Knee osteoarthritis is a joint disease that causes pain, stiffness, and limited movement as a result of the deterioration of the joint cartilage over time. While exercise, weight control, and medication are used in the early stages, partial or total knee replacement may be considered in advanced cases.
What is knee osteoarthritis?
Knee osteoarthritis, also