What is knee arthritis?
Knee arthritis is a degenerative condition involving the joint surfaces of the knee. It tends to gradually progress with time and is often related to previous injuries of the knee.
What are the symptoms of knee arthritis?
Knee arthritis presents with stiffness, pain and swelling of the knee. It is also quite common for patients to either become increasingly knock-kneed or bow-legged. Walking distance can be affected, the knee can swell significantly on occasion with acute exacerbation’s of pain, climbing and descending stairs and getting in and out of chairs can become increasingly difficult. As symptoms progress and pain becomes more marked, some patients wake quite a lot at night with discomfort.
What are the treatment options for knee arthritis?
Knee arthritis can be quite well managed initially with non-operative management including painkillers, activity modification and physiotherapy to strengthen the muscles and realign the patellar (knee cap). As symptoms progress then treatment options can be considered such as aspiration and injection of steroid and local anaesthetic or Viscosupplementation injections such as Ostenil. Keyhole surgery (arthroscopy) has a very limited role for patients with established arthritis of the knee.
Ultimately if symptoms progress significantly and joint space is being affected then joint replacement surgery can produce excellent results in patients with end-stage knee arthritis with improvement of pain and mobility. There are different types of knee replacements available including partial knee replacements, usually of the medial (inner) side of the knee and/or of the patellar femoral knee cap joint. A full knee replacement is often performed involving replacement of the whole joint with a resurfacing joint replacement and plastic spacer in between.
When should I see my doctor?
I would consider making an appointment with your doctor if knee symptoms are becoming increasingly intrusive. If you are limited in activity or your knee is swelling and painful. It may also be worth arranging to be reviewed by a physiotherapist in the early stages of knee arthritis.
What are the next steps?
If your doctor feels that symptoms have deteriorated to a level where treatment should or could be considered it would be appropriate to have standard x-rays performed of the knee, including AP standing, lateral and skyline views. This can delineate the problem, on some occasions MR scanning is also required and you would usually need to be referred to a specialist for this. Following referral from your GP we could arrange for a clinical assessment and review and a discussion regarding treatment options, including non-operative and operative management.
