Dr. Ekaterina Urch, orthopedic surgeon and knee specialist, covers the symptoms, causes, and best treatment options for knee arthritis.
What is arthritis?
Arthritis is the result of inflammation in one or more of your joints. This inflammation can cause pain, swelling, and stiffness in various joints within the body and can even lead people to replacing their joints because the arthritis has interfered with their every-day activity level. This can be particularly true with arthritis felt in the knee, one of the more common areas where arthritis can occur. Depending on how bad the pain is, it can interfere with the activities people enjoy and can keep them from pursuing an active life.
Types of Arthritis
Not all types of arthritis are created equal. In fact, there are more than 100 different forms of arthritis. However, the two more common types of arthritis include osteoarthritis and rheumatoid arthritis. Osteoarthritis, which is known as a degenerative “wear-and-tear” type of arthritis, is commonly found in the knee. It is rare for osteoarthritis to be found in younger people. It is more commonly found in people 50 years of age and older.
Why is osteoarthritis causing you so much pain?
Your joints contain cartilage between the bones to act as a protective cushioning. Osteoarthritis is the cartilage wearing away, becoming frayed and rough. When the protective space is compromised, bone on bone rubbing will produce painful bone spurs. The development of osteoarthritis can occur slowly, and the pain will worsen over time.
Unlike osteoarthritis which can occur in a single joint, rheumatoid arthritis usually affects the same joint on both sides of the body. Known as an autoimmune disease, rheumatoid arthritis attacks multiple joints throughout the body, resulting in pain and stiffness. This autoimmune disease causes a person’s immune system to attack its own tissues, damaging healthy tissue such as cartilage and ligaments, and softening bone.
After a traumatic injury occurs to a joint, posttraumatic arthritis can develop. In areas like the knee, if a broken bone has damaged the joint surface, this could lead to arthritis in the knee joint years following the injury.
Symptoms of Arthritis
Pain and inflammation from arthritis generally develop over time. “Swelling certainly can be a symptom of arthritis. At some point you could have what are similar to potholes in your cartilage, or you could get popping, clicking, and catching in your knee. It may start to feel like bones are rubbing together, which is a common sign that it is time to seek treatment,” states knee specialist at The Center, Dr. Ekaterina Urch.
Other symptoms of knee arthritis:
- The joint may become stiff and swollen, making it difficult to bend and straighten the knee.
- Pain and swelling may be worse in the morning, or after sitting or resting.
- Vigorous activity may cause pain to flare up.
- Loose fragments of cartilage and other tissue can interfere with the smooth motion of joints. The knee may “lock” or “stick” during movement. It may creak, click, snap or make a grinding noise (crepitus).
- Pain may cause a feeling of weakness or buckling in the knee.
- Many people with arthritis note increased joint pain with changes in the weather.
Nonsurgical treatment for Knee Arthritis
When a patient is ready to address their arthritis, treatment will first be approached from a nonsurgical standpoint. Our orthopedic doctors in Bend have a number of different nonsurgical options they will first discuss with their patients and have them try before considering surgical treatment options.
- Some of these nonsurgical recommendations could help slow the progression of arthritis in the knee:
- Minimize activities that aggravate the condition, such as climbing stairs.
- Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) will put less stress on your knee.
- Losing weight can reduce stress on the knee joint, resulting in less pain and increased function.
Other nonsurgical options to help ease arthritis pain:
- Physical Therapy
- Assistive Devices
- Applying heat or ice, using pain-relieving ointments or creams, or wearing elastic bandages to provide support to the knee may provide some relief from pain.
What medications help relieve knee pain from arthritis?
There are many different types of drugs that can help treat arthritis of the knee. Different patients respond in different ways to medications, and because of this, a doctor works closely with their patients to determine which medications and dosages are safe and effective.
Some of these medications may include:
- Over-the-counter, non-narcotic pain relievers and anti-inflammatory medications.Like all medications, over-the-counter pain relievers can cause side effects and interact with other medications you are taking. Be sure to discuss potential side effects with your doctor.
- Another type of pain reliever is a nonsteroidal anti-inflammatory drug, or NSAID (pronounced “en-said”). NSAIDs, such as ibuprofen and naproxen, are available both over-the-counter and by prescription.
- Corticosteroids (also known as cortisone) are powerful anti-inflammatory agents that can be injected into the joint.
Surgical Treatment for Knee Arthritis
Should pain reach the point of disability for a patient and nonsurgical treatment is no longer effective, a doctor may recommend surgery to help restore function. As with all surgeries, there are some risks and possible complications with different knee procedures. Your doctor will discuss the possible complications with you before your operation.
Arthroscopy. During arthroscopy, doctors use small incisions and thin instruments to diagnose and treat joint problems.
Arthroscopic surgery is not often used to treat arthritis of the knee. In cases where osteoarthritis is accompanied by a degenerative meniscal tear, arthroscopic surgery may be recommended to treat the torn meniscus.
Cartilage grafting. Normal, healthy cartilage tissue may be taken from another part of the knee or from a tissue bank to fill a hole in the articular cartilage. This procedure is typically considered only for younger patients who have small areas of cartilage damage.
Synovectomy. The joint lining damaged by rheumatoid arthritis is removed to reduce pain and swelling.
Osteotomy. In a knee osteotomy, either the tibia (shinbone) or femur (thighbone) is cut and then reshaped to relieve pressure on the knee joint. Knee osteotomy is used when you have early-stage osteoarthritis that has damaged just one side of the knee joint. By shifting your weight off the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in your arthritic knee.
Total or partial knee replacement (arthroplasty). Your doctor will remove the damaged cartilage and bone, and then position new metal or plastic joint surfaces to restore the function of your knee. The doctor and patient determine whether inpatient or outpatient surgery will best fit the patient’s needs and abilities.