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St. Mary's Center for Orthopaedics

Arthritis of the Knee

What is Arthritis of the Knee?

Arthritis in the knee is a condition that occurs when degenerative changes develop in the cartilage that lines the knee joint. This condition, which is more commonly seen in women, is characterized by pain in the front part of the knee (behind the patella, or kneecap) that typically worsens when the patient walks on inclined terrain, goes up and down stairs, knees, squats, and rises from the sitting position.   The one body part most affected by arthritis is the knee. There are three basic types of arthritis:

  • Osteoarthritis – Osteoarthritis (OA) is the most common form of knee arthritis. OA is usually a slowly progressive degenerative disease in which the joint cartilage gradually wears away. It most often affects middle-aged and older people.
  • Rheumatoid Arthritis – Rheumatoid arthritis (RA) is an inflammatory type of arthritis that can destroy the joint cartilage. RA can occur at any age. RA generally affects both knees.
  • Post-traumatic Arthritis – Post-traumatic arthritis can develop after an injury to the knee. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, ligament injury, or meniscus tear.

What are the Symptoms of Arthritis of the Knee?

In most cases, the pain associated with arthritis develops gradually, although sudden onset is possible.  Symptoms include:

  • Stiff and swollen joints that make it difficult to bend or straighten the knee.
  • Pain and swelling are worse in the morning after a period of inactivity.
  • Pain may increase after activities such as walking, kneeling, or climbing the stairs.
  • The pain may often cause a feeling of weakness in the knee, resulting in a “locking” or “buckling.”
  • Changes in the weather may affect the degree of pain from arthritis.

How is Arthritis of the Knee Diagnosed?

Your doctor will perform a physical examination that focuses on your walk, the range of motion in the limb, and joint swelling or tenderness. X-rays typically show a loss of joint space in the affected knee.  Blood and other special imaging tests, such as magnetic resonance imaging (MRI) may be needed to diagnose rheumatoid arthritis.

How is Arthritis of the Knee Treated?

Non-surgical Treatment

If you have osteoarthritis of the knee, you can take advantage of a wide range of treatment options. The effectiveness of different treatments varies from person to person. The choice of treatment should be a joint decision between you and your physician.

The purpose of treatment is to reduce pain, increase function and generally reduce your symptoms. Patient satisfaction is a fundamental goal in treating osteoarthritis of the knee. Non-surgical treatment includes: lifestyle modifications; exercise; supportive devices, other methods.

Some of the most common recommendations include:

  • Avoid activities that make the pain worse
  • Ice the knee for 20 to 30 minutes throughout the day to reduce inflammation
  • Use over the counter pain and anti-inflammitory medications
  • Lifestyle modifications – can include losing weight, switching from running or jumping exercises to swimming or cycling, and minimizing activities that aggravate the condition, such as climbing stairs.
  • Physical therapy
  • Exercise – can help increase range of motion, flexibility and strengthen leg muscles
  • Water Exercises
  • Supportive devices – knee brace, shoe inserts, cane
  • Prescription strength medications (oral steroids and anti-inflammitory medication) – if over the counter medication are not strong enough
  • Injections of medication in the knee, if the prescription strength medications are not sufficient pain relief

Surgical Treatment

If your arthritis does not respond to these non-surgical treatments, you may need to have surgery. There are a number of surgical options, including the following:

  • Arthroscopic surgery uses fiber optic technology to enable the surgeon to see inside the joint and clean it of debris or repair torn cartilage.
  • An osteotomy cuts the shinbone (tibia) or the thighbone (femur) to improve the alignment of the knee joint.
  • A total or partial knee arthroplasty replaces the severely damaged knee joint cartilage with metal and plastic.
  • Cartilage grafting is possible for some knees with limited or contained cartilage loss from trauma or arthritis.

Current research is focusing on new drugs as well as on cartilage transplants and other ways to help slow the progress of arthritis.