Knee Osteoarthritis and Knee Arthritis Symptoms: A Common Disease You Need to Know and Prepare For

Knee osteoarthritis is a disease caused by degeneration of the knee joint’s cartilage surface, leading to friction and knee arthritis.
Knee osteoarthritis is commonly found in aged adults, overweight people, those who use the knees heavily, or those who experienced knee accidents.
The symptoms start with knee pain, stiffness, and catching. Leaving untreated, the latter symptoms may include more aching, loud knee sounds, or joint deformity.
Diagnosing knee osteoarthritis involves history taking, physical examination, and X-ray imaging to assess the severity.
Knee osteoarthritis treatments range from behavioral modification and physical therapy to medication and surgery in severe cases.
Proper self-care helps slow knee degeneration, reduce pain from knee osteoarthritis, and maintain knee functions for as long as possible.
Consulting with a knee specialist is crucial for proper knee osteoarthritis treatment planning from the early stages.

Knee osteoarthritis has almost become a familiar term for the elderly. However, as the lifestyle today has changed, various convenient facilities and food have brought knee osteoarthritis to us earlier. Currently, we don’t find knee arthritis symptoms only in the elderly group, but also in adults aged 45 and above.

Table of Contents

What is knee osteoarthritis?

Knee osteoarthritis is a disease caused by degeneration and deterioration of the knee joint’s cartilage surface. Under normal conditions, functions of the cartilage surface include enabling smooth and unobstructed joint movements, as well as bearing the body weight.

The condition of knee arthritis will lead to inflammation at the cartilage surface and synovial membrane, causing synovial fluid to be less produced or lose its properties. This results in a thinner or, possibly, lost cartilage surface.

In patients with severe knee osteoarthritis, the joint surface becomes rough and unlubricated with bone spurs forming around the joint, causing more bowing deformity and loss of knee balance in parallel with the increased disease severity.

Causes or risk factors that lead to knee osteoarthritis and cartilage damage and deterioration

There are several knee osteoarthritis causes as follows:

Increasing age
Excessive body weight (overweight or obesity) with BMI exceeding normal criteria (BMI > 25)
Long-term heavy and continuous knee use, such as jobs requiring frequent heavy lifting or floor sitting, squatting, kneeling activities
Accidents that occurred in the knee area, such as knee bone fractures, kneecap fractures, anterior cruciate ligament tears, or meniscus tears
History of knee joint infections
Genetic predisposition to knee osteoarthritis
Various chronic inflammatory joint diseases such as rheumatoid arthritis, gout, etc.

How to know if you have "knee osteoarthritis

Patients with knee osteoarthritis will have symptoms resulting from abnormal physical characteristics of joints as a basis. These symptoms will advance along with increasing age or degeneration, and sometimes cause knee arthritis.

Knee arthritis often occurs periodically in degenerated knees and arises when there’s more injury to those knees, such as when patients use their knees extensively from standing, walking, going up and down stairs, to engaging in knee-damaging activities. For patients with more severe symptoms of knee osteoarthritis, knee arthritis may occur frequently or continuously which worsens the patients’ knee functions.

Knee osteoarthritis symptoms can be divided into 2 groups

1. Symptoms caused by abnormal physical characteristics of the degenerated knee

These will result in knee deformity (bowing inward-outward) or affect knee usage and movement. These symptoms include:

Narrow joint space at the degenerated knee: The narrowing of the joint space takes place due to lost cartilage and usually affects the inner joint space first. This causes knee tilting, which results in knee bowing deformity.
Bone spurs: The forming bone spurs at the edges of joint surfaces contribute to joint stiffness or limited knee bending and straightening abilities. When moving the knee, there are loud knee sounds like coarse sand in the joint or knee catching.
Symptoms affecting the muscles that mobilize the knee: As a consequence of the worn, rough, and unsmooth joint, the symptoms like heavy legs, leg fatigue, or weak legs occur because the muscles that mobilize and rotate the joint work harder in order to move the knee and perform various activities.

2. Symptoms caused by knee arthritis

Arthritis is a process when the body responds to things that cause injury to body tissues (in knee osteoarthritis, arthritis reacts to the worn and damaged cartilage). This involves increased inflammatory agents and white blood cells entering the inflammatory area. Knee arthritis symptoms caused by knee osteoarthritis include:

Knee pain: caused by increased inflammatory agents in the inflamed area. This is often the first important symptom of knee osteoarthritis. There will be pain, aching, catching, sharp, burning sensations felt around the joint, especially inside the knee. There may be pain in the front or back of the knee depending on the disease severity. When the symptoms get worse, there will be constant knee pain when moving, standing, and walking, which will make patients unable to use their knees as smoothly as before.
Knee swelling, redness, heat: caused by increased blood and fluid in the inflamed area.

Diagnosing knee osteoarthritis

History Taking

As patients with knee osteoarthritis often have the signs and symptoms previously mentioned, diagnosis of this disease can involve just history taking and physical examination without X-rays. X-rays of the knee are necessarily required for assessing disease severity levels and considering further treatment approaches.

