Knee Arthritis

Knee Arthritis

Knee arthritis is one of the most common causes of knee pain. It is characterized by pain, swelling and stiffness. There are many types of knee arthritis. The most common types are: osteoarthritis, rheumatoid arthritis and post-traumatic arthritis.


Three common types of knee arthritis:


Osteoarthritis
Osteoarthritis is the end result of progressive articular cartilage wear and tear. Radiological features include joint space narrowing, osteophytosis, subchondral sclerosis and subchondral cyst formation.


Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease and can cause chronic inflammation of joints. It typically affects small joints of hands and feet. More commonly occurs in women at age younger than 40.


Post-traumatic arthritis
As its name implies, it is sequel of knee injury. It usually develops years after fracture of thigh and/ or shin bone that extended into the joint, meniscal tear or knee ligament injury.


Causes of knee arthritis


Osteoarthritis: cause is not known

  • Age: risks increase with advancing age
  • Sex: women are more likely to have osteoarthritis
  • Bone deformities: results in mal-alignment of weight bearing joint and acceleration of wear and tear of the articular cartilage
  • Joint injuries: injuries that occur during sports activities or accident
  • Other diseases: Diabetes, dysfunctioning thyroid

Rheumatoid arthritis: is an autoimmune disease

  • Age: any age, mostly around 40-60 years of age
  • Sex: women are more likely affected
  • Family history: positive family history of the disease

Post-traumatic arthritis

  • Direct injury: articular cartilage injury
  • indirect injury: injury to knee ligament, meniscus or limb alignment may accelerate the process of cartilage wear and tear

Symptoms of knee arthritis

These include pain, swelling and stiffness. The pain is typically worse in early morning after period of inactivity, will be transiently improved with movement but then worse again with prolonged activities. These symptoms impair activities of daily living e.g. walking, squatting and standing and may become severe enough to disturb the sleep at night time.


Diagnosis of knee arthritis

Knee arthritis can be diagnosed by detailed medical and family history, physical examination, biochemical tests as well as radiological imaging.


Biochemical tests:

  • These tests are useful for diagnosing inflammatory arthritis.
  • Inflammatory markers like ESR, CRP and autoimmune markers like RF, ANA, ds DNA etc may be helpful in diagnosis of certain types of inflammatory arthritis.
  • Knee arthrocentesis for joint fluid may also be taken for investigation of septic arthritis and gouty arthritis

X-ray will disclose:

  • joint space narrowing, osteophytosis, subchondral sclerosis and subchondral cysts in osteoarthritis
  • soft tissue swelling, bony erosion in Rheumatoid arthritis
  • malunion, malalignment in post-traumatic arthritis

MRI is useful for study of soft tissue and pathologies.

  • early detection of articular cartilage changes
  • early detection of knee synovitis, inflammatory aggregate
  • early detection of knee ligaments and menisci injury

Treatment of knee arthritis


Conservative management:

Majority of knee arthritis can be treated conservatively as the followings:

  • Lifestyle modification
    • weight control: aims to reduce load in osteoarthritic knee
    • avoid aggravating activities: e.g. running, jumping, certain sports
    • walking aids: like cane and crutches, help to share loads across the knee
  • Physiotherapy
    The physiotherapist will design tailored programme to control symptoms of pain and swelling as well as exercise therapy to stretch and strengthen muscle group to improve limb function for daily activities.
  • Medications
    The doctor will prescribe drugs to treat types of arthritis accordingly.
  • NSAIDS
    Most common drugs are nonsteriodal anti-inflammatory drugs (NSAIDs). Cox-2 inhibitor is a group of NSAIDs with excellent pain control and fewer GI side effects.
  • Glucosamine
    Glucosamines are constituents of articular cartilage and may be prescribed as supplement for you.
  • Intraarticular injection of hyaluronic acid
    Hyaluronic acid is a chief component in extracellular matrix and joint fluid. It may be helpful in case of osteoarthritis.

Surgical management:

Surgical management will be recommended if conservative measures failed.
Options include: knee arthroscopy and knee arthroplasty

  • Knee arthroscopy
    The doctor may offer knee arthroscopy for treating intra-articular pathologies.
  • Knee arthroplasty:
    Knee arthroplasty is artificial component designated to replace worn out joints.

Rehabilitation management:

The doctor and physiotherapy will collaborate to design an optimal rehabilitation program to suit your clinical condition.


Last Updated : Aug 2017
Please note that all medical health articles featured on our website have been reviewed by Quality Healthcare doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.

Knee Arthritis

 

 

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Please note that all medical health articles featured on our website have been reviewed by Quality Healthcare doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.
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