Osteoarthritis

What is Arthritis of the Knee?

Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. The joint surface is covered by a smooth articular surface that allows pain-free movement in the joint. This surface can wear out for several reasons; often the definite cause is not known. Arthritis often affects the knee joint.

When the articular cartilage wears out, the bone ends rub on one another and cause pain. This condition is referred to as Osteoarthritis or “wear and tear” arthritis, as it occurs with aging and use. It is the most common type of arthritis.

Causes of Osteoarthritis

There are numerous conditions that can cause arthritis but often the exact cause is never known. In general, but not always, it affects people as they get older.

The causes include:

• Trauma (fracture)
• Increased stress such as overuse and overweight
• Infection of the bone
• Connective tissue disorders
• Inactive lifestyle and obesity (overweight). Your weight is the single most important link between diet and arthritis, as being overweight puts an additional burden on your hips, knees, ankles and feet.
• Inflammation (rheumatoid arthritis)

Symptoms of Osteoarthritis

Osteoarthritis causes pain and decreased mobility of the knee joint. In the arthritic knee, there is an absent joint space that shows on X-ray. In the normal knee, there is a normal joint space.

The cartilage lining is thinner than normal or completely absent. The degree of cartilage damage and inflammation varies with the type and stage of arthritis. The capsule of the arthritic knee is swollen. The joint space is narrowed and irregular in outline; this can be seen in an X-ray image. Bone spurs or excessive bone can also build up around the edges of the joint. The combinations of these factors make the arthritic knee stiff and limit activities due to pain or fatigue.

Diagnosis of Osteoarthritis

Doctors diagnose osteoarthritis with a medical history, a physical exam and X-rays of the affected part. Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are also performed to diagnose osteoarthritis.

Treatment Options for Osteoarthritis

Dr Maor may prescribe you anti-inflammatory medicines. You may be recommended occupational therapy or physiotherapy, which includes exercises and other forms of treatment. In severe cases, surgery may be suggested. The type of surgery will depend on your age and severity of the disease. In those with severe osteoarthritis, joint replacement can give very good results.

Initial treatment for osteoarthritis is conservative, consisting of rest, avoidance of vigorous weight-bearing activities, and the use of non-narcotic analgesic and/or anti-inflammatory medications. With worsening symptoms, a walking stick or braces may be helpful. For more severe symptoms, an injection into the joint is frequently advised and can be quite helpful. When conservative measures have been exhausted, offer no relief, and have become disabling, surgery may be recommended. Surgery is usually considered if non-surgical treatment fails to give relief. There are different surgical procedures that can be used like: synovectomy, osteotomy or arthroplasty.

Dr Maor will discuss the options and help you decide which type of surgery is the most appropriate for you.