Osteoarthritis of the Knee

 

Osteoarthritis (OA) most commonly affects the knee joint. Your knee is a hinge joint allowing it to bend (flex) and straighten (extend).

Cartilage covers the ends of the bone to allow smooth movement of the joint. Osteoarthritis is when this cartilage becomes gradually thinner, either as part of the normal ageing process or following injury.

WHO GETS IT?

Anyone can get OA but it is more common :

  • Over the age of 45
  • In females
  • If you are overweight
  • If other immediate family members have OA
  • If you’ve had a severe knee injury in the past

SYMPTOMS

Can include:

  • Pain which usually increases with weight bearing activities such as walking, sit to stand or stairs & improves with rest
  • stiffness/ reduced range of movement
  • Swelling
  • A grating sensation (crepitus) on movement
  • Weakness of the muscles around the joint can develop causing the knee to give way at times
  • With more advanced OA the knee may become painful also at night time when your knee has been in 1 position for a while

Click on the arrow below to watch an informative video about OA knee.

Click here to download an informative PDF about osteoarthritistis.

DIAGNOSIS

  • diagnosis can be made by a combination of listening to your symptoms & examination by your GP or health care professional
  • X-rays are not routinely needed unless considering further intervention such as surgery

MANAGEMENT

  • Weight loss if overweight – check here to see whether you are within a healthy weight range

Being overweight increases the likelihood of developing OA of the knee. It is estimated that 4 x your bodyweight goes through the knee when walking. So for every 10lbs you are overweight an extra 40 pounds is being exerted through the knee! Weight loss will help to relieve OA symptoms, improve function and quality of life.

  • Regular exercise – Arthritis Research UK knee exercises – Please click here to read more about the benefits of regular exercise.​
  • Wearing supportive footwear reduces the strain on your knees and keeps the joint in better alignment
  • Using a walking stick if needed, if needed, will also reduce strain on the joint
  • Using pain relief, anti-inflammatory cream, gels or tablets (see your GP or pharmacist for further advice about suitable medication)
  • Corticosteroid Injections can be helpful to manage your symptoms if the pain is not responding to other treatments.

Corticosteroid is injected into the knee joint (intra-articular) with the aim of reducing swelling & pain. If you experience good relief from the injection it can be repeated. This should ideally be no more than 3 times per year with at least a 3 month gap between injections.

Total Knee Replacement Surgery:

Total Knee Replacement (TKR) is a routine but major operation. It is usually offered when:

  1. All appropriate conservative measures have been tried and failed to reduce pain or improve mobility significantly. This would include physiotherapy, steroid injection, walking stick, pain relief and weight loss (if your BMI is above 40).
  2. Pain is interfering with your quality of life, activities of daily living and sleep.
  3. You have severe pain, swelling and stiffness in your knee joint.
  4. You are well enough to undergo surgery and rehabilitation afterwards.

Most TKR operations include replacing the joint surfaces at the end of your thigh bone (femur) and at the top of your shin bone (tibia). Sometimes the undersurface of the knee cap (patella) is resurfaced as well. The new parts are usually cemented into place. If cement is not used then the new components are textured which encourages bone to grow onto it, creating a natural bond.

Before surgery it is important to stay as active as possible. Strengthening the muscles of the knee and both legs will aid your recovery after surgery.

Following surgery – recovery will depend upon the individual and type of procedure carried out. Most people will have a hospital stay of 2-5 days. Initially you will use a walking frame or crutches and a physiotherapist will teach you exercises to gain good range of movement of the knee and strengthen the leg muscles. Once you go home you may continue with physiotherapy treatment in an outpatient department until you have regained your optimum function.

To help you decide if a TKR is suitable for you please click on the PDF below for the Knee OA patient decision aid. (However please note that it is currently being reviewed by NHS England & acupuncture is now not recommended for OA knee):

See more information here.

USEFUL LINKS

www.versusarthritis.org

www.sheffieldachesandpains.com – information about OA knee

www.nhs.uk/Conditions/knee-pain – general advice about management of knee pain & links to OA knee

www.knee-pain-explained.com– information about OA knee

https://www.nhsinform.Scot/injuries/muscle-bone-and-joint-injuries-problems – general advice about management of knee pain