Osteoarthritis of the Knee (Knee Arthritis): "Degenerative Joint Disease" can cause pain, stiffness, and cartilage breakdown.
Edited By: Seth S. Leopold, M.D.
Last updated Friday, January 22, 2010
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Figure 1 - Arthritic Knee
Figure 2 - Normal Cartilage
Figure 3 - Defect in joint surface cartilage
Figure 4 - X-ray showing arthritis of the knee
Figure 5 - Joint deformity from knee arthritis
Figure 6 - Model of a knee replacement prosthesis
Figure 1 - The incision used for minimally-invasive quadriceps-sparing total knee replacement is much smaller than the one used for traditional knee replacement, and in the less-invasive procedure, the important quadriceps muscle and tendon are not disrupted as in traditional knee replacement. LifeART image ©2004 Lippincott Williams & Wilkins. All rights reserved.
Figure 2 - The skin incision for minimally-invasive quadriceps-sparing total knee replacement is typically about 4? in length, compared to about 8? or more for traditional total knee replacements.
Figure 3 - X-ray of a traditional total knee replacement. This operation is done for patients who have arthritis throughout the knee. Excellent long-term results are obtained in most patients.
Figure 4 - Model of a traditional total knee replacement. The patella (knee cap) is not shown in this model.
About
Basics of knee arthritis
Many kinds of arthritis can affect the knee joint, but by
far the most common is osteoarthritis, which some people call "degenerative
joint disease."
This occurs when the joint surface cartilage (also called
hyaline cartilage, or articular cartilage) becomes worn away, leaving the raw
bone beneath exposed (See Fig 1). The cartilage normally serves
as a “pad” or a bearing in the joint, and under normal conditions, the
cartilage bearing is even slicker than a hockey puck on ice. When the bearing
wears away, the result is a roughed joint surface that causes the pain and
stiffness that people associate with osteoarthritis (See Fig 2 and Fig 3).
For most patients who have only mild arthritis, the pain
can be managed with simple things such as ice, rest, activity modifications,
pills, or joint injections.
However,
if the arthritis becomes severe (See Fig 4 and Fig 5), the pain may not respond to those kinds of
interventions.
Patients with severe arthritis sometimes can benefit from joint
replacement
surgery, either partial (unicompartmental) knee replacement or total knee replacement (See Fig 6),
which now can be done using a minimally-invasive quadriceps-sparing approach
that can significantly shorten the recovery
and decrease the pain following surgery.Immediate medical attention
Osteoarthritis of the knee is not an emergency. It
can, however, result in disturbing “flare ups,” with increased pain and
swelling. Many patients who experience a sudden flare-up will go to the doctor
for care, and for many patients this apparently “acute” set of symptoms will
result in the diagnosis of this chronic condition.Facts and myths
MYTH: Osteoarthritis of the knee is not usually the result of “overuse.”
True. There have been studies of long-distance runners that show that they are not more likely to get arthritis than more sedentary individuals. However, people in occupations that require extreme and repeated heavy exertions (such as farmers) experience higher rates of osteoarthritis.
MYTH: Osteoarthritis of the knee is a “normal result of aging.”
True. Studies show aging have more “doctor-diagnosed” arthritis.
MYTH: Osteoarthritis of the knee is not just “aches and
pains.”
False. It is a condition whose biology, x-ray appearance (See Fig 4), and clinical symptoms are defined.
MYTH:
Not much can be done for osteoarthritis of the knee.
False. In fact, there are
exercise programs that can alleviate the pain in mild arthritis, a variety of
medications and injections can be helpful for moderate arthritis, and severe
arthritis of the knee is very commonly successfully treated with knee
replacement surgery (See Fig 6). New minimally
invasive approaches appear to decrease the recovery time from this operation.
MYTH: Women have more “doctor-diagnosed” arthritis than men.
True. Studies show women also report greater activity and work limitations, greater psychological distress, and more severe joint pain than their male counterparts.
