Knee Arthritis
A Degenerative Joint Condition Affecting the Knee
Arthritis is a condition characterised by inflammation in one or more of your joints, and its primary symptoms include pain, swelling, and stiffness. While arthritis can affect any joint in the body, it is particularly prevalent in the knee.
The most common forms of arthritis are osteoarthritis, rheumatoid arthritis, and posttraumatic arthritisalthough there are over 100 distinct variations of this condition.
WHAT CAUSES KNEE ARTHRITIS
Knee arthritis, or osteoarthritis of the knee, is primarily caused by the progressive wear and tear of the knee joint. The knee joint consists of the thighbone (femur), shinbone (tibia), and kneecap (patella), with articular cartilage covering the bone ends. Over time, this protective cartilage may deteriorate, leading to friction and inflammation within the knee joint. As a result, the joint loses its cushioning and smooth gliding capabilities, resulting in pain, stiffness, and diminished function.
HOW TO RECOGNISE & IDENTIFY KNEE ARTHRITIS SYMPTOMS
Common symptoms of kneearthritis include:
Pain: Persistent, aching pain in the knee, particularly during or after activities and often even at night.
Stiffness: Reduced range of motion and difficulty bending or straightening the knee.
Swelling: Swelling around the knee joint, which may worsen as the condition progresses.
Crepitus: A grating or cracking sensation when moving the knee.
Instability: A feeling that the knee is giving way or buckling under stress.
Decreased mobility: Difficulty with daily activities such as walking, climbing stairs, and getting in and out of chairs.
FACTORS THAT CAN INCREASE THE LIKELIHOOD OF KNEE ARTHRITIS
Several factors can increase the risk of developing knee arthritis, including:
Age: The risk of knee arthritis rises with age, with most cases occurring in individuals over 50.
Gender: Women are more susceptible to knee arthritis than men.
Heredity: A family history of arthritis may increase your risk.
Obesity: Excess weight places added stress on the knee joint, accelerating cartilage breakdown.
Previous injuries: Traumatic injuries, such as ligament tears or fractures, can elevate the risk.
Occupation and activity: Jobs or activities involving repetitive knee stress can contribute to arthritis development.
Anatomic factors: Abnormalities in knee joint alignment or bone structure can also increase susceptibility to arthritis in the knee.
PREVENTION OF KNEE ARTHRITIS: HOW TO PROTECT YOUR JOINTS
Preventing kneearthritis involves a combination of lifestyle choices, physical activity, and proactive measures to maintain knee joint health.
Here are some effective strategies:
Maintain a Healthy Weight: Excess body weight places added stress on the joints, increasing the risk of kneearthritis. Adopt a balanced diet and regular exercise to achieve and maintain a healthy weight.
Proper Exercise Technique: Use correct form and technique when exercising or playing sports to reduce the risk of knee injuries.
Strengthen the Muscles Around the Knee: Building strong quadriceps and hamstrings can help support the knee joint.
Wear Appropriate Footwear: Proper shoes provide stability and cushioning for the knees.
Implementing these prevention strategies can significantly reduce the risk of kneearthritis and promote long-term knee joint health.
HOW KNEE ARTHRITIS IS DIAGNOSED
When a person experiences knee pain, they would usually begin by scheduling an appointment with their general practitioner (GP). The GP will take a detailed medical history, inquire about the nature and duration of yourknee pain, and conduct a physical examination to assess your range of motion, joint stability, and any signs of inflammation.Based on their evaluation, the GP may also order initial tests such as X-rays, blood tests, or other imaging studies to help determine the underlying cause.
If the knee pain is looking to be attributed to arthritis and is causing significant discomfort, your GP will refer you to an orthopaedic surgeon, such as Dr Anthony Keeley.
Your consultation begins with a comprehensive review of your medical history. Dr Keeley will delve into your overall health, previous medical conditions, medications you are currently taking, and any prior knee injuries or surgeries.
You will have the opportunity to discuss the onset of your knee pain, including its timeline, the nature of the pain (e.g., sharp, dull, persistent, intermittent), and any specific movements or activities that worsen or alleviate the pain.
Dr Keeley will engage in a detailed conversation about your knee pain symptoms. Expect to answer questions about the pain’s exact location, whether it radiates to other areas, its severity on a scale from 0 to 10, and how it affects your daily life and activities. This information is pivotal in painting a detailed picture of your condition and its impact on your well-being.
Conducting a physical examination of your knee and the surrounding areas is a critical step in your consultation. Your GP will evaluate your knee’s range of motion, strength, stability, and check for tenderness or pain. Specialized tests will also be conducted to pinpoint the source of your discomfort.
To acquire a more comprehensive understanding of your condition, Dr Keeley may request diagnostic imagingor other testssuch as:
X-rays: X-rays are valuable for identifying bone abnormalities, such as fractures or osteoarthritis. They provide clear images of the knee joint’s bone structures.
MRI (Magnetic Resonance Imaging): MRI is especially effective for assessing soft tissues, such as ligaments, tendons, and the meniscus. It helps identify conditions like meniscal tears or ligament injuries.
