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Knee osteoarthritis is the major cause of disability in people over 60 years of age. A recent study in 2020 by Lancet Discovery Science found out that the global prevalence of osteoarthritis is 16%. The figures are indicative of the large number of the global population suffering from this condition.
Since the disease is understood to be progressive, the need to catch the symptoms at early stages is the key to successful treatment.
In laymen's terms, osteoarthritis is a condition where the natural cushioning between the joints faces wear and tear. It results in the joint bones rubbing against each other, causing pain, stiffness, swelling, and with time, development of contractures and bone spurs.
Knee osteoarthritis is also known as “degenerative joint disease of the knee.”
Osteoarthritis of the knee is the most commonly occurring form of arthritis. While it is more commonly observed in people above 45 years of age, younger people may also sometimes suffer from this condition. It has also been observed through various studies that women are more likely to face this condition than men.
There are two types of knee osteoarthritis:
Doctors usually classify the stages of knee osteoarthritis as follows:
| Stage | Description |
|---|---|
| 0 | The knee appears normal and shows no signs of damage. |
| 1 (Minor) |
Patients show minor wear and tear of the knee joint. There may also be bone spur growths on the knee joint. However, for many patients, the stage may not be very painful. Treatment at this stage may only be in the form of lifestyle changes and supplements (like glucosamine). |
| 2 (Mild) |
Knee shows more bone spur growth. The patient may be experiencing some joint pain, stiffness around the joint, and a feeling of being uncomfortable when sitting for extended periods. The cartilage and soft tissues may still be healthy. However, some proteolytic breakdown of the cartilage matrix may be noted. Treatment methodology involves plans to stop the progression of the disease. Pain-relieving therapies may be prescribed along with braces and knee supports and supplements (e.g., Glucosamine). |
| 3 (Moderate) |
The cartilage shows signs of erosion. Additionally, the gap between the bones is narrowed, causing high levels of pain to the patient when walking. The synovial fluid may show proteoglycan and collagen fragments, and the joint may get rougher. The inflammation may result in frequent pain to the patient. There may also be popping sounds when walking. Treatment involves over-the-counter pain-relieving medications, therapies, weight loss. If the pain continues to grow, the patient may be given hyaluronic acid injections in the knee joint to increase mobility. Bone osteotomy and / or realignment surgery may also be beneficial. |
| 4 (Severe) |
The space within the joint is considerably reduced, causing severe wear and tear of the cartilage. This leads to chronic inflammation, decreased synovial fluid, extreme friction between the joints, and inability to move without extreme pain. This stage also shows the development of more bone spurs which may cause severe pain to the patient when moving. The treatment may involve knee replacement surgery, bone osteotomy and / or bone realignment. |
Since osteoarthritis is a progressive disease, it may grow from one stage to the next if left untreated. The final stages of the disease may leave a patient disabled with a complete inability to walk.
It is therefore advisable to consult your doctor when you notice the early signs of knee pain or other symptoms.
Osteoarthritis is a progressive disease, and a normal progression may be confused for a flare-up.
However, overexerting the knee, being involved in activities that cause pressure on the knee joint, repetitive motions, sudden weight gain, or even extreme cold weather may increase the level of discomfort in a patient.
Unfortunately, osteoarthritis is a progressive disease and may lead to complete blockage of movement if not treated timely.
The pain as well as the intensity of other symptoms varies from one patient to the other and may get more debilitating with time.
Common symptoms include:
Aging is the most common cause of osteoarthritis. A big percentage of adults develop a certain degree of osteoarthritis after an age.
Following are the known risk factors for developing arthritis of the knee:
Your doctor may start the diagnosis with a physical examination. He may also ask you questions on:
In addition to these, the orthopaedic specialist may order the following tests:
The primary goal of treatment is pain management and restoring mobility. Treatment methodology hence begins with conservative techniques followed by surgical intervention if conservative treatment has become ineffective.
Conservative treatment options include:
Surgery techniques include the following:
Arthroscopy - This minimally invasive surgery (MIS) procedure is performed by making small incisions and using a telescope-like instrument (called an arthroscope) to remove damaged cartilage and repair tissue damage. It is preferably done on patients younger than 55 years of age. Post-surgery recovery is fast.
Osteotomy - This procedure is done to remove knee alignment. It is recommended if the damage is limited to one area of the knee or if a broken knee has not healed well.
Arthroplasty (joint replacement surgery) - As the name suggests, the joint is replaced by artificial parts (made of metal or plastic). It is usually recommended for cases of severe osteoarthritis and for people above 55 years of age.
The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care. Get in touch with us to find out more about Orthopaedic Services at your nearest Pantai Hospital.
Pantai Hospital Malaysia is accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.
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