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Last Updated on August 29, 2023 by Shabnam Sengupta
The most common type of arthritis is osteoarthritis. Osteoarthritis most commonly affects knee joints to cause knee osteoarthritis. This condition increases the risk of fractures in the patella, tibia, or femur. Knee osteoarthritis can strike anyone at any age. However, the chances of having it increase after the age of 45. Knee osteoarthritis can also occur as a result of an injury, infection, or obesity and over-weight. In some cases, it may also occur due to hormones and genetics. Surprisingly, osteoarthritis is more common in females than in males.
According to a research paper published in the Lancet journal, there were approximately 654.1 million individuals aged 40 and older with knee osteoarthritis in 2020. In India, knee osteoarthritis is a significant concern, particularly among older adults and individuals with certain risk factors. Prevalence rates of osteoarthritis among individuals over the age of 40 range from 16% to 23%, with a higher prevalence observed in older age groups. The economic burden of knee osteoarthritis is substantial, with healthcare costs associated with treatment and management contributing to the overall financial impact. Fractures and related complications have a profound negative impact on the affected individuals’ quality of life, mobility, and independence, which in turn affects society as a whole. Chronic pain and the need for long-term home care are common consequences of this condition.
What are the symptoms of knee osteoarthritis?
Pain
Persistent pain in the knee joint is the most common symptom of knee osteoarthritis. The pain may be dull or sharp and can worsen with activities such as walking, climbing stairs, or standing for extended periods. Pain may also increase after periods of inactivity.
Stiffness
Stiffness in the knee joint, particularly after periods of rest or inactivity, is a common symptom of knee osteoarthritis. The knee may feel stiff and difficult to move, making it challenging to move or bend the knee.
Swelling
Swelling or inflammation in the knee joint is a symptom of knee osteoarthritis. The joint may appear visibly swollen, feel warm to the touch, and be accompanied by a sensation of tightness.
Reduced Mobility
Another symptom of knee osteoarthritis is the decrease in the knee joint’s range of motion. It may become difficult to fully straighten or bend the knee, limiting flexibility and mobility.
Crepitus
One of the very common symptoms of knee osteoarthritis is crepitus. It refers to a crackling or grating sensation that one can feel or hear when moving the knee joint. The roughening or wearing down of the cartilage within the joint causes this noise.
Weakness
Some individuals with knee osteoarthritis may experience muscle weakness around the knee joint. This weakness can contribute to instability and difficulties with balance and walking.
Functional Limitations
As knee osteoarthritis progresses, individuals may experience limitations in performing daily activities, such as walking, climbing stairs, or getting up from a seated position. These functional limitations can significantly impact the overall quality of life.
What are the causes of knee osteoarthritis?
The causes of knee osteoarthritis can be multifactorial, involving a combination of genetic, biomechanical, and lifestyle factors. Here are some common causes:
Chronic injury and joint stress
People who spend a lot of time on their feet, and do heavy lifting while standing, squatting, or crawling frequently may have ‘mini-traumas’ in their knee joints. This can cause knee osteoarthritis.
Lack of physical activity
While too much strain on the knee joint can lead to arthritis, so can a lack of it. To promote cartilage health and repair, the knee joint cartilage must be subjected to weight-bearing stress. Prolonged lack of physical activity can also cause knee osteoarthritis.
Muscle tone issues
When the hamstring, quadriceps, and calf muscles are weak, the knee cartilage and underlying bone endure greater stress. Knee osteoarthritis can develop as a result of this.
Biochemical changes
Research has identified certain biochemical abnormalities in knee joints that osteoarthritis causes.
Joint Misalignment
Abnormal alignment of the knee joint, such as bowlegs or knock knees, can place uneven stress on the joint surfaces, leading to increased wear and tear.
What are the risk factors associated with knee osteoarthritis?
Age
With increasing age, the cartilage undergoes more wear and tear, and its ability to mend decreases.
Weight
Strain can occur on a joint due to an increase in weight, particularly on the knees. Every pound acquired may add 3 to 4 pounds of additional weight to the knees.
Heredity
This includes genetic changes that may increase a person’s risk of developing osteoarthritis.
Gender
Osteoarthritis of the knee affects more women than men.
Repetitive stress injuries (RSIs)
These injuries occur when repeated stress occurs on a joint. This usually depends on a person’s occupation. People who work in jobs that require a lot of physical activity that strains the joints are more prone to developing osteoarthritis.
