Arthritis is a condition which affects the surfaces of joint (i.e. the cartilage) and wears it down until it no longer moves as smoothly as it used to, and no longer cushions the joint. Damage to the cartilage can lead to bones rubbing directly together, which can lead to pain, stiffness etc.

There are three common types of arthritis that affect the knee:

1. Osteoarthritis - Osteoarthritis is the most common type of arthritis affecting the knee, and is a gradually progressive degeneration of the knee cartilage. The surface of the knee joint becomes rough, and this can lead to pain, stiffness and limited motion.
2. Rheumatoid arthritis or Inflammatory arthritis is an autoimmune disease which can affect multiple joints, including the knee.  Patients with rheumatoid arthritis usually report that the pain is worse after rest and inactivity (e.g. in the morning) as the joints tend to stiffen. On the other hand, the pain tends to improve with rest.
3. Post-traumatic arthritis may occur following an injury to the ligaments, cartilage, and bones of the knee. This can cause  instability to the joint and lead to increased wearing of the cartilage surfaces.

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All normal knee joints experience some damage and are undergoing repair. This is due to the normal wear and tear that the knee will experience from daily activities. However, in some people this normal repair process can become faulty, and osteoarthritis can develop. It is not exactly understood why osteoarthritis occurs, but it is well known that the following factors can play a role in the development of OA:

• Age
• Genetics
• Obesity
• Gender
• Previous joint injury, damage or deformity
• Occupational overuse of a joint

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Arthritis in a knee can cause the following symptoms:

• Pain: Some patients describe the pain to be a dull deep ache, which moves down the front of the shin.

• Swelling: Swelling can develop due to inflammation and irritation of the synovial lining of the joint, which produces excess joint fluid in response. This can lead to an effusion, or collection of fluid within the joint.

• Stiffness: This can be due to formation of bony spurs called osteophytes can form in and around the knee joint, from tightening of the surrounding soft tissue (i.e. muscles, tendons, ligaments) and tightening of the joint capsule itself.  

• Mechanical symptoms: Some patients describe the knee ‘catching’ or ‘giving way’. This can happen if there is any loose articular or meniscal cartilage debris within the joint itself.

The treatment of knee arthritis will depend on the stage of the disease, how severe the symptoms are, the degree of disability it is causing and what the patient hopes to be able to do with the knee in the future.  

We always recommend to start with the safest and least invasive treatments first, and escalate as needed until the symptoms are controlled.

Non-surgical treatments include:

• Rest and limited activity to reduce the symptoms of an inflamed knee joint.
• Weight loss to reduce stress on the knee
• Physiotherapy to improve range of motion and strengthen the muscles
• Non-steroidal anti-inflammatory medication like aspirin, naproxen, or ibuprofen for pain and reducing inflammation.
• Steroid Injections directly into the knee joint may be recommended. These may provide temporary, symptomatic relief, but are not generally recommended or prescribed for prolonged use.

Surgical treatments include:

• Knee arthroscopy
• Partial knee replacement
• Total knee replacement
• High Tibial Osteotomy