Knee Osteoarthritis

What is osteoarthritis?

Osteoarthritis is a “wear and tear” disease of the joint. The cartilage — the smooth cushion covering the ends of the bones — slowly wears away.

Types

• Primary — no clear cause; mainly linked to age.
• Secondary — caused by something else, such as an old injury, joint deformity or another joint disease.

How it develops

• The cartilage becomes thin.
• Higher pressure on the bone underneath the cartilage leads to bony spurs.
• The joint lining becomes inflamed.
• The joint space narrows, so the joint becomes stiff and painful.

Risk factors

• Ageing
• Female sex
• Being overweight
• Previous joint injury, such as an ACL or meniscus tear
• Weak thigh muscles
• Frequent kneeling, squatting or heavy lifting
• Family history

Symptoms and signs

• Pain that gets worse with activity and better with rest
• Morning stiffness lasting less than 30 minutes
• Creaking or grinding sound (crepitus)
• Hard, bony swelling around the joint
• Reduced joint movement
• In advanced knee OA, the knees may bow outwards

Management plan

• Weight loss. Losing 5 to 10% of body weight reduces pain.
• Exercise. Strengthen the thigh and hip muscles; low-impact cardio such as cycling or swimming.
• Painkillers. Paracetamol, anti-inflammatory gel, or a short course of anti-inflammatory tablets.
• Supplements — some patients use products such as Mobithron Advanced or Piscledine; always discuss with your doctor before starting any supplement.
• Supports. A knee brace or walking stick if needed.
• Joint injections. Steroid, hyaluronic acid, PRP or prolotherapy.
• Nerve block or radiofrequency ablation (RFA) for persistent pain.
• Joint replacement surgery for severe cases.