What is knee osteoarthritis?
Wear and tear of the knee joint in which the smooth cartilage surfaces of knee are wearing away to expose bone. It may be related to prior injury, genetics, and/or body weight. The cartilage that cushions the bones of the knee softens and wears away. The bones then rub against one another, causing knee pain and stiffness.
What are the symptoms?
Pain, swelling, stiffness, deformity, limited walking/standing tolerance, inability to participate in sports/other activities, difficulty sleeping
What are the treatment options?
- Regular non-impact exercise if medically able (exercise bicycle, yoga, pilates, elliptical, swimming, water aerobics, etc.)
- Home exercise program or physical therapy focusing on strengthening muscles around the knee
- Weight loss
- Ice knee 2-3 times/day for 20 minutes – use a towel to protect your skin, ice pack(s), then wrap with an ACE wrap
- Activity modification (stop aggravating activities within reason)
- Bracing – simple knee sleeve or other brace
- Over the counter (OTC) Non-steroidal anti-inflammatory (NSAIDS) medications (if tolerated)
- Aleve, naproxen, Advil, ibuprofen, etc.
- Prescription NSAIDS (Meloxicam (Mobic), Diclofenac, etc)
- Other medications/supplements (if tolerated)
- Tylenol (do not exceed 3000mg/day)
- I highly recommend you avoid narcotic medications for arthritis pain.
- Assistive devices (trekking poles, cane, walker)
- Corticosteriod injections (may be given every three months if effective)
- Joint fluid therapy (viscosupplementation, chicken shots, etc.) – may be repeated every 6 months if effective
- Euflexxa, Hyalgan, Supartz , Synvisc-One
What if I still have pain?
If the conservative measures listed above stop working, you may be a candidate for surgery, which would be a partial knee replacement or total knee replacement. Please see your orthopaedic surgeon to discuss whether this would be recommended for you. In the meantime, work to optimize your medical condition - such as by losing weight, quitting smoking, keeping your blood sugars under control if diabetic, and staying active to maintain your strength and flexibility.
What is the difference between a partial knee replacement and total knee replacement?
Your knee is divided into three major compartments: the medial compartment (the inside part of the knee), the lateral compartment (the outside part of the knee), and the patellofemoral compartment (the front of the knee behind the kneecap).
Patients with osteoarthritis that is limited to just one part of the knee may be candidates for unicompartmental knee replacement (also called a "partial" knee replacement). In a unicompartmental knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and bone in the rest of the knee is left alone.
However, if you have osteoarthritis in more than one part of the knee, a total knee replacement would replace all of the parts of the knee affected by arthritis.