobility.
- Knee Injections: Cortisone is a potent anti-inflammatory and can decrease knee pain and swelling when injected directly into the joint. Viscosupplementation is a series of injections in which a fluid called hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance in joint fluid. It is thought that injecting this substance can lubricate the joint and provide symptomatic relief over time. In later stages of arthritis, surgical treatment may be considered to relieve your arthritis symptoms. There are a number of options based on how focal the arthritis remains, severity of disease, location, your overall health:
- Knee arthroscopy: Using 2-3 small incisions, the surgeon visualizes the joint though a camera and can remove loose cartilage and bone fragments. This is a “clean out” procedure and you are able to go home the same day as surgery. Depending on how severe your arthritis is, this surgery may or may not relieve symptoms.
- Cartilage Restoration: Select patients with focal cartilage damage may qualify for a procedure to restore or reconstruct the injured knee surface.
- Partial Knee Replacement: For certain patients who have arthritis limited to one compartment in the knee. The damaged bone surfaces are removed and replaced with metal and plastic implants.
- Total Knee Replacement: The severely damaged knee joint surfaces are removed and replaced with artificial implants made of metal and plastic.