Prognosis
Osteoarthritis of the knee is a serious condition.
Osteoarthritis is the most common of the more than 100 kinds of arthritis, and
the knee joint is the most commonly affected large joint in the body.
Osteoarthritis of the knee results in pain, stiffness, and
joint deformity (See Fig 5), which can affect one’s
ability to walk, work, and enjoy life.
It
is a chronic disease, meaning that it takes months to years to appear; while it
is not “curable,” it most certainly is treatable, using activity modifications,
medications, injections, and if those interventions don’t work, knee
replacement surgery. New minimally invasive approaches appear to decrease the
recovery time from this operation.Lethality
Osteoarthritis of the knee is not deadly.Pain
Osteoarthritis of the knee indeed can, and usually
does, cause pain. Other symptoms include swelling, stiffness, sometimes warmth,
and joint deformity.Debilitation
Osteoarthritis of the knee is progressive, and when it
becomes severe, it indeed can severely affect one’s ability to walk, climb
stairs, enter or exit a vehicle, and enjoy one’s day-to-day activities.Comfort
Osteoarthritis of the knee indeed can, and usually
does, cause pain and discomfort. Other symptoms include swelling, stiffness,
sometimes warmth, and joint deformity.Curability
Osteoarthritis of the knee is not curable.
However, while it is not “curable,” it most certainly is
treatable, using activity modifications, medications, injections, and if those
interventions don’t work, knee replacement surgery. New minimally invasive
approaches appear to decrease the recovery time from this operation.
Fertility and pregnancy
Osteoarthritis of the knee will not affect a patient’s
ability to get pregnant or have children. However, some medications used to
treat arthritis need to be used with care (or not at all) during a pregnancy.
It is important to inform one’s obstetrician and family physician about all
medications and nutritional supplements that one takes.Independence
Osteoarthritis of the knee indeed can affect one’s
ability to walk, climb stairs, enter or exit a vehicle, and enjoy one’s day-to-day
activities. These things do affect one’s ability to remain independent,
particularly as the disease reaches its more severe stages.Mobility
When osteoarthritis of the knee becomes severe, it
indeed can severely affect one’s ability to walk, climb stairs, enter or exit a
vehicle.Daily activities
Osteoarthritis of the knee can affect one’s ability to
walk, climb stairs, enter or exit a vehicle, perform housework and enjoy one’s
day-to-day activities.
Even mild to moderate osteoarthritis of the knee can
adversely impact athletic performance and enjoyment of sports, particularly
impact sports and sports that involve running.
Although
there is little “hard science” on this point, most knee surgeons and
rheumatologists (doctors who treat arthritic conditions non-operatively)
believe that patients with osteoarthritis of the knee should consider avoiding
impact sports such as running in order to avoid increasing the rate at which
the disease progresses.Energy
Many patients indeed find that the chronic pain associated
with osteoarthritis of the knee does contribute to fatigue.
Osteoarthritis of the knee does not affect metabolism, but
some patients attribute weight gain to the inactivity that results from the
knee pain caused by osteoarthritis of the knee.
It
is important that patients with osteoarthritis of the knee avoid decreasing
their activity level, and it is important that they remain fit. However, this
often does require some modification of exercise programs – running and walking
programs are usually poorly tolerated by (and not recommended for) patients
with osteoarthritis of the knee. Stationary bike, swimming, and water aerobics
usually are well-tolerated and they are recommended.Diet
Diets do not cure or treat osteoarthritis so far as we
know. However, it is important to try to avoid weight gain when one has
osteoarthritis of the knee, as increased body weight is associated with
worsening of symptoms.Relationships
Osteoarthritis of the knee can affect relationships
and social interactions to the extent that it makes getting around more difficult.Other impacts
Osteoarthritis of the knee is not contagious, and doesn’t
predispose one to other diseases or conditions.