X-ray

X-rays taken in standing weight-bearing position on both legs will show abnormalities of the knees such as narrowed knee joint spaces, bone spurs along the edges of the knee bones and kneecap bones. In severe cases, knee bowing deformity will also be found.

Initial knee osteoarthritis treatments for those with mild conditions

For those with knee osteoarthritis symptoms in the initial stage, as well as those who risk of developing this disease, there are 3 simple guidelines given as prevention and initial treatment of knee osteoarthritis:

1. Control your weight

People with their body weight above the standard should lose their weight.
It’s found that losing 5% of the body weight will start showing results of knee pain improvement.
For those who cannot lose weight despite their best efforts, they should be careful not to gain weight. The more weight gained, the greater the burden on our knees.

2. Avoid inappropriate knee use

Avoid standing or sitting in one position for a long period.
Avoid being in positions that bend your knees beyond a right angle (bending more than 90 degrees) such as kneeling, squatting, cross-legged sitting, or crouching. Knee bending creates increased pressure in the knee and will cause more damage to the cartilage surface.
Avoid carrying or lifting heavy objects for a long period because this will increase weight and burden on the knee.

3. Strengthen and regain knee muscle strength

Most people often misunderstand that walking and moving at work are already an exercise. In fact, it should be called a usage rather than an exercise. Therefore, when there’s heavy usage, it may cause more degeneration.
Knee muscle exercises are not difficult or complicated. They don’t require any equipment as well, just pay attention and spend some time on them.
The exercise postures start with sitting on a chair and resting your back on a backrest. After that, lift your feet up and tighten your thigh muscles by flexing your ankle for 5-10 seconds. Do it 15-30 times on each side, at least 3 times a day. The more you can do, the more you’ll strengthen the muscles around the knee.

Knee osteoarthritis treatment with surgery

In cases where knee osteoarthritis symptoms are in the severe stage, and medication or conservative treatment is ineffective, doctors will consider knee osteoarthritis surgery. This effective and precise treatment for knee osteoarthritis can reduce knee pain and allow patients to return to walking, standing, or performing daily activities normally with better quality of life.

For those with symptoms in the initial stage, the combination of self-care and knee muscle exercises can significantly improve disease symptoms, or even heal in some adult cases. For those with severe symptoms who cannot be treated with initial methods, it’s necessary to see medical specialists for advice on knee osteoarthritis treatments. There are various treatment methods to be chosen depending on each patient’s symptoms.

Who will deserve surgical or non-surgical method for knee osteoarthritis treatment?

Treating knee osteoarthritis is both science and art that cannot be clearly specified because each person’s injury symptoms and their severity are different. Today, we’ll get to know more about both surgical and non-surgical treatments of knee osteoarthritis, and which approach suits who.

Non-surgical treatment methods for knee osteoarthritis

Non-surgical knee osteoarthritis treatments are suitable for people whose disease symptoms are in initial to moderate stages, meaning that their symptoms are not severe and they don’t experience pain from movement or knee use that significantly impacts daily life.

The combination of self-care and treatments for knee osteoarthritis can significantly improve disease symptoms, or even heal in some adult cases. Non-surgical treatment methods for knee osteoarthritis are divided into behavioral modification, physical therapy, exercises, and medication.

1. Behavioral modification

This may be difficult, but behavioral modification helps greatly in treating knee osteoarthritis. The main behaviors that patients are suggested to do include:

Controlling body weight to be within standard criteria. It’s found that reducing body weight by 5% from the initial weight when experiencing knee pain will help improve the condition.
Avoiding using knees too heavily, such as not kneeling, squatting, cross-legged sitting, or crouching. Knee bending creates increased pressure in the knee and will cause more damage to the cartilage surface.
Avoiding carrying or lifting heavy objects for a long period because this will increase weight and burden on the knee.

2. Physical therapy and exercises

Physical therapy and exercises aim to strengthen and rehabilitate knee muscle strength.

Exercises to strengthen knee muscles focus on the front thigh muscles (Quadriceps) and back thigh muscles (Hamstring), which help support and bear body weight while absorbing the weight transferred to the knee. It’s found that thigh muscle exercises clearly help improve knee pain and prevent long-term knee pain.
For the elderly, the easiest and most suitable exercise is walking on flat ground at a speed and duration that doesn’t cause knee pain. The patients can walk on a treadmill or on normal ground, and should observe how long after walking that knee pain occurs. It means the duration is excessive and should be reduced, or the patient can change to walking on soft grass to help reduce impact on the knee.

3. Medication to treat knee osteoarthritis

If aforementioned treatments of knee osteoarthritis cannot reduce knee pain, medication must be involved, which should be under medical discretion and care.

Pain relievers and anti-inflammatory drugs are medications used to treat pain symptoms as they occur. They can effectively reduce pain during knee arthritis periods.

However, these drugs have temporary anti-inflammatory effects. When the drug effect wears off, pain symptoms can return. That’s because these drugs don’t treat knee osteoarthritis directly, but only treat the knee arthritis that knee osteoarthritis causes.

