Arthritis

Overview

Knee osteoarthritis is a common condition that occurs when the protective cartilage in the knee wears down, while bone around the joint grows or loses its normal smooth contours. Knee osteoarthritis symptoms may develop slowly or come on relatively quickly. Common symptoms include:

  • Pain, Your knee may hurt during or after movement
  • Tenderness. Your knee may feel tender to touch
  • Stiffness. Knee stiffness may be most noticeable when you wake up in the morning or after a period of inactivity
  • Loss of flexibility. You may not be able to move your knee through its full range of motion
  • Grating sensation. You may hear or feel a grating sensation when you stand up, walk, or climb stairs
  • Bone spurs – extra bone growth around the knee may feel like hard lumps

The cause of knee osteoarthritis is not well understood, but risk factors include:

  • Older age
  • Female gender
  • Obesity
  • Prior knee injury (e.g., ACL or meniscus injury)
  • Certain occupations or sports that place high stress on the knees
  • Genetics
  • Abnormal joint alignment

The diagnosis of knee osteoarthritis starts with a careful history and physical examination. Imaging is often recommended, starting with plain radiographs (X-rays). Sometimes your provider will recommend more advanced imaging, such as MRI. Occasionally blood tests or joint fluid analysis are used to rule out other types of arthritis related to inflammatory or infectious conditions.

Knee osteoarthritis symptoms can usually be effectively managed, although the underlying process cannot be reversed. Staying active and maintaining a healthy weight may slow progression of the disease and help improve pain and joint function.

Medications may be recommended for the treatment of knee joint pain. These typically include over-the-counter pain relievers such as anti-inflammatories or acetaminophen. Topical treatments such as heat or ice may be used. Physical therapy is often recommended as well, including stretching and strengthening exercises. Knee braces may be helpful for some patients.

When conservative treatments are inadequate, a knee joint injection with corticosteroid or hyaluronate (lubricant) may be recommended. There are many alternative injections that may help with knee osteoarthritis pain, including platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and dextrose prolotherapy. However, these injections are still considered experimental by the FDA and are usually not covered by medical insurance.

When nonoperative management options have been exhausted, surgery may be considered. In cases of relatively focused osteoarthritis in a certain part of the knee, realigning the bones (osteotomy) or partial joint replacements may be considered. With more diffuse knee osteoarthritis, a total knee replacement (arthroplasty) may be the best option.

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