Osteoarthritis of the knee is associated with joint
deformity (such as bowing of the legs, “knock-knees”, and loss of the ability
to fully straighten or fully bend the affected knee; See Fig 5). These joint deformities are not readily managed by interventions
other than surgery, but can be corrected at the time of knee replacement for
patients who elect to have that surgery. New minimally invasive approaches
appear to decrease the recovery time from this operation.
Incidence
It is not possible to predict who will get osteoarthritis
of the knee. However, there are some risk factors that may increase the
likelihood that knees will become arthritic. These risk factors include:
- Genetics.
Arthritis often runs in families.
- Severe trauma. Fractures (broken bones) and total removal of
the supporting cartilages of the knee (meniscus) both increase the
likelihood of knee arthritis.
- Obesity. This is associated with arthritis of the knees.
Acquisition
Osteoarthritis is not caused by an infection, though
severe bacterial infections certainly can cause “post-infectious arthritis,”
which is in many ways even worse than osteoarthritis of the knee.
There are some risk factors that may increase the
likelihood that knees will become arthritic. These risk factors include:
- Genetics.
Arthritis often runs in families.
- Severe
trauma. Fractures (broken bones) and total removal of the supporting cartilages
of the knee (meniscus) both increase the likelihood of knee arthritis.
-
Obesity.
This is associated with arthritis of the knees.
Genetics
Some arthritis indeed appears to run in families.Communicability
Osteoarthritis of the knee is not contagious.Lifestyle risk factors
There are two important “environmental” risk factors
associated with arthritis of the knee. These are:
- Severe
trauma. Fractures (broken bones) and total removal of the supporting cartilages
of the knee (meniscus) both increase the likelihood of knee arthritis.
-
Obesity.
This is associated with arthritis of the knees.
Injury & trauma risk factors
Severe trauma, including fractures (broken bones) that
involve the knee joint can, in time, result in arthritis of the knee. Whether
this really is “osteoarthritis” or should be considered a separate kind of
arthritis (post-traumatic arthritis) remains an open question, though in the
severe stages of this condition, the treatments are the same.
In the ‘60s and ‘70s, it was common for surgeons to remove
the supporting cartilages of the knee (meniscus) if the meniscus was torn as
part of a trauma. It is now known that this, too, results in the development of
knee arthritis. As a result of learning this fact, surgeons now either try to
repair or minimize the portion of the meniscus that is removed should it become
torn.
Prevention
By maintaining an ideal body weight and avoiding
severe trauma to the knee, it is possible to minimize the risk of arthritis.
However, many patients with osteoarthritis are slender and have never severely
injured their knees, so there is no “guaranteed” way to avoid getting this
condition.
Anatomy
Osteoarthritis of the knee occurs when the joint surface
cartilage (also called hyaline cartilage, or articular cartilage) becomes worn
away, leaving the raw bone beneath exposed. The cartilage normally serves as a
“pad” or a bearing in the joint, and under normal conditions, the cartilage
bearing is even slicker than a hockey puck on ice. When the bearing wears away,
the result is a roughed joint surface that causes the pain and stiffness that
people associate with osteoarthritis.Initial symptoms
Pain, swelling, and stiffness are the main symptoms of
knee arthritis. When it becomes more advanced, joint deformity (knock-knees or
bow-legs) can occur.Symptoms
Pain, stiffness, swelling, and joint deformity are the
symptoms of arthritis of the knee.Progression
Early in the course of arthritis, the symptoms can be
intermittent, perhaps related only to particular activities or sustained
activity. At that point, usually rest and avoiding the precipitating activity
will improve the symptoms.
As the arthritis worsens, the symptoms can become more
persistent or more severe, such that simply walking on level ground can result
in pain.
When
arthritis is severe, the pain with activities can linger even after the
activity stops, such that the knee can remain painful even after one stops
walking.Conditions with similar symptoms
Other forms of arthritis can cause similar symptoms to
osteoarthritis of the knee; in particular, post-traumatic arthritis and
post-meniscectomy arthritis are almost indistinguishable in many cases from
osteoarthritis of the knee.
