The three basic types of arthritis affecting the knee are osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. Knee pain and stiffness can develop gradually or have sudden onset. Often, pain is worse in the morning after inactivity, but can also increase after physical activities such as walking, climbing or kneeling. Doctors use a physical exam to evaluate walking, range of motion and joint tenderness. Also, X-rays, MRI and blood tests may be used to diagnose knee arthritis.
Lifestyle Changes
- Behavior modification
- Exercise
- Support devices
A wide range of treatment options exist for the treatment of knee arthritis. Effectiveness of different treatment varies from person to person. The goal is to reduce pain and increase function of the knee. Behavior modifications involving weight loss, exercise changes and minimizing aggravating activities can accomplish such goals. Losing weight can decrease excess stress on weight-bearing knee joints, which decreases pain while increasing mobility. Switching to activities such as swimming and cycling are less stressful on joints than running and jumping.
Prescribed exercise and physical therapy can strengthen leg muscles around arthritic joints. Stronger muscles can help reduce stress on the knee joints, which can alleviate pain while improving function. Also, supportive devices such as canes, shoe inserts and knee braces have the ability to reduce symptoms. Shoe inserts can cushion mechanical strain during walking to reduce stress on knee joints. Braces can be unloaded or supportive. Unloaded braces shift weight away from the joint, while a supportive brace supports the entire knee during weight loading.
Drug Treatment
- Anti-inflammatory
- Corticosteroids
- Others
Medication treatment is dependent on each individual. Usually, anti-inflammatory pain relievers are the first choice for treatment of early knee arthritis. Non-steroidal anti-inflammatory drugs and COX-2 inhibitors are commonly used for cases of knee arthritis with swelling and pain.
Corticosteroid injections may be prescribed for moderate to severe knee arthritis. A corticosteroid is a hormone normally produced by the adrenal cortex, which has a synthetic equivalent. Corticosteroid injections have been somewhat useful for swelling caused by knee arthritis, but may not be very beneficial in joint mechanics. Also, corticosteroid injections may cause joint damage when used long-term.
Other pharmaceutical treatment options involve a variety of different joint injection compounds. Some doctors feel that hyaluronic acid injections can increase the viscoelasticity of the fluid within the painful joint, which assists in joint mobility. Some rheumatoid arthritis injections use gold salt or other medications.
Surgical Treatment
- Arthroscopic debridement
- Osteotomy
- Total or partial arthroplasty
- Cartilage grafts
Arthroscopic surgery uses fiber optics to remove joint debris and repair torn cartilage, which may exacerbate or cause pain and inflammation in knee arthritis. An osteotomy is used to cut the long bones of the leg to improve knee alignment to reduce symptoms. Partial and total knee arthroplasty removes damaged knee joint cartilage and bone, which is replaced by plastic or metal implants. Cartilage grafting is used to replace damaged knee cartilage with healthy cartilage from other bones in your body. The aim is for the graft to repair the damaged area and alleviate knee discomfort.
Alternative Therapies
Glucosamine and chondroitin can be used as a dietary supplement to reduce knee pain. Both compounds are found in normal joints and it is thought that oral supplementation may help replace decreased amounts of both substances.
