Knee Osteoarthritis

Common symptoms of knee osteoarthritis are:

• Knee pain that comes and goes, and gets worse when the knees are active, such as climbing up or down stairs.

• Warmth and swelling in the knees, which can be due to fluid buildup in the joint in some severe cases.

• Usually, the inner joint line is painful.

• Intermittent exacerbation of knee pain that lasts for few days.  

• A snapping noise from the knees when moving that shows that the cartilage is damaged.

• A crackling sound from the knee while walking.

What are the causes of Knee Osteoarthritis (OA)?

One of the main reasons for knee osteoarthritis is the long-term use of our knees, which leads to a lot of damage to the joint over our lifespan. Our bodies go through a lot of stress compared to a machine. It is amazing that they can last for more than 70 years of use. However, joint damage is a natural part of getting older, and this is what makes osteoarthritis in the knee happen.

Risk factors that can increase the chances of getting osteoarthritis of the knee

Some factors that can lead to early onset of knee osteoarthritis are 1. History of knee injury 2. History of knee joint infection 3. Other types of arthritis 4. Obesity 5. Excessive use of knee joint (example: cyclist) 6. One leg is smaller than other leg 7. History of knee joint surgery at early age etc.  

How the diagnosis of Osteoarthritis of knee is made?

The diagnosis of osteoarthritis of the knee is usually based on history from the patient and some investigations.

The common symptoms are pain, stiffness, swelling, and reduced mobility of the knee joint.

The physical examination, which may reveal joint line pain, bent knees, fluid buildup, and reduced range of motion of the knee joint.

The imaging tests, such as X-rays or MRI, which may show cartilage loss, bone spurs, bone damage, and joint space narrowing.

The lab tests, such as blood tests or joint fluid analysis, which may help rule out other causes of joint pain, such as rheumatoid arthritis, gout, or infection.

Treatment of Knee Osteoarthritis

1. Change the activities that put a lot of stress on the knees to lower the risk of cartilage damage. If these are not effective, patients should see a doctor for other possible methods to avoid more harm.

2. Oral medicines can alleviate pain and inflammation.

3. Patients in the early or middle stages of the condition can benefit from non-surgical treatment options that involve knee joint injections and physical therapy.

4. In severe osteoarthritis, total knee replacement surgery alongside physical therapy may be considered.

Pain Interventions in Knee Osteoarthritis

Hyaluronic Acid injection: A knee intra-articular injection of hyaluronic acid is a procedure that involves injecting a gel-like substance called hyaluronic acid into the knee joint. Hyaluronic acid is a natural component of the synovial fluid that lubricates and cushions the joint. The injection aims to improve the viscosity and elasticity of the synovial fluid, reduce inflammation, and pain, and enhance the function and mobility of the knee joint.

Ozone injection: Ozone injections are typically recommended for patients with mild to moderate osteoarthritis of the knee who have not responded well to other treatments, such as painkillers, anti-inflammatory drugs, or physical therapy. The injections may provide relief for up to six months, depending on the type and dose of ozone used. However, the effectiveness and safety of ozone injections are still controversial, and the results may vary from person to person.

Regenerative therapy by growth factors: Growth factors are isolated from the patient’s own blood that contains a high concentration of platelets, which are cells that help with healing and tissue regeneration. This may also be injected into the affected area of the knee joint, where it may stimulate the growth of new cartilage, reduce inflammation, and improve function.

Orthotic advices for knee osteoarthritis

Orthotic devices are supports or inserts that you wear to help with knee pain and function caused by osteoarthritis. They may work by shifting weight away from the damaged part of the knee, reducing pressure and inflammation, or improving alignment and stability of the joint.

There are different types of orthotic devices, such as:

Knee braces: These are made of metal, plastic, foam, or elastic materials that wrap around the knee. They may be adjustable, hinged, or custom-fitted. They may provide support, stability, or pain relief for the knee joint.

Foot/ankle orthoses: These are insoles or shoes that fit inside your footwear. They may be wedged, neutral, or variable in stiffness. They may help correct the alignment of the foot and ankle, which can affect the knee joint.

Cane or stick: A cane or a stick can take some of the weight off the affected knee and provide more balance and stability. However, using a cane or a stick requires proper fitting, instruction, and practice to be effective and safe.

The effectiveness and safety of orthotic devices for knee osteoarthritis are still under investigation. Some studies have shown positive results, while others have found no benefit or even adverse effects. The outcomes may depend on various factors, such as the type and severity of the knee condition, and the patient’s individual response.

You can always contact Dr Chinmoy Roy at Rajarhat pain clinic at Newtown, Kolkata for best treatment of knee osteoarthritis.