Rheumatoid arthritis, the next most common cause of
arthritis, can also affect the knee. It tends to cause other joints to be
involved, and often causes more of an inflammatory set of symptoms (swelling
and warmth, as well as pain), and can in fact effect other organ systems as
well.
The
diagnosis of osteoarthritis versus rheumatoid arthritis can be made by a
physician with experience in treating conditions of this type.
Causes
No one knows what causes osteoarthritis of the knee.
However, there are some risk factors that may increase the
likelihood that knees will become arthritic. These risk factors include:
- Genetics.
Arthritis often runs in families.
- Severe
trauma. Fractures (broken bones) and total removal of the supporting cartilages
of the knee (meniscus) both increase the likelihood of knee arthritis.
-
Obesity.
This is associated with arthritis of the knees.
Effects
Pain, swelling, and stiffness are the main symptoms of
knee arthritis. When it becomes more advanced, joint deformity (knock-knees or
bow-legs) can occur.
As the condition worsens, it often becomes less responsive
to medical treatments such as pills or injections.
In
many patients with advanced arthritis, particularly if those medical approaches
are no longer helpful, surgery can offer relief of symptoms. Some patients with
severe osteoarthritis sometimes can benefit from joint replacement surgery,
either partial (unicompartmental) knee replacement or
total knee replacement, which now can be done using a minimally-invasive
quadriceps-sparing approach that can
significantly shorten the recovery and decrease the pain following surgery.
Diagnosis
To diagnose osteoarthritis of the knee, a physician
will take a thorough history and perform a thorough physical examination first.
Following this, simple x-rays, taken with the patient standing, are an
effective way to diagnose this condition.Diagnostic tests
The simplest test to diagnose osteoarthritis of the knee
is the x-ray. Taken with the patient standing up, plain x-rays can diagnose the
condition with great accuracy.
Very
mild arthritis can be seen on a bone scan or an MRI even before it is visible
on plain x-rays, but in reality, these tests are seldom helpful clinically for
this purpose.Effects
The diagnostic tests for osteoarthritis of the knee,
including x-rays and MRIs, are generally not painful and they are
well-tolerated by most patients.Health care team
Osteoarthritis of the knee is common and generally
straightforward to diagnose. Family physicians, internists, orthopedic
surgeons, rheumatologists, and physiatrists often are the ones who make the
diagnosis of osteoarthritis of the knee.Finding a doctor
Both rheumatologists and orthopedic surgeons are
“specialists” in arthritis care.
If
surgery is being considered to manage osteoarthritis of the knee, visiting with
a fellowhip-trained, high-volume knee replacement surgeon would be a reasonable
step to consider.
Treatment
Simple steps that can be taken, which don’t have much
risk, include avoidance of the activities that cause symptoms (activity
modification) and weight loss (if appropriate). Some patients find nutritional
supplements such as glucosamine and chondroitin to be helpful; however, the
data on these products is somewhat inconsistent. They don’t help everyone.
Some patterns of osteoarthritis of the knee can be treated
with an arthritis brace, such as a knee sleeve or an “Unloader” type brace.
Should those interventions not be satisfying, in
consultation with one’s physician, the next steps might include
over-the-counter pain remedies such as acetaminophen (Tylenol) and
over-the-counter anti-inflammatories such as ibuprofen (Advil, Motrin) or
naproxen (Naprosyn), among others. However, these pills are not for everyone,
and if one hasn’t used them before, one should consider consulting one’s family
physician first. Sometimes, prescription-strength non-steroidal
anti-inflammatory drugs (NSAIDs) can be prescribed, but again, this must be
done in consultation with a physician, and these drugs do have risks and side
effects associated with them.
In general, narcotic pills (“painkillers” like Tylenol #3,
Vicoden, Percocet, oxycodone) and narcotic pain patches (fentanyl, Duragesic)
should be avoided for most patients with osteoarthritis of the knee.