Athletes
Athletes who participate in soccer, tennis, or long-distance running may be more likely to develop osteoarthritis of the knee.
Other diseases
Osteoarthritis is more common in people who have rheumatoid arthritis. This type of osteoarthritis occurs in those with another joint disease, called secondary arthritis.
Metabolic issues
Osteoarthritis is more common in those with metabolic problems, such as iron overload or excess growth hormone.
What is the diagnosis process of knee osteoarthritis?
Knee osteoarthritis is typically diagnosed through clinical evaluation, medical history assessment, and diagnostic imaging. The following are the common methods for the diagnosis of knee osteoarthritis:
Medical history
The healthcare provider will discuss your symptoms, their duration, and any previous injuries or medical conditions that may be contributing to your knee pain.
Physical examination
A physical examination by your doctor will be the first step in the diagnosis of knee osteoarthritis. The healthcare provider will perform a physical examination of your knee joint, assessing its range of motion, stability, and signs of inflammation. They may also look for joint swelling, tenderness, and the presence of crepitus (a crackling sound) during movement.
Imaging studies
Various imaging techniques may be used to evaluate the knee joint and confirm the diagnosis of osteoarthritis. These may include:
- X-rays: Knee osteoarthritis X-ray images provide detailed structures of the bones and can reveal joint space narrowing, bone spurs, and other characteristic changes associated with osteoarthritis. X-rays show bone and cartilage deterioration as well as the existence of bone spurs. This may aid in the diagnosis of knee osteoarthritis. When X-rays do not reveal a clear cause for joint discomfort or when the X-rays indicate that other types of joint tissue may be injured, MRI scans may be ordered.
- Magnetic Resonance Imaging (MRI): MRI scans use powerful magnets and radio waves to produce detailed images of the knee joint, including the cartilage, ligaments, and surrounding soft tissues. This can help assess the extent of cartilage damage and identify other possible causes of knee pain.
- Ultrasound: Ultrasound imaging can be used to visualize soft tissues, such as the synovium and ligaments, and may help identify inflammation or fluid accumulation within the joint.
- Laboratory Tests: While there are no specific blood tests for the diagnosis of knee osteoarthritis, blood tests may be ordered to rule out other conditions that can mimic osteoarthritis, such as rheumatoid arthritis.
What are the complications associated with knee osteoarthritis?
- Stiffness and pain
- Physical and mobility challenges.
- Osteoarthritis causes joints to become stiff, weak, and painful over time. As a result, you might not be able to accomplish the things you used to be able to do.
- Difficulty in walking, going up and down a staircase, etc.
How is knee osteoarthritis treated?
The treatment of knee osteoarthritis aims to alleviate pain, improve joint function, and enhance the individual’s overall quality of life. The treatment approach may involve a combination of non-pharmacological interventions, medications, and, in severe cases, surgical options. Here are some common treatment strategies for knee osteoarthritis:
Non-Pharmacological Interventions
- Weight management: Maintaining a healthy weight or losing excess weight can reduce stress on the knee joint.
- Exercise and physical therapy: Strengthening exercises, low-impact aerobic activities, and flexibility exercises can help improve joint stability, and mobility, and reduce pain.
- Assistive devices: The use of assistive devices like braces, orthotics, or walking aids can provide support and reduce pressure on the knee joint.
- Hot and cold therapy: Applying heat or cold packs to the knee can help alleviate pain and inflammation.
Pharmacological Interventions
- Analgesics: Over-the-counter pain relievers like acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce inflammation.
- Topical Medications: Creams, gels, or patches containing NSAIDs or capsaicin can be applied directly to the knee joint for localized pain relief.
- Intra-Articular Injections: Corticosteroids or hyaluronic acid injections can relieve temporary pain and reduce inflammation in the knee joint.
Surgical Interventions:
- Arthroscopy: Minimally invasive surgery to repair or remove damaged tissue within the knee joint.
- Osteotomy: A surgical procedure that involves reshaping or realigning the bones to relieve pressure on the damaged area.
- Total Knee Replacement: In severe cases, the damaged knee joint may be replaced with an artificial joint made of metal and plastic components. You must consult the doctor as they will suggest to you when to undergo knee replacement surgery.
Complementary and Alternative Therapies:
- Acupuncture: The insertion of thin needles into specific points on the body to help reduce pain and improve symptoms.
