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What is Arthritis?

Arthritis is a disease human joints which manifests as pain, swelling and stiffness in our joints. Knee joint is the commonest joint to be affected by arthritis.

Arthritis of the knee can be frustrating, and debilitating disease leading to poor quality of life.

What are various types of knee arthritis?

There are around many types of arthritis; however most common type knee arthritis include following:

• Osteoarthritis (OA) is the most common type worldwide. This is basically a wear- and tear-type arthritis. The fundamental defect that occurs in OA is the loss and damage to the knee cartilage which is fundamentally provides cushion and protection to the knee joint. After cartilage loss, further damage may occur to the knee in the form of bone spurs and narrowing of the joint space. And the end process leads to pain, stiffness, swelling and limited movement. OA is a progressive disease and gets worse as one ages.
• Post-traumatic arthritis is another type of arthritis which happens following injury like fractures, sprains around knee joint. Following trauma, the arthritis process accelerates.
• Rheumatoid arthritis (RA) is basically an autoimmune disease. Our immune system protects us from infection, toxin or other foreign substance. However, in RA, our immune system behaves in an abnormal way leading to inflammation in our joints even though there’s no foreign invader. The abnormal process causes pain, stiffness and swelling of the membrane covering our joints. RA usually affects the small joints of hand, wrist and ankle but knee also can get affected as part of the disease process or as a sole joint.

What are the risk factors for knee osteoarthritis?

• Age (usually 50 or more but can even affect in 30’s or 40’s)
• Gender (female are more prone)
• Obesity
• Repeated knee injury or trauma
• Smoking
• Some genetic factors can cause early arthritis

Is there a severity grading for knee arthritis?

There are four stages of knee osteoarthritis which is usually graded on the basis of a standing knee x-ray:

• Stage 1 (Minor).  Some wear and tear in your knee joint. Most people don’t experience pain.
• Stage 2 (Mild). In this stage, one might start to feel pain and stiffness and there is some reduction or joint space narrowing in x-ray.
• Stage 3 (Moderate). Here one experiences more pain. Bony spurs are apparent in x-ray and more joint narrowing leading to pain with modest walking or stair climbing.
• Stage 4 (Severe). Severe osteoarthritis means that the cartilage is almost gone. The joint is severely narrowed with bones rubbing against each other.

What are the signs and symptoms of knee arthritis?

• Joint pain
• Inability to walk freely for long distance
• Swelling
• Loss of flexibility of knee (Decreased range of motion)
• Stiffness of joint
• Clicking or grinding sound as bones rub against each other

How to diagnose knee arthritis?

• Commonly X-ray of knee
• Blood tests to rule of other causes like infection, rheumatoid arthritis
• Ultrasound these days are widely used in many Pain clinics by specialist doctors
• CT Scan or MRI on occasions to diagnose or rule out other concomitant causes of knee pain

What is the treatment of knee arthritis?

1. Preventive:
   • Maintain healthy weight is very important.
   • Exercise using low-impact activities (swimming, cycling) instead of high-impact activities (jogging, tennis).
2. Physical therapy exercises that help with flexibility, and strength.
3. Medications
   • Topical anti-inflammatory creams
   • Simple analgesics like paracetamol, tramadol or NSAIDs after consultation with your doctor (type of medicine, duration can be tailor-made according to each individual)
   • Nutraceuticals

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1. Recent Non-surgical treatment options (Knee Injections/Interventions)
   • Hyaluronic acid or Viscosupplement therapy into knee joint
   • Cortisone injection in the knee
   • Platelet-rich plasma (PRP) in the joint- prepared from patient’s own blood which regenerates and forms new cartilage and knee tissue
2. Radiofrequency ablation of knee genicular nerves (pain carrying nerves)
3. Surgery in advanced arthritis

When should I see my doctor?

See your healthcare who provider if you have pain, swelling or stiffness in your knees. Early advice can help in accurate diagnosis, staging and making lifestyle changes so that further progression can be slowed down with better response to treatment.

Consult our pain & spine specialist at Neuronpainclinic