The joints in our body are lined with a soft smooth material called cartilage. Osteoarthritis occurs when this cartilage is worn away. Sometimes this can occur as a result of a past injury or certain aspects of your natural anatomy, but often it is degenerative and occurs with time. When the cartilage in your knee is worn away, the bone underneath becomes exposed causing inflammation and pain. As the wear and tear continues, spurs of bone called osteophytes are produced at the edges of the joint and your knee alignment may change with a bow leg or knock knee shape. The inflamed joint can also generate a lot of fluid and swelling which, in combination with the wear and tear, leads to increasing joint stiffness. The joint fluid may also collect at the back of the knee forming what is known as a Bakers cyst.
Knee arthritis can often be diagnosed with a simple xray of the knee. The xray can show where the cartilage has been worn away, the presence of any bone spurs, and if the knee has started to bow or become knock kneed.
Symptoms of knee osteoarthritis include pain around the knee which can be generalised or localised to the specific area of the knee that is affected. The knee can also swell which can cause stiffness. The pain and swelling is often exacerbated with activity such as prolonged walking or going up and down stairs. Sometimes patients can experience acute flairs of pain which can take days or weeks to settle again. Initially these symptoms may be manageable with pain killers, physiotherapy, weight loss, using a walking aid and modifying daily activities. However with time knee arthritis tends to progress and these symptoms can become more and more intrusive to patients quality of life, and limit the activities that they once enjoyed without any pain. When this occurs some patients decide to have more invasive treatments such as knee joint injections or a knee replacement.
Knee injections can provide patients with good pain relief but the duration of their beneficial effect can be variable. Whilst some patients may experience several months of benefit, they are not a long term solution as they do not reverse the arthritis but rather make the symptoms of arthritis more manageable. Similarly draining the fluid from your knee or from a Bakers cyst does not reverse the underlying arthritis and the fluid or cyst will simply return.
Key hole procedures (knee arthroscopy) is only suitable for a small subgroup of patients with knee arthritis who may have specific symptoms created by debris within the knee. If your symptoms fail to improve with non-operative treatment or knee joint injections you may be offered a knee replacement.
Mr Craik provides private knee consultations at Ashtead Hospital in Surrey and will discuss with you the range of treatment options available.