North West Hip & Knee Clinic - Arthritis of the Knee


Mr Aslam Mohammed FRCS, FRCS (Orth)
Consultant Hip & Knee Surgeon

Specialising in:
Lower Limb Arthroplasty & Sports Injury
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Osteaorthritis of the knee

What is arthritis?


The term arthritis literally means inflammation of a joint, but is generally used to describe any condition in which there is damage to the cartilage. Inflammation is the body's natural response to injury. The warning signs that inflammation is present are redness, swelling, heat and pain. It can affect any synovial joint; the hip and knee joint are commonly affected by arthritis.

The cartilage (Hyaline cartilage) that coats the ends of bone in a joint is able to absorb load and stress. It has a very low coefficient of friction to allow smooth joint movement. The proportion of cartilage damage and synovial inflammation (the lining) and swelling of the joint varies with the type and stage of arthritis. Usually the early pain is due to inflammation. Later in the disease, pain is from the irritation of the worn joint structures and inability of the joint to move properly and smoothly.

causes of arthritis of the knee

What are the different types of arthritis?


There are many different types of arthritis the most common ones being Osteoarthritis and Rheumatoid Arthritis.

Osteoarthritis is the most common form of arthritis. It is often referred to as wear and tear arthritis as it involves the thinning and breakdown of the articular cartilage lining. The bone may lose shape and thicken at the ends or produce bony spurs (osteophytes). It causes pain in the joints and surrounding soft tissues and limits the range of movement of a joint. Osteoarthritis affects many joints including the large, weight bearing joints of the hips and knees and also the spine, hands, feet and shoulders. There are several reasons for the development of osteoarthritis including age, being overweight, heredity factors, and joint damage from a previous injury or during early development of a joint. The severe pain of osteoarthritis can be very tiring and disabling.

Rheumatoid arthritis is an auto-immune disease in which the body's immune system (the body's way of fighting infection) attacks healthy joints, tissues, and organs. Occurring most often in women of childbearing age, this disease inflames the lining (or synovium) of joints. It can cause pain, stiffness, swelling, and loss of function in joints. When severe, rheumatoid arthritis can cause deformity of the joints leading to disability and loss of function.

Rheumatoid arthritis affects mostly joints of the hands and feet and tends to be symmetrical. This means the disease affects the same joints on both sides of the body (like both hands and both feet) at the same time and with the same symptoms. About two to three times as many women as men have this disease. No other form of arthritis is symmetrical as a rule.

Ankylosing spondylitis describes a form of arthritis that mainly affects the joints of the spine particularly cervical spine(the neck). However it may affect other parts of the body, e.g. hips, shoulders, knees or ankles. It causes inflammation outside the joint where the ligaments and tendons are attached to the bone, whereas in most forms of arthritis the inside of the joint is inflamed. It usually affects the little joints between the vertebrae of the spine and tends to diminish the movement which takes place at these joints. It affects younger people, teenagers to mid thirties and more men than women.

arthritis of the knee what are the symptoms

What causes arthritis?


Predisposing factors to Osteoarthritis include Age, Gender, Race and Genetics all which cannot alter.
Potentially Preventable  predisposing factors include: Obesity, Injury and joint trauma- in the knee from fractures and torn ligaments and cartilage (menisci), Mechanical stress, Deformity and malalignment in the hip, growth abnormalities or childhood hip problems, Prior inflammatory disorders, Endocrine and metabolic disorders.

arthritic knees treatment options

 What are the symptoms of Arthritis?


Symptoms vary according to the form of arthritis. Each form affects the body differently. Arthritic symptoms generally include pain and swelling or tenderness in one or more joints, there can be redness or heat in a joint, stiffness and limitation of motion of the joint, early morning stiffness, and skin changes, including rashes. Overall as the disease progresses there is loss of activity and function with loss of quality of life despite conservative treatment.


arthritic knees treatment options

What you can do?

  • Consult a doctor to determine the type of arthritis you have. Treatment will depend on a correct diagnosis.
  • Take medication as recommended by your doctor
  • Rest/ and or exercise. A balance as advised by your doctor or health professional.
  • Protect your joint/s from further damage.
  • Pain relief such as heat or cold therapy
  • Weight control to prevent extra stress on weight bearing joints
  • Maintain your general health and well being.

top arthric treatments

What your doctor can do for you?


There is no cure for arthritis, so beware of 'miracle cures'. Your doctor may prescribe anti-inflammatory medicine. They may recommend occupational therapy or physiotherapy, which includes exercises and heat treatment. In severe cases, surgery may be suggested, such as a hip or knee replacement. The type of surgery will depend on your age and severity of the disease.

top arthric treatments

What are the treatment options?


Initial treatment for osteoarthritis is conservative with a balance of rest and exercise, avoiding vigorous weight bearing activities, education in arthritis management, support, and joint protection such as walking aids or braces, and non invasive pain relief techniques. Pharmacy measures include analgesic and anti- inflammatory medication, complementary medication, possibly injections into the joint of cortisone/ corticosteroids. OA should be managed with combined non pharmacological and pharmacological approaches.

Treatment of osteoarthritis focuses on decreasing pain and improving joint movement, and may include:

  • Education and understanding,
  • Exercises to keep joints flexible and improve muscle strength
  • support, from health professionals and family
  • Joint protection, to prevent stress or strain on painful joints e.g. suitable foot wear
  • Weight control to prevent extra stress on weight bearing joints
  • Physiotherapy and/ or heat or cold treatments.
  • Surgery to relieve chronic pain in damaged joints.

Does dieting, supplements and exercise help?


Medication approaches i.e. anti inflammatory gels/rubs, the use of non steroidal anti inflammatory medication, non narcotic analgesics such as paracetamol and complementary and alternative medications such as glucosamine with or without chondroitin and injections of glucocorticoids into the joint if needed.

Exercise is very important because it increases lubrication of the joints and strengthens the surrounding muscles, putting less stress on joints. Exercise in heated swimming pools-hydrotherapy can bring enormous relief from pain and stiffness. Also studies have shown that exercise helps people with arthritis by reducing joint pain and stiffness and increasing flexibility, muscle strength and energy. It also helps with weight reduction and offers an improved sense of well-being.

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North West Hip & Knee Clinic - Arthritis of the knees
Copyright Mr Aslam Mohammed 2009