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Osteoarthritis of the Knee

The knee joint is the most common place to have osteoarthritis. It is more common in the compartment on the inside (medial aspect) of the knee though often can happen in both. Many people have degenerative changes in their joints but suffer no pain. We are unsure why some have pain and others don’t. Osteoarthritis can occur at any age but is more common as you get older. Being overweight or obese is another risk factor for osteoarthritis. Other conditions such as ACL injuries, haemochromatosis and connective tissue disorders can increase your likelihood of knee osteoarthritis. Studies have shown that elite soccer players are also more likely to have early onset osteoarthritis than the general population.
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In the image above, the left x-ray is of a normal knee and the right x-ray shows a knee with severe osteoarthritis.

What is Osteoarthritis?


In our joints, the ends of our bones are covered in a rubbery material called cartilage. This can help with the guiding the smooth motion within a joint and as a ‘shock absorber’ dissipating the amount of force across the joint rather than in one particular spot. In osteoarthritis this cartilage has started to break down- the collagen it is made up of has also changed. Because of these changes the joint isn’t as able to absorb forces like it would have previously so pain and swelling can occur. As this worsens you can get changes to the surrounding bone and inflammatory processes can further worsen your pain.

Do I have Knee Osteoarthritis?


Normally people with arthritis complain of pain and stiffness at the affected joint. They may also have grinding, clicking or swelling. It is most likely painful to kneel for any period of time and it’s sore after long walks. If you suspect you have osteoarthritis it may be worth going to see your GP or physiotherapist who should be able to diagnose this. The clinician may also request x-rays to gauge the severity of this.

Treatment


If you have osteoarthritis the joint cannot be rebuilt but evidence has shown there is a lot you can do to help with pain and function. Your first port of call should usually be physiotherapy. Strengthening of the muscles around your knee have been shown to be beneficial for pain (so be prepared to start exercising). If you are heavier, losing weight will not only reduce the amount of force down through the joint but reduced body fat is associated with having less severe inflammation!

There is a lot of discussion right now about different injection therapies (PRP, stem cells etc) for osteoarthritis but at present the evidence isn’t strong enough to recommend these as your first port of call.

If conservative treatment isn’t working then it may be worth investigating a knee replacement. Most people who have this operation do have good outcomes for pain and function.

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