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Arthritis Of The Knee Specialist

Urgently Ortho

Orthopaedic Urgent Care, Sports Medicine & Wellness Clinics located in Scottsdale, AZ

Arthritis of the Knee Q & A

Arthritis of the Knee

Arthritis is inflammation of a joint. Pain, swelling, and stiffness are the primary symptoms of arthritis. Any joint in the body may be affected by the disease. The most common types of arthritis are osteoarthritis and rheumatoid arthritis, but there are many more different types. The knee is a particularly common joint for arthritis to occur in.

Arthritis of the knee can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people.

Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep people staying active.

 

Anatomy

 

Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). The patella lies in front of your knee and assists in bending of your knee. 

The ends of the three bones where they touch are covered with articular cartilage, a substance that protects and cushions the bones as you bend and straighten your knee.

Two wedge-shaped pieces of meniscus act as "shock absorbers" between your femur and tibia.

 

Description

There are three major types of arthritis that affects the knee:

    • Osteoarthritis
    • Rheumatoid
    • Post Traumatic
Osteoarthritis

 

Osteoarthritis is the most common form of arthritis in the knee, it is a degenerative, "wear-and-tear" type of arthritis.   It may occur in any individual, but most often in people 50 years of age and older have the most symptoms.

In osteoarthritis, the cartilage in the knee joint gradually wears away. As this happens, it becomes frayed and rough, and the protective space between the bones decreases resulting in bone rubbing on bone, and producing painful bone spurs.  Osteoarthritis develops slowly and the pain it causes worsens over time.

 

Rheumatoid Arthritis

 

Rheumatoid arthritis is an autoimmune disease. This means that your own immune system attacks your own tissues. The cartilage becomes damaged and the bone softens. The synovial membrane that covers the knee joint begins to swell, this results in knee pain and stiffness.

Rheumatoid arthritis attacks multiple joints throughout the body and affects the same joint on both sides of the body. If the knee joint is affected, it will be affected the same on both the right and left.

Posttraumatic Arthritis

Posttraumatic arthritis is form of arthritis that develops after an injury to the knee.  If you injure the ligament in your knee, and there is instability, additional wear and tear could occur, which over time can result in arthritis.  A fracture, meniscus tear or ligament injury are examples of injuries that can lead to posttraumatic arthritis.

Symptoms

The joint affected by arthritis may be painful and inflamed. Generally, the pain develops over time, although sudden onset is possible. Other symptoms can include:

  • Stiff and swollen, making it difficult to bend and straighten the knee.
  • Pain and swelling may be worse in the morning, or after sitting and resting.
  • Vigorous activity may cause pain to flare up.
  • Sticking or locking during movement.  Your knee may click, snap or make a grinding noise.
  • A feeling of weakness or buckling in the knee.
  • Possible increased joint pain with rainy weather.

 

Physical Examination

 

 

During your first visit, be prepared to explain how you hurt yourself and how it feels. The more you can explain to your provider, the more they can understand your symptoms and medical history. At your visit, your provider will perform a physical exam and evaluate all the structures of the area. You will receive an x ray to determine if there are any fractures present or the extent of the arthritis. Many arthritic conditions can be diagnosed with a thorough physical examination and x ray of the joint, but other tests, such as a Magnetic Resonance Imaging (MRI) scan may be ordered. The MRI creates better images of the joint. These images allow the physician to determine if this injury requires non-surgical or surgical treatment. Blood may need to be taken and evaluated for specific types of arthritis.

Treatment

Treatment for arthritis is most often Non-Surgical first.  After exhaustive non-surgical treatment, surgery may be needed to correct the problem.

Non-Surgical Treatment

Lifestyle modifications. Some changes in your daily life can protect your knee joint and slow the progress of arthritis.

  • Limit activities that aggravate the condition, such as climbing stairs.
  • Switching from high impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your knee.
  • Maintain the correct weight can reduce stress on the knee joint, resulting in less pain and increased function.

In addition to lifestyle modifications, there are many types of non-surgical treatment options for Arthritis and all have their advantages and disadvantages.  Your Orthopedic Specialist can review these options and assist you in determining which will be most effective in treating your injury:

  • Non-steroidal anti-inflammatory medicines
  • Heat or Ice application
  • Physical Therapy
  • Bracing
  • Orthotics or shock absorbing shoes
  • Corticosteroids and corticosteroid injections
  • PRP (Plasma Rich Protein) injections
  • Stem Cell Therapy
  • Disease-modifying anti-rheumatic drugs (DMARDs) are commonly prescribed for Rheumatoid Arthritis.
  • Visco-supplementation injections into the joint
  • Glucosamine and chondroitin sulfate supplementation
  • Acupuncture or magnetic therapy

 

Surgical Treatment

If the symptoms persist after exhaustive non-surgical treatment and your pain from arthritis causes disability you may need a surgical procedure to assist with the condition.

  • Arthroscopic surgery:  This procedure is not often used to treat arthritis of the knee, but may be recommended to treat associated issues like a torn meniscus.
  • Cartilage grafting: Normal, healthy cartilage tissue is taken from another part of the knee or from a tissue bank to fill a hole in the articular cartilage.
  • Synovectomy: The joint lining damaged by rheumatoid arthritis is removed to reduce pain and swelling.
  • Osteotomy: The tibia or femur is cut and then reshaped to relieve pressure on the knee joint.
  • Total or partial knee replacement: Removal of the damaged cartilage and bone, and then position new metal or plastic joint surfaces to restore the function of your knee.

 

(Left) A partial knee replacement is an option when damage is limited to just one part of the knee.

(Right) A total knee replacement prosthesis.

 

Rehabilitation

The first line of treatment is always rehabilitation. A physical therapy program will guide you in regaining your joint strength and function. This may occur in conjunction with bracing or taping or surgery. Your rehabilitation specialist will assist in the decision-making process for the best options.