Arthritis of the Knee

Arthritis can occur in one or both knees. The most common type of knee arthritis is osteoarthritis, which is the degeneration of the cartilage that cushions the bones. There are three main compartments at the knee joint where articular cartilage protects the bones, and cartilage degeneration may occur in one, two, or all three compartments.

• Medial compartment: Between the tibia (shin bone) and femur (thigh bone) on the inside of the knee
• Lateral compartment: Between the tibia (shin bone) and femur (thigh bone) on the outside of the knee
• Patellofemoral compartment: Between the femur (thigh bone) and patella (knee cap) on the front of the knee

Symptoms of arthritis in the knee can include:

• Stiffness in the knee, especially in the morning
• Decreased range of motion in the knee
• Weakness in the knee due to lack of use
• Pain that worsens over time, especially at night
• Buckling or locking of the knee
• Audible crackling or popping sensation upon movement

Treatment for arthritis of the knee begins with symptom management. There is no known cure for arthritis, but proactive treatment can alleviate your symptoms and improve your quality of life.

• Anti-Inflammatory Medications: Non-steroidal anti-inflammatory medications can decrease inflammation and pain caused by knee arthritis. These are often recommended in addition to physical therapy to minimize pain while patients regain motion and strength.
• Physical Therapy (PT): PT may be recommended to improve range of motion and strength in the affected knee. It can also help train the muscles to compensate for the decreased range of motion. Coupled with daily walking of at least 1.5 miles, PT facilitates more mobility and better quality of life for patients with knee arthritis.
• Lifestyle Modifications: Some patients will benefit from lifestyle modifications, such as limiting or stopping certain activities that cause or aggravate pain. This may include avoiding high-impact exercises (such as running and jumping) and regularly engaging in low-impact exercises to manage symptoms. Walking aids and/or knee braces may be recommended to stabilize the knee joint.
• Weight Loss: Where appropriate, weight loss can reduce stress on the knee joint and slow the gradual wear and tear that is caused by arthritis.
• Injections: Patients who need temporary pain relief or who cannot undergo surgery may benefit from injections to the knee joint. Steroid and hyaluronic acid injections can both be effective for knee arthritis.
• Surgery: In some cases, surgery may be necessary to treat arthritis in the knee. When only one or two knee compartments is involved, a partial knee replacement may be appropriate. When all three knee compartments are involved, a total knee replacement with an artificial implant will usually provide a better outcome. Surgery should not be considered until after conservative treatments are attempted and patients have persistent dysfunction and symptoms that significantly impact their daily lives.