What is osteoarthritis of the knee?

Osteoarthritis (OA) is inflammation of the joint and commonly affects the knee. It is a chronic, progressive, degenerative disease of the cartilage that covers the ends of bones, often called “wear and tear arthritis”. As the cartilage deteriorates the bones rub together causing joint pain, swelling and stiffness, and bone spurs. OA makes it difficult to do many everyday activities like walking and climbing stairs.

Because cartilage has a limited blood supply it has very little ability to repair or rebuild cartilage. Most OA treatments are designed to improve symptoms. Currently no treatments slow the progression OA.

Cartilage loss leads to pain, disability, reduced mobility and a loss of quality of life. OA is the leading cause of pain and disability worldwide and the most common reason for total knee replacement surgery.

What causes OA?

Generally, OA is a disease of aging that usually affects people over the age of 50.

It tends to run in families and affects women more often than men. Excess weight puts extra pressure on the knee joint.

For every pound you gain, it adds 3-4 pounds of extra weight on your knees. Repetitive stress on the joint, due to work or athletic endeavors can increase the risk of developing OA. Previous injuries to the knee including ligament and meniscus damage can cause instability and result in post-traumatic OA at any age.

What are the symptoms of knee OA?

The primary symptoms are pain, swelling and stiffness. As OA progresses, the pain worsens.

• Pain and stiffness that impairs the ability to bend the knee including when standing up or sitting down.
• Pain and stiffness that is worse in the morning and with long periods of inactivity.
• Pain climbing stairs and walking
• Pain that interferes with sleep
• Swelling and tenderness due to periodic inflammation caused by the formation of bone spurs or excess fluid on the knee.
• A grinding sensation when using the knees, as a result of bone spurs and wearing of the ends of the bones. Clicking and crackling sounds as the cartilage frays, and the protective space between the bones decreases.
• Locking or sticking of the knee from loose bodies or fragments of cartilage that float in the joint and interfere with movement.
• Reduced range of motion.
• Deformity of the joint.

How is OA diagnosed?

At your appointment the knee experts at Grossmont Orthopedics will review of your medical history and symptoms, and perform a physical examination including testing range of motion. Diagnostic tests may be ordered including x-rays which will show the space between the knee bones which if narrowed will indicate OA. A bone scan may be needed to determine the condition of the bone and soft tissues. Blood tests will rule out Rheumatoid Arthritis, an immune disorder.

Nonsurgical OA Treatments

OA is incurable. Current treatments aim to control the pain and symptoms by modifying lifestyle behavior. Some changes can protect the knee and slow the progress of OA.

Conservative management includes weight loss, modifying activities that aggravate the condition, strength building and stretching for mobility, pain relievers, cortisone injections, bracing, acupuncture, dietary supplements like glucosamine and chondroitin sulfate, and physical therapy. When these approaches fail to relieve pain, approaches arthroscopic minimally invasive surgery may be offered.

Surgical treatments

• Arthroscopy is a minimally invasive procedure that allows the surgeon to see inside the knee to diagnose and treat joint problems including torn ligaments and meniscus damage.
• OATS Osteochondral Autograft restores articular cartilage. This is a procedure to take healthy cartilage tissue from another part of the joint to fill in small discrete areas of cartilage damage. If the cartilage defects are large, donor cartilage will be used. When synthetic grafts are used it is called Synthetic Scaffold Resurfacing and is good to treat larger areas of cartilage damage.
• Knee Osteotomy is a procedure to address arthritic damage in one part of the knee. Here the bones are reshaped to relieve pressure, relieve pain and improve function.
• Microfracture is a procedure designed to stimulate repair damaged knee cartilage by creating tiny microfractures in the damaged areas. This stimulates the release of bone marrow containing stem cells that can grow new cartilage. The goal is to restore cartilage and avoid knee replacement surgery. Microfracture is best for people under the age of 40 with recent damage. Sports athletes frequently seek this minimally invasive surgery because recovery is typically 4-6 months. The majority of patients treated with microfracture surgery experience considerable pain relief, improved quality of life and the ability to participate in sports again.
• Knee replacement surgery can be life-changing for people who suffer with knee arthritis.

OA is serious debilitating disease, but at Grossmont Orthopedics in La Mesa, CA, we have multiple options to help you to live pain free. Contact us to discover all your treatment options and get back to the life you love.