Knee Arthritis: What Causes Arthritis? How to Best Manage Your Knee Arthritis?

What is Knee Arthritis?

The most common cause of Knee Arthritis is Knee Osteoarthritis (OA).

Knee osteoarthritis is a degenerative knee condition where the articular cartilage of your knee joint gradually wears away, exposing the underlying bone.

As your knee arthritis progresses, bony spurs also develop in and around your knee joint in response to the change in load distribution and biomechanics.

Within your knee there are two joints which can be affected by knee arthritis: thetibiofemoral joint - the joint between your thigh bone (femur) and your lower leg (tibia) and the patellofemoral joint (the joint between the kneecap and the femur itself).

What Causes Knee Arthritis?

There are several factors which have been found to predispose people to developing osteoarthritis in the knee joints:

Age
As you age it is normal for joint surfaces to “wear down”, especially the major weight bearing joints of the lower limb. The ability of joint cartilage to repair itself also declines as you grow older.

Weight
Your weight will directly affect the amount of load the joints in your lower limb have to support during weight bearing activities.

Previous Knee Joint Injury
Previous injury to your knee can change the biomechanics of your knee joint. This leads to abnormal distribution of load through the knee in everyday tasks.

Genetics
The gene that produces your articular knee cartilage is sometimes defective and can lead to either decreased lay down of cartilage, or normal lay down of defective cartilage on the joint surfaces.

Jobs or Sports that repeatedly load your knee joint
Joint compression is essential for stimulating joint nutrition. Repetition of activities that excessively load the knee joint, such as squatting, lifting heavy objects and running, has been linked to an earlier onset of knee arthritis.

What are the Symptoms of Knee Arthritis?

Knee Pain
- often with a gradual onset and progression
- often worse first thing in the morning or after periods of inactivity
- often aggravated with weight bearing activities such as walking, going up or down stairs, kneeling and squatting
Knee stiffness
Knee swelling
Warmth around the knee
Clicking or grating
Decreased strength of the lower limb muscles

How is Knee Arthritis Diagnosed?

Your physiotherapist or doctor will suspect signs of knee arthritis from how you explain your knee symptoms. They will also conduct a series of knee tests which help to identify signs of knee arthritis.

An X-ray may also be used to confirm the diagnosis, as well as establish the location and degree of your knee arthritis.

What is the Treatment for Knee Arthritis?

Physiotherapy

Knee arthritis is a degenerative condition. Physiotherapy treatment is aimed at improving the symptoms of the disease (i.e. knee pain, swelling, stiffness), and you should begin to notice a positive difference within one or a few physiotherapy sessions.

The main goals of physiotherapy for your knee arthritis are:

Reduce your knee pain and inflammation.
Normalise your knee joint range of motion.
Strengthen your knee: esp quadriceps (esp VMO) and hamstrings.
Strengthen your lower limb: calves, hip and pelvis muscles.
Improve your patellofemoral (knee cap) alignment and function.
Normalise your muscle lengths.
Improve your proprioception, agility and balance.
Improve your technique and function eg walking, squatting.

Knee Braces

Your physiotherapist may recommend the use of a knee brace to support your knee and help to de-load certain structures. There are many different styles available and it is important to find one that suits your individual needs!

PhysioWorks stocks an extensive range of knee arthritis braces. You can check them out here:

Knee Arthritis Surgery

In some cases, patients with knee arthritis choose to undergo knee surgery to address the degeneration in the knee. The most common forms of surgery for this condition are arthroscopes, partial or total knee replacements.

If your knee arthritis symptoms are reaching an unmanageable level and treatment results have plateaued, it may be worth talking to your doctor about your surgical options.

Risks of surgery include infection, persistent instability and pain, stiffness, and difficulty returning to your previous level of activity. The good news is that better than 90% of patients have no complications post-surgery.

Post-Surgical Knee Rehabilitation

Post-operative knee rehabilitation is one of the most important, yet too often neglected, aspects of knee surgery. The most successful and quickest outcomes result from the guidance and supervision of a qualified knee physiotherapist.

Your rehabilitation following knee surgery focuses on restoring full knee motion, strength, power and endurance. You will also require balance, proprioception and agility retraining that is individualise towards your specific functional needs.

For more information, please ask your physiotherapist.

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