Joint injections, including intra-articular corticosteroid
injections and “viscosupplement” injections
like Synvisc, Hyalgan, Supartz and others can be helpful for some patients.
Patients with severe arthritis who have tried the above
remedies sometimes can benefit from joint replacement surgery, either partial
(unicompartmental) knee replacement or total knee
replacement, which now can be done using a minimally-invasive
quadriceps-sparing approach that can
significantly shorten the recovery and decrease the pain following surgery.
Self-management
Keeping one’s body weight appropriate and choosing
activities that don’t reproduce the arthritic pain are two things patients with
osteoarthritis of the knee can do to help decrease the arthritic symptoms.Health care team
Several kinds of health care providers participate in the
management of osteoarthritis of the knee, including:
- Family
physicians and internists
- Rheumatologists
- Physical
Medicine and Rehabilitation Specialists (Physiatrists)
-
OrthopedicSurgeons
Pain and fatigue
Several approaches can be used to manage the pain
associated with osteoarthritis of the knee, including:
- Activity
modification, appropriate kinds of exercise, and weight loss when necessary may
alleviate some knee arthritis symptoms
- Nutritional
supplementation (glucosamine and chondroitin) are helpful to some patients,
although the literature on these supplements is not consistently in favor of
their use
- Non-narcotic
pain tablets (acetaminophen/Tylenol) or over-the-counter non-steroidal
anti-inflammatory drugs, if medically appropriate, sometimes are helpful
- Prescription
strength non-steroidal anti-inflammatory drugs (NSAID) are useful for some
patients, though in general, long-term use of these drugs is discouraged
- Arthritis
unloader braces or knee sleeves are helpful for some patterns of arthritis
- Joint
injections (corticosteroid or “cortisone” injections; or “viscosupplement”
injections such as Hyalgan, Synvisc, Orthovisc, or Supartz) might help
-
Total
knee replacement surgery may be used if non-operative interventions don’t
suffice; a minimally-invasive quadriceps-sparing approach can decrease the post-operative pain and
length of convalescence in some patients undergoing this procedure.
Diet
Keeping one’s weight proportional to one’s height can
decrease the likelihood of developing osteoarthritis of the knee, and can
decrease the symptoms of the condition once it has set in.Exercise and therapy
There is some evidence that appropriately-designed
exercise programs can decrease the pain of knee arthritis, in particular
earlier stages of the condition. Gentle strengthening of the quadriceps (front
of the thigh) muscles, such as by using a stationary bicycle, is probably the
most effective approach for this.Medications
- Nutritional
supplementation (glucosamine and chondroitin) are helpful to some patients,
although the literature on these supplements is not consistently in favor of
their use
- Non-narcotic
pain tablets (acetaminophen/Tylenol) or over-the-counter non-steroidal
anti-inflammatory drugs, if medically appropriate, sometimes are helpful
- Prescription
strength non-steroidal anti-inflammatory drugs (NSAID) are useful for some
patients, though in general, long-term use of these drugs is discouraged
- Joint
injections (corticosteroid or “cortisone” injections; or “viscosupplement”
injections such as Hyalgan, Synvisc, Orthovisc, or Supartz) might help
Narcotic
painkillers, whether in pill form (oxycodone, Tylenol #3, Vicoden, Percocet,
Lortab, etc. or patch form (Duragesic, fentanyle, etc.) in general should be
avoided for the treatment of osteoarthritis of the knee.Surgery
Knee replacement is a surgical
procedure that decreases pain and improves the quality of life in many patients
with severe arthritis of the knees. Typically, patients undergo this surgery
after non-operative treatments (such as activity modification,
anti-inflammatory medications, or knee joint injections) have failed to provide
relief of arthritic symptoms. Surgeons have performed knee replacements for
over three decades, generally with excellent results; most reports have
ten-year success rates in excess of 90 percent.