CT Scan (Computed Tomography): CT scans offer detailed cross-sectional images of your knee joint and are valuable for assessing complex bone abnormalities.
Ultrasound: Ultrasound is a useful tool for evaluating soft tissue injuries and conditions in real-time, making it an excellent choice for assessing tendons and ligaments
In certain cases, blood tests may be ordered to assess inflammatory markers or autoimmune factors, especially when inflammatory conditions like rheumatoid arthritis are suspected. These tests can provide valuable insights into the underlying causes of your knee pain.
Some patients may require joint aspiration, (also known as arthrocentesis). This involves Dr Keeley removing a small sample of synovial fluid from yourknee joint. This fluid is then analysed to identify signs of infection or inflammation.
If Dr Keeley suspects nerve-related issues, nerve conduction studies may be conducted to evaluate the function of nerves in the knee and leg.
In patients where osteoporosis is a concern, bone density testing (DEXA scan) can be performed to assess bone strength and density.
Diagnostic injections, such as knee joint injections, may be used to confirm the source of pain. If a patient experiences relief after the injection, it suggests that the pain originates from the knee joint itself.
Depending on the clinical presentation and the suspected cause of knee pain, specialised tests like a gait analysis may be employed to evaluate how your knee pain affects your walking pattern.
In complex cases or when knee pain is associated with specific conditions like inflammatory arthritis, a consultation with a rheumatologist can be recommended for a comprehensive evaluation.
The choice of these diagnostic methods will depend on your individual symptoms and clinical presentation and following Dr Keeley’s comprehensive evaluation, he will share his preliminary diagnosis and interpretation of the root cause of your pain.
TREATMENT OF KNEE ARTHRITIS
The treatment of knee arthritis aims to relieve pain, improve function, and enhance the patient's quality of life. The treatment options include:
Implementing strategies to manage weight, protect the knee joint, and maintain an active yet low-impact lifestyle.
A tailored exercise program to strengthen the muscles around the knee and improve joint stability.
Pain-relieving medications and anti-inflammatory drugs can be prescribed.
Corticosteroid injections or hyaluronic acid injections can provide temporary pain relief.
The use of knee braces or supports can help alleviate discomfort.
Partial knee replacement can be the right option for patients with osteoarthritis that is limited to a small section of the knee (medial compartment primarily) with a particular interest in certain sporting activities (examples include tennis and surfing). If you have a knee that is only worn in this part, with minimal angulation of your leg, an intact ACL, and meet several other criteria, this may be an option for you.
Total knee replacement is the most common type of knee replacement (about 90% of knee replacements in Australia) and involves replacing all of the arthritic knee joint surfaces on the femur (thigh bone), tibia (shin bone) and patella (kneecap). The advantage of replacing all of these surfaces at once is it reduces the chance of you ever requiring further surgery on that knee. Dr Keeley can talk to you further about the numerous techniques that have been developed in recent years to ensure you have a smoother recovery from your knee replacement. Knee replacements also last longer than previously due to improved techniques and materials.
LEARN MORE ABOUT TOTAL KNEE REPLACEMENT
COMPLICATION OF UNTREATED KNEE PAIN
Neglecting knee pain can result in various complications that extend beyond physical discomfort, affecting your overall quality of life and well-being. Since knee pain often serves as a symptom of an underlying issue, leaving it unattended can lead to several potential complications:
If the root cause of knee pain, such as osteoarthritis, inflammatory arthritis, or meniscus tears, remains untreated, the condition may worsen over time. This can result in increased pain, further joint damage, and decreased mobility.
Unaddressed knee pain may evolve into chronic pain, making it more challenging to manage and diminishing your overall quality of life. Chronic pain can also lead to psychological distress, such as depression and anxiety.
Knee pain can significantly limit your ability to perform daily activities, such as walking, climbing stairs, and bending comfortably. These limitations can impact your independence and overall well-being.
Chronic knee pain often leads to reduced usage of the affected knee and leg. Over time, this can result in muscle weakness and atrophy, further compromising your mobility and balance.
To compensate for knee pain, individuals may develop an altered gait or limp. This abnormal walking pattern can place additional stress on other joints and muscles, potentially causing pain in these areas as well.
Pain and limited mobility can increase the risk of falls, leading to fractures or other injuries, particularly among older adults.
In conditions like osteoarthritis, untreated knee pain can lead to joint damage and deterioration. In severe cases, this may necessitate more extensive surgical interventions.
Persistent knee pain can have psychological and emotional effects, resulting in a decreased quality of life, sleep disturbances, and emotional distress.
The cumulative impact of untreated knee pain can significantly diminish your overall quality of life, affecting your ability to engage in activities you enjoy and maintain an active, fulfilling lifestyle.
Untreated knee pain can lead to compensatory movements, potentially resulting in secondary musculoskeletal problems, such as back pain or hip pain.
The choice of these diagnostic methods will depend on your individual symptoms and clinical presentation and following Dr Keeley’s comprehensive evaluation, he will share his preliminary diagnosis and interpretation of the root cause of your pain.