Knee arthritis is one of the most common causes of pain and disability in adults. Understanding the condition - what causes it, how it progresses, and what options exist at each stage - allows patients to make informed decisions about their care.
What Is Knee Arthritis?
The knee joint involves three bones - the femur (thighbone), tibia (shinbone), and patella (kneecap) - and is divided into three compartments: the medial (inner), lateral (outer), and patellofemoral (kneecap) compartments. Each surface is covered by smooth cartilage that allows frictionless movement.
In knee arthritis, this cartilage breaks down progressively. The most common form is osteoarthritis - mechanical wear with age and use. Other causes include rheumatoid arthritis and other inflammatory joint conditions, and post-traumatic arthritis following a knee injury.
Knee osteoarthritis affects approximately 15% of adults over 60 and is a leading cause of chronic pain and reduced mobility worldwide.
Symptoms of Knee Arthritis
Knee arthritis typically develops gradually. Common symptoms include:
- Pain during activity - walking, climbing stairs, rising from a chair
- Pain at rest or at night in more advanced arthritis
- Morning stiffness that eases after 20-30 minutes of movement
- Swelling and warmth around the knee joint
- A grinding, grating, or clicking sensation with movement
- Reduced range of motion - difficulty fully straightening or bending the knee
- Progressive deformity - bowing of the legs (varus) or knock-knees (valgus)
- Giving way or a sense of instability
Symptoms often fluctuate - patients may have good periods and bad flare-ups. Over time, the general trend is progressive worsening, though the pace varies significantly between individuals.
Non-Surgical Treatment Options
Non-surgical management is the foundation of treatment for early and moderate knee arthritis. Options include:
- Exercise and physiotherapy - Strengthening the quadriceps and surrounding muscles reduces load on the knee joint. Low-impact exercise such as cycling, swimming, and walking is recommended.
- Weight management - Every kilogram of body weight adds approximately 3-4 kg of load through the knee joint. Weight loss is one of the most effective non-surgical interventions.
- Anti-inflammatory medication - NSAIDs can reduce pain and swelling, used appropriately with medical guidance.
- Knee bracing - Unloader braces can reduce pain in single-compartment arthritis by shifting load away from the damaged compartment.
- Cortisone injections - Corticosteroid injections into the knee provide temporary relief, useful for flare-ups.
- Hyaluronic acid injections - Gel injections may provide relief in some patients, though evidence is mixed.
These measures do not reverse arthritis but can significantly improve quality of life and delay or avoid the need for surgery in suitable patients.
When Is Knee Replacement Needed?
Knee replacement is considered when arthritis has advanced to the point where pain and disability significantly affect daily life, and non-surgical measures are no longer providing adequate relief. The decision is based on symptoms and quality of life - not on X-ray findings alone.
A severely damaged knee on X-ray does not automatically require surgery. Equally, a patient with moderate X-ray changes but significant disability may be an appropriate candidate. The key question is: is this arthritis affecting your life enough to warrant an operation, and are you fit for surgery?
When surgery is appropriate, total knee replacement using kinematic alignment and patient-specific technology offers a reliable, well-established solution.
Frequently Asked Questions
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A GP referral is required. Contact Orthopaedics 360 to arrange your appointment at Eastwood Private Hospital.