Broadly speaking, there are two
types ways to insert a total knee replacement: the traditional approach, and the
newer minimally-invasive (sometimes called quadriceps-sparing) approach.
Traditional total knee
replacement involves a
roughly 8” incision over the knee, a hospital stay of 3-5 days, and sometimes
an additional stay in an inpatient rehabilitation setting before going home.
The recovery period(during which the patient walks with a walker or cane)
typically lasting from one to three months. The large majority of patients
report substantial or complete relief of their arthritic symptoms once they
have recovered from a total knee replacement.
Minimally-invasive
quadriceps-sparing total knee replacement is
a new surgical technique that allows surgeons to insert the same time-tested,
reliable knee replacement implants through a shorter incision using surgical
approach that avoids trauma to the quadriceps muscle (see figure 1), which is
the most important muscle group around the knee. This new technique, which is
sometimes called quadriceps-sparing knee replacement uses an incision that is
typically only 3-4” in length (see figure 2), and the recovery time is much
quicker – often permitting patients to walk with a cane within a couple of
weeks of surgery or even earlier. The less-traumatic nature of the surgical
approach also may decrease post-operative pain and diminish the need for rehab
and therapy compared to more traditional approaches.
The main potential benefits of
this new technique include:
More rapid return of knee
function. Patients who undergo this procedure seem to get muscle strength and
control back more quickly than patients who have had traditional total knee
replacement. (See Video) This is because the quadriceps muscle
and tendon are not divided in the course of the surgical exposure like in
traditional knee replacement, and the kneecap is not everted (flipped out of
the way) as it is in traditional total knee replacement.
Smaller incision. While
this procedure would not be worth performing for cosmetic benefits, many
patients do prefer the shorter incision. Traditional knee replacement incisions
often measure 8” or longer; minimally-invasive quadriceps-sparing knee
replacement incisions are about 4” in length for most patients.
Decreased post-operative
pain. (See Video)This may be a function of the smaller
incision and the fact that the incision stays out of the important quadriceps
muscle/tendon group.
Same reliable surgical
implants as Traditional Knee Replacement. Much has been learned about implant
design in the nearly 40-year history of contemporary knee replacement.
Minimally-invasive quadriceps-sparing total knee replacement is an evolution of
surgical technique, which permits the use of time-tested implant designs (see
figure 3 and figure 4). This gives some reassurance that while the surgical approach
is new, the implants themselves have a good proven track record.
The major apparent risks of the
procedure compared to traditional total knee replacement:
The procedure is new.
Though surgeons have studied the approach, the studies are recent and have
replicated (repeated and verified) by only a few groups of surgeon-scientists.
These studies give some insight into which patients and patterns of arthritis
are most suitable for this procedure, the relative novelty of the approach it
is likely that as time passes we will discover more about the risks and
shortcomings of this technique. Also, even an experienced knee replacement
surgeon will have performed many more surgeries through the traditional
approach than through the less-invasive method; we know that the more
procedures one does, the more reliable the results are.
The procedure is more challenging. Operating through a smaller surgical window
takes some getting used to, and this can increase operative time compared to
procedures performed using the traditional technique. This may increase the
likelihood that an intra-operative injury to tendon or ligament might occur,
which could compromise the result. This may also increase the likelihood of
component malalignments, which could affect function and durability. However,
two preliminary studies on this technique in fact found that these adverse
outcomes did not take place.Joint aspiration
Joint injections can be effective at relieving the
symptoms associated with osteoarthritis of the knee. Broadly speaking, there
are two kinds of injections:
1. Corticosteroid injections (“cortisone shots”).These injections have been used to relieve arthritis
symptoms--including pain, swelling, and inflammation--for over 50 years.
Despite this, there have been surprisingly few well-designed scientific studies
to determine which patients might benefit from this treatment, or how long the
relief might last.
Just the same, cortisone shots
are commonly used--and often are successful--in helping to relieve arthritis
symptoms temporarily. Some patients are able to use them to get enough pain
relief to hold off joint replacement surgery for months or even years.
