Arthritis

Who does this affect?

This condition is most common in older patients and is usually due to "Osteoarthritis" - A degenerative ("wear and tear") process in which the smooth surfaces of the knee joint become damaged and irregular.

Other causes include:

• Trauma (fracture)
• Infection
• Connective tissue disorders
• Inactive lifestyle e.g. Obesity, as additional weight puts extra force through joints which can lead to arthritis over a period of time.
• Inflammation e.g. Rheumatoid arthritis

In an arthritic knee:

• 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 becomes swollen - fluid produced by the inflamed joint lining often builds up within the knee joint.
• The joint space is narrowed and irregular in outline - this can be seen in an X-ray image.
• Bone spurs ("osteophytes") or excessive bone can also build up around the edges of the joint.

Symptoms

• Knee pain is typical, worse on standing and walking - This can progress to pain at rest or at night
• Knee stiffness and swelling are common
• Difficulty in walking up / down stairs
• Knee joint deformity - a "bow-legged" or "knock-kneed" deformity may develop, depending on which part of the joint is worst affected.

Diagnosis

The diagnosis of osteoarthritis is made on history, physical examination & X-rays.

Non- surgical treatment

This can include simple measures such as:

• Painkillers and/or anti-inflammatory medication
• Weight loss
• Physiotherapy
• Activity modification
• Walking stick

Surgical treatment

Arthroscopic debridement.

In less severe cases symptoms may be treatable with an Arthroscopic ("keyhole") operation. - The joint can be washed out and any loose or roughened areas of cartilage can be smoothed out. Unfortunately this is not always successful in this situation, and sometimes the effects are only temporary.

Total knee replacement

If non-surgical treatment is unsuccessful, knee replacement is usually very successful in relieving pain and improving quality of life.

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