Therefore, using these drugs is recommended only when symptoms occur and for short periods only. They should be combined with other knee osteoarthritis treatments such as weight control or changing daily routines that harm the knee as well.

Importantly, using anti-inflammatory drugs requires great caution because they may lead to side effects. When being used continuously for long periods, anti-inflammatory drugs possibly cause increased blood pressure, decreased kidney functions, stomach ulcers, or gastrointestinal bleeding.

Steroid medication is commonly used for injection to reduce knee arthritis because it’s a fast-acting drug that reduces inflammation very well. Aside from that, it has quite significant side effects such as more sensitivity to infection. Normally, doctors will choose steroid injections only for patients who really need it, and avoid using them continuously multiple times or for extended periods.
Symptomatic slow-acting drugs of osteoarthritis (SYSADOA) are drugs that help reduce pain and knee arthritis from knee osteoarthritis. These drugs are slow to show their effects, but can control pain for long durations after being used for appropriate periods. Their effects usually start coming off 3-4 weeks after continuous drug use.

In general, these drugs are recommended for continuous use for about 3-6 months. Using drugs in this group aims to reduce pain as well as the amount of pain relievers and anti-inflammatory drugs used in knee osteoarthritis treatments. Additionally, some data shows that these drugs help slightly delay the deterioration and thinning of cartilage surfaces. Drugs in this group include glucosamine, diacerein, or chondroitin, etc.

Artificial joint lubricant injections (Viscosupplementation) are drugs used to inject directly into the joint. They act locally and aim at replacing the deprived joint fluid from knee osteoarthritis, helping reduce friction within the joint and knee arthritis for long periods. They may also help lessen pain and medication use for several months.

Viscosupplementation is suitable for patients who cannot continuously take anti-inflammatory pain medications due to side effects or having chronic conditions that prevent medication taking. There are various types of lubricant injections, mostly administered once a week into the joint space and typically involving a series of 1 to 5 injections.

Collagen-added supplements are substances considered an addition to treating knee osteoarthritis, not a direct treatment of knee osteoarthritis. Currently, they can be purchased ubiquitously and available in many forms, possibly more than a hundred types in the market.

These substances help reduce both pain and knee arthritis symptoms and are often advertised as being able to prevent and treat knee osteoarthritis. However, credible evidence from studies of these substances is still limited and their results are often not clear enough to register collagen-added supplements as treatment medications. Patients who want to use them are recommended to apply with careful consideration.

Surgical treatment methods for knee osteoarthritis

Surgical methods for knee osteoarthritis treatment are suitable for those whose symptoms do not improve after non-surgical methods. Those with severe knee osteoarthritis symptoms and pain that disturb their daily life are included as well, for example, severe pain when standing and walking, loose knee joints, or clearly visible knee bowing deformity, etc.

Surgery to treat knee osteoarthritis can be divided into two major approaches: bone realignment surgery to correct knee bowing deformity and artificial joint replacement surgery.

1. Bone realignment surgery to correct knee bowing deformity

This method requires cutting bone to create bone fractures, then the doctor will fix and stabilize the bone with metal fixation devices.

This surgical method extends the lifespan of using the original knee joint, but requires post-surgical care for the bone to heal well before fully returning to use the knee. It is suitable for young people who need to use their knees quite extensively for walking, standing, and working.

2. Artificial joint replacement surgery

This method works very well in reducing joint pain and knee bowing deformity from knee osteoarthritis. It helps restore normal knee functions and improve quality of life for patients with severe knee osteoarthritis who still have severe pain affecting daily life after non-surgical knee osteoarthritis treatments.

Artificial joint replacement surgery involves replacing the original degenerated, worn cartilage and knee joint with an artificial one. With years of surgical experiences of the medical team at kdms Hospital in Bangkok, Thailand, combined with advanced surgical devices and artificial joint technology, artificial joint replacement surgery has been performed with much less time, more accurate joint alignment and placement, and faster recovery with less pain.

However, treating knee osteoarthritis doesn’t have simply right or wrong answers because each patient’s symptoms and lifestyle are different. Consulting with medical specialists to get comprehensive information for decision-making is something patients should do for planning knee osteoarthritis treatments and having the best outcomes.

What are the perks of treating knee osteoarthritis at kdms Hospital?

Patients will gain the most benefits from having knee osteoarthritis treatments directly with orthopedic specialists, especially treatment effectiveness. At kdms Hospital in Bangkok, Thailand, we encompass medical experts specialized in bones, joints, and muscles, advanced medical technologies, and holistic approaches from diagnosis to recovery, enabling our patients to return to a great quality of life.

Q&A

Increasing age
Body weight exceeding normal criteria (overweight or obesity)
Long-term heavy and continuous knee use, such as jobs requiring frequent heavy lifting or floor sitting, squatting, kneeling activities
Accidents that occurred in the knee area, such as knee bone fractures, kneecap fractures, anterior cruciate ligament tears, or meniscus tears
Various chronic inflammatory joint diseases such as rheumatoid arthritis, gout, etc.