- Herbal Supplements: Some herbal supplements, such as glucosamine and chondroitin sulfate, are believed to provide symptom relief, although scientific evidence is mixed.
The choice of treatment depends on various factors, including the severity of symptoms, individual preferences, and the healthcare provider’s recommendations.
How to prevent knee osteoarthritis?
The following measures will help in the general health of the knees and may prevent the development and progression of knee osteoarthritis:
While it may not be possible to prevent knee osteoarthritis entirely, certain lifestyle modifications and strategies can help reduce the risk or delay the onset of the condition. Here are some preventive measures that may be beneficial:
Maintain a healthy weight
Excess weight puts additional stress on the knee joints, increasing the risk of osteoarthritis. Maintaining a healthy weight or losing weight if necessary can help reduce the load on the joints and may prevent you from knee osteoarthritis.
Exercise regularly
Exercise helps strengthen the muscles around the knee joint, improves joint stability, and supports overall joint health. Regular exercise may prevent you from knee osteoarthritis. Engage in regular exercise that includes a combination of cardiovascular activities, strength training, and flexibility exercises.
Protect your joints
When participating in sports or physical activities, use appropriate protective equipment, such as knee pads, to minimize the risk of knee injuries that can lead to osteoarthritis.
Practice good posture and body mechanics
Maintain proper posture and body mechanics during activities such as sitting, standing, lifting, and bending to minimise excessive stress on the knee joints.
Avoid repetitive knee stress
Limit activities that involve repetitive stress on the knees, such as kneeling, squatting, or prolonged periods of standing, especially on hard surfaces. This may aid in the prevention of knee osteoarthritis.
Use joint-supporting footwear
Wear comfortable and supportive shoes that provide cushioning and shock absorption to reduce the impact on the knee joints.
Warm up and cool down
Before engaging in physical activities, warm up your muscles and joints with gentle exercises and stretching. Afterwards, cool down and stretch to help maintain flexibility and prevent muscle tightness.
Maintain a healthy lifestyle
Adopt a healthy lifestyle that includes a balanced diet rich in nutrients, adequate hydration, and avoiding smoking, as smoking has been associated with an increased risk of osteoarthritis.
FAQ on Knee Osteoarthritis
Are diabetes and knee osteoarthritis related?
Diabetes and knee osteoarthritis share risk factors like obesity and inflammation. They can indirectly affect each other due to limited physical activity caused by osteoarthritis and potential medication interactions. Managing both conditions requires close medical supervision and lifestyle adjustments.
Can knee osteoarthritis affect kidney diseases?
Knee osteoarthritis and kidney diseases primarily affect different parts of the body. But they may indirectly influence each other due to shared risk factors, medications, inflammation, and reduced physical activity.
Can knee osteoarthritis cause heart problems?
No, knee osteoarthritis does not directly cause heart problems. It is a degenerative joint disease affecting the cartilage and bones, not the heart. However, some risk factors associated with osteoarthritis, such as obesity and inactivity, may contribute to developing heart issues over time.
Can knee osteoarthritis cause liver problems?
Knee osteoarthritis is primarily a joint-related condition and does not directly cause liver problems. However, certain medications used to manage knee osteoarthritis, such as acetaminophen (paracetamol) and nonsteroidal anti-inflammatory drugs (NSAIDs), can potentially affect the liver when used excessively or inappropriately. Prolonged or high-dose use of these medications can contribute to liver damage.
Does high cholesterol cause knee osteoarthritis?
There is no direct evidence to suggest that high cholesterol causes knee osteoarthritis. Osteoarthritis primarily results from wear and tear on the joints over time, genetic factors, and other risk factors such as age, obesity, and joint injuries. However, high cholesterol levels and related conditions like obesity can contribute to other health issues that may indirectly affect joint health and exacerbate osteoarthritis.
Why is knee osteoarthritis a sign of weak bones?
Knee osteoarthritis is not a direct sign of weak bones. It is a degenerative joint disease that primarily affects the cartilage in the joints, not the bones themselves. However, underlying bone health can play a role in the development and progression of osteoarthritis. Factors such as reduced bone density or osteoporosis can weaken the support for joints, potentially increasing the risk of joint damage and worsening osteoarthritis symptoms. So, while osteoarthritis is not a sign of weak bones per se, the overall health of the bones can impact the condition's severity and progression.
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