Arthritis of the Knee
There are three basic types of arthritis that may affect the knee joint:
Osteoarthritis
Osteoarthritis (OA) is the most common form of knee arthritis. OA is usually a slowly progressive degenerative disease in which the joint cartilage gradually wears away. It most often affects middle-aged and older people.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an inflammatory type of arthritis that can destroy the joint cartilage. RA can occur at any age. RA generally affects both knees.
Post-traumatic Arthritis
Post-traumatic arthritis can develop after an injury to the knee. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, ligament injury, or meniscus tear.
Symptoms
Generally, the pain associated with arthritis develops gradually, although sudden onset is also possible. The joint may become stiff and swollen, making it difficult to bend or straighten the knee. Pain and swelling are worse in the morning or after a period of inactivity. Pain may also increase after activities such as walking, stair climbing, or kneeling. The pain may often cause a feeling of weakness in the knee, resulting in a “locking” or “buckling.” Many people report that changes in the weather also affect the degree of pain from arthritis.
Diagnosis
Your doctor will perform a physical examination that focuses on your walk, the range of motion in the limb, and joint swelling or tenderness. X-rays typically show a loss of joint space in the affected knee. Blood and other special imaging tests, such as magnetic resonance imaging (MRI) may be needed to diagnose rheumatoid arthritis.
Nonsurgical Treatment
If you have osteoarthritis of the knee, you can take advantage of a wide range of treatment options. Only one in four people with osteoarthritis of the knee need surgery, but the effectiveness of different treatments varies from person to person. The choice of treatment should be a joint decision between you and your physician. The purpose of treatment is to reduce pain, increase function and generally reduce your symptoms. Patient satisfaction is a fundamental goal in treating osteoarthritis of the knee In its early stages, arthritis of the knee is treated with nonsurgical measures. Nonsurgical treatments fall into four major groups: lifestyle modifications; exercise; supportive devices; other methods.
Other Methods
Other measures may include applications of heat or ice, water exercises, liniments or elastic bandages.
Lifestyle Modification
Lifestyle modifications can include losing weight, switching from running or jumping exercises to swimming or cycling, and minimizing activities that aggravate the condition, such as climbing stairs. Many, but not all, people with osteoarthritis of the knee are overweight. Simple weight loss can reduce stress on weight bearing joints, such as the knee. Losing weight can result in reduced pain and increased function, particularly in walking.
Exercise
Exercises can help increase range of motion and flexibility as well as help strengthen the muscles in the leg. Physical therapy and exercise are often effective in reducing pain and improving function. Your physician or a physical therapist can help develop an individualized exercise program that meets your needs and lifestyle.
Supportive Devices
Using supportive devices, such as a cane, wearing energy-absorbing shoes or inserts, or wearing a brace or knee sleeve can be helpful. Some research studies have focused on the use of knee braces for treatment of osteoarthritis of the knee. They may be especially helpful if the arthritis is centered on one side of the knee. A brace can assist with stability and function. There are two types of braces that are often used. An “unloader” brace shifts load away from the affected portion of the knee. A “support” brace helps support the entire knee load. In most studies, the knee symptoms improved, with a decrease in pain on weightbearing and a general ability to walk longer distances.