Cortisone shots are a treatment for pain; they do not alter the course of
arthritis, and they do not cure the condition.
2.
“Viscosupplement” injections. These are any of several compounds that are made
up of hyaluronic acid, which is a component of normal joint fluid. Some of the
common ones include Synvisc, Hyalgan, Supartz, and Orthovisc. They are given as
a series of injections, usually weekly for 3-5 weeks. There is some
disagreement as to how and whether they work. Read more details on JBJS Article - Corticosteroids VS. Hylan GF20 in (
) pdf format (0.13MB).Splints or braces
Two kinds of braces are sometimes used:
- Over-the-counter
knee sleeves, usually made of neoprene (wet suit material). These can be
purchased at drug stores and medical supply houses, and some patients find them
to be supportive and comfortable.
-
Arthritis
“Unloader” braces. These are custom-fitted to the knee by a bracing specialist
(an orthotist) and a prescription is needed. They are not for every pattern of
arthritis, and work best if the arthritis is limited either to the inside or
the outside of the knee. They can be expensive; insurance sometimes covers part
or all of the cost.
Alternative remedies
Nutritional supplementation (glucosamine and chondroitin
are the most common forms of this) is helpful to some patients, though the
science on this is not entirely supportive of their effectiveness.
There
are some studies to suggest that acupuncture can decrease the pain associated
with osteoarthritis of the knee.
Work
Looking for a “light duty” alternative to heavy manual
labor is one good approach for coping with osteoarthritis of the knee.
Many
patients who work at desks find that prolonged sitting in one position is
associated with stiffness and pain upon first arising, so periodically
standing, stretching, or moving the knee through an arc of motion can be
helpful at minimizing this “start-up” pain.Adaptive aids
For some patients, particularly those who cannot
tolerate surgical interventions for medical or other personal reasons, use of a
cane, crutches, or a walker can be of use.Resources
For more information about arthritis, contact the
Arthritis Foundation (www.arthritis.org).
For more information about orthopedic surgery, contact
the American Academy of Orthopedic Surgeons (www.aaos.org).
Condition research
Medical researchers continue to look into the causes
and best treatments for symptoms of osteoarthritis of the knee, which is very
common, and sometimes disabling.Pharmaceutical research
There is considerable research being done into the
medical management of osteoarthritis. Recently, increasing awareness of the
complications and problems associated with use of non-steroidal
anti-inflammatory drugs (NSAIDs), including effects on the kideys, the stomach,
and the heart.Surgical research
There is considerable research being done studying the
surgical approaches for this condition, including newer approaches for total
knee replacements; one of these, the minimally-invasive, quadriceps sparing
approach appears to help patients recover
more quickly and with less pain than traditional approaches to knee
replacements.
Other
surgical interventions, including osteotomy (cutting and re-orienting the bones
around the knee) and arthroscopy (using a surgical camera and small motorized
shavers to “clean up” the raw bone ends) also are topics of surgical research
relevant to patients with knee arthritis.
Summary of knee arthritis
- Osteoarthritis
of the knee is common and can result in severe pain and disability; as
a result of this condition, several hundred thousand people each year
in the U.S. undergo total knee replacement.
- Mostpeople with osteoarthritis of the knee can be managed without surgery.
- The cause of osteoarthritis of the knee is not known, but some risk factors include obesity, severe knee trauma, and genetics.
- There are
many other kinds of arthritis that can affect the knee; it is important
to make sure that the correct diagnosis is made, as some of these other
conditions are treated very differently.
-
Thediagnosis of osteoarthritis of the knee is usually very
straightforward, and is made in almost all cases by a physician taking
a thorough history, performing a physical examination, and getting
x-rays with the patient standing up.
Surgery for Knee Arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call the Bone & Joint Surgery Center at 206-598-BONE (2663) or Eastside Specialty Clinic at 425-646-7777 to make an appointment. Our clinical center is located in Seattle Washington, USA