The knee is one of the largest and most complex joints in the body. The knee is made up of bones, cartilage, ligaments, and tendons. The knee joins the thigh bone (femur), the shin bone (tibia), the smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) altogether to make up the knee joint. The knee is a synovial joint, meaning it contains a fluid-filled capsule.
Tendons connect the knee bones to the leg muscles that move the knee joint, and ligaments join the knee bones and provide stability to the knee.
WHAT IS KNEE ARTHRITIS?
Arthritis is the swelling and tenderness of one or more of your joints. The primary symptoms of arthritis are joint pain and stiffness. Any joint in the body may be affected by the disease, but it is particularly common in the knee.
Knee arthritis is caused by thinning of the cartilage of the knee joint, usually due to injury or ‘wear and tear’ over time. This can make it hard to do many everyday activities, such as walking or climbing stairs.
There are more than 100 different types of arthritis. The most common types of arthritis affecting the knee are:
Age-related, this type of arthritis usually occurs in people aged 50 years and older but may occur in younger people too. This is due to wear and tear, where the cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, resulting in knee pain and stiffness.
- Rheumatoid arthritis
This is a disease in which the synovial membrane that surrounds the knee joint becomes inflamed, swells and thickens. This swollen membrane occupies more space in the knee area, resulting in cartilage loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a group of disorders termed “inflammatory arthritis.”
- Post-traumatic arthritis
Usually occurring after a serious knee injury, the fractures of the bones surrounding the knee or tears of the knee ligaments may damage the articular cartilage over time, which results in knee pain and limiting knee function.
While arthritis is mainly an adult disease, some forms affect children.
WHAT ARE THE SYMPTOMS OF KNEE ARTHRITIS?
The most common symptom of knee arthritis is knee pain. Other symptoms of knee arthritis include:
- Stiffness or swelling in the joint that makes it difficult to bend or straighten the knee
- Pain or swelling that worsens after a period of inactivity (such as after sitting and resting, or when waking in the morning)
- Worsening of pain after physical activity
- Loose fragments of cartilage and tissue that causes a ‘locking’ or ‘sticking’ sensation during movement. There may be a cracking or grinding sound known as crepitus
WHAT ARE THE CAUSES AND RISK FACTORS OF KNEE ARTHRITIS?
Risk factors of knee arthritis include:
Being overweight puts additional stress on your knee joints
- Wear and tear
Activities that involve the repetitive use of the knee joint result in excessive wear and tear
As we age, our risk of knee arthritis increases
Women are at higher risk to certain types of arthritis
- Family history
- Previous knee injuries
If you have suffered from a previous knee injury, your joints are more likely to develop arthritis
WHAT IS THE DIAGNOSIS OF KNEE ARTHRITIS?
A history of the injury and a physical examination of the knee will be conducted by the Doctor. Your doctor will focus on the area of tenderness and range of motion of your knee.
Imaging tests will be taken, such as an x-ray, a MRI and a CT scan if more information is required. These can help provide a more detailed picture of the knee joint, which allows the doctor to check for bone spurs or changes in the bone formation. If your doctor suspects you have certain types of arthritis such as rheumatoid arthritis, he may also take a blood test sample.
WHAT ARE THE TREATMENT OPTIONS FOR KNEE ARTHRITIS?
Treatment options for knee arthritis include both nonsurgical and surgical treatment.
Nonsurgical treatment options include:
Exercise helps to reduce weight, hence reducing the pressure on the knee joints which contributes to knee arthritis. Studies have shown that individuals who exercise experience reduced pain.
Physiotherapy helps to strengthen your knee joints and increase range of motion, which can help to reduce pressure on the knees.
- Knee aids
Knee aids such as a knee brace or a compression sleeve helps support the knee joint.
Injections such as corticosteroid or hyaluronic acid can be injected directly into the knee to for pain relief.
Surgery for knee arthritis is recommended when nonsurgical methods fail to relieve the pain. Surgery aims to repair or remove damaged portions of the knee joint to provide pain relief. Surgery options include:
For arthritis that is accompanied with a degenerative meniscal tear, arthroscopy is used to treat a torn meniscus.
- Cartilage grafting
For younger patients who have small areas of cartilage damage, cartilage grafting is used to replace damaged cartilage.
If the joint lining damaged by rheumatoid arthritis, synovectomy is used to reduce pain and swelling.
If you have early-stage osteoarthritis that has damaged only one side of the knee joint, osteotomy is used to reshape the thighbone or shinbone to relieve pressure on the knee joint
- Arthroplasty (partial or total knee replacement)
This removes damaged cartilage and bone, and a metal or plastic piece is inserted to replace it.
WHAT IS THE RECOVERY PROCESS AFTER SURGERY FOR KNEE ARTHRITIS?
Depending on the type of surgery performed, the recovery period varies. Typically, you will be using a knee brace or crutches. Physiotherapy may also be recommended to help you regain muscle strength and restore range of motion in your knee.