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Osteo-arthritis of the knee.
What is osteo-arthritis of the knee?
What causes osteo-arthritis of the knee?
Progression of knee osteo-arthritis
How do doctors make the diagnosis of osteo-arthritis of the knee?
Staging of osteo-arthritis of the knee
Treatment of osteo-arthritis of the knee - general
Treatment of OA knee - medications
"Women's" knee replacement.
Diet and Knee OA
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What is osteo-arthritis (OA) of the knee?
Osteoarthritis is commonly called "wear and tear" arthritis. It is distinguished from different kinds of inflammatory arthritis such as rheumatoid arthritis, gout, lupus arthritis, and arthritis associated with other diseases such as psoriasis, coeliac disease, etc.
It is characterised by the symptoms of pain, swelling and difficulty functioning, and by the signs of damage to the cartilage progressing to formation of "osteophytes" (nodules of bone growing in response to inflammation), leading to changes in the shape of the knee joint and ending with end stage "bone on bone" arthritis.
Causes of osteoarthritis of the knee.
Trauma to the knee may lead to osteoarthritis. The trauma could be a single injury such as a car accident where the knee strikes the dash, or a sports injury, or other such single event traumas. The trauma can be cumulative, such as in severe obesity, repeated microtrauma in stop-and-start sports, or from abnormal weight bearing such as prolonged limping from a problem with the back, legs or hip.
Progression of OA knee
A study was done which showed that cartilage erodes at about 4% a year once a person has OA knee. They did MRIs of OA patients. MRI can measure the volume of cartilage. Surprisingly there was no relationship found between the rate of erosion of cartilage and such things as BMI (body mass index.) The only predictor of fast erosion was how bad the patient's symptoms were at the beginning. Perhaps patients with more symptoms load the knee badly e.g., more limping which may cause progression.
Diagnosis of OA of the knee.
The doctor first sees if the patients has the symptoms of pain, swelling and decrease in function. Clinical exam may show very little in early stages but can confirm the diagnosis in later stages, especially when osteophytes can be felt. The doctor may measure the circumference of the knee to compare to the good knee. An increase in the size of the tibial plateau ( the top of the tibia which forms the lower part of the knee joint) results from osteophyte formation.
The doctor then makes sure there is no other cause such as rheumatoid or gout. An arthritis blood screen may be ordered.
A straight Xray will show all osteoarthritis of the knee other than the earliest stages. (See "staging")
MRI is use when considering surgery.
Arthroscopic surgery can be done diagnostically to see how bad the condition is and whether there are problems with cartilage damage or ligaments, or therapeutically e.g., to repair cartilage.
Staging of OA knee
WOMAC is a method of staging based on the symptoms (pain and stiffness) and degree of disability. It is good for predicting who needs and will do well with surgery especially total knee replacement.
Treatment of knee OA
The causes if any should first be addressed. If obesity is a problem the doctor will prescribe diet.
Exercise is important. Joints were made to be used, not abused, not overused. Cartilage, which is the first structure to be attacked in OA grows and repairs itself in relationship to use. Cartilage is a mesh of fibres with a matrix between the fibres. The mesh orients itself to bear the pressures exerted on the knee. If the knee is rested too much after injury the new and repaired cartilage which forms as part of the healing process will form randomly and not in the line of force needed for weight bearing. This kind of cartilage is soft and wears easily when put under pressure. Steady gentle exercise helps the body heal with good quality cartilage.
Physiotherapy and occupational therapy help with the proper use of joints to cope with present symptoms and prevent further trauma.
What is osteo-arthritis of the knee?
What causes osteo-arthritis of the knee?
Progression of knee osteo-arthritis
How do doctors make the diagnosis of osteo-arthritis of the knee?
Staging of osteo-arthritis of the knee
Treatment of osteo-arthritis of the knee - general
Treatment of OA knee - medications
"Women's" knee replacement.
Diet and Knee OA
Return to top
What is osteo-arthritis (OA) of the knee?
Osteoarthritis is commonly called "wear and tear" arthritis. It is distinguished from different kinds of inflammatory arthritis such as rheumatoid arthritis, gout, lupus arthritis, and arthritis associated with other diseases such as psoriasis, coeliac disease, etc.
It is characterised by the symptoms of pain, swelling and difficulty functioning, and by the signs of damage to the cartilage progressing to formation of "osteophytes" (nodules of bone growing in response to inflammation), leading to changes in the shape of the knee joint and ending with end stage "bone on bone" arthritis.
Causes of osteoarthritis of the knee.
- Genetic
- Trauma
Trauma to the knee may lead to osteoarthritis. The trauma could be a single injury such as a car accident where the knee strikes the dash, or a sports injury, or other such single event traumas. The trauma can be cumulative, such as in severe obesity, repeated microtrauma in stop-and-start sports, or from abnormal weight bearing such as prolonged limping from a problem with the back, legs or hip.
Progression of OA knee
A study was done which showed that cartilage erodes at about 4% a year once a person has OA knee. They did MRIs of OA patients. MRI can measure the volume of cartilage. Surprisingly there was no relationship found between the rate of erosion of cartilage and such things as BMI (body mass index.) The only predictor of fast erosion was how bad the patient's symptoms were at the beginning. Perhaps patients with more symptoms load the knee badly e.g., more limping which may cause progression.
Diagnosis of OA of the knee.
The doctor first sees if the patients has the symptoms of pain, swelling and decrease in function. Clinical exam may show very little in early stages but can confirm the diagnosis in later stages, especially when osteophytes can be felt. The doctor may measure the circumference of the knee to compare to the good knee. An increase in the size of the tibial plateau ( the top of the tibia which forms the lower part of the knee joint) results from osteophyte formation.
The doctor then makes sure there is no other cause such as rheumatoid or gout. An arthritis blood screen may be ordered.
A straight Xray will show all osteoarthritis of the knee other than the earliest stages. (See "staging")
MRI is use when considering surgery.
Arthroscopic surgery can be done diagnostically to see how bad the condition is and whether there are problems with cartilage damage or ligaments, or therapeutically e.g., to repair cartilage.
Staging of OA knee
- Xray staging
- WOMAC
WOMAC is a method of staging based on the symptoms (pain and stiffness) and degree of disability. It is good for predicting who needs and will do well with surgery especially total knee replacement.
Treatment of knee OA
The causes if any should first be addressed. If obesity is a problem the doctor will prescribe diet.
Exercise is important. Joints were made to be used, not abused, not overused. Cartilage, which is the first structure to be attacked in OA grows and repairs itself in relationship to use. Cartilage is a mesh of fibres with a matrix between the fibres. The mesh orients itself to bear the pressures exerted on the knee. If the knee is rested too much after injury the new and repaired cartilage which forms as part of the healing process will form randomly and not in the line of force needed for weight bearing. This kind of cartilage is soft and wears easily when put under pressure. Steady gentle exercise helps the body heal with good quality cartilage.
Physiotherapy and occupational therapy help with the proper use of joints to cope with present symptoms and prevent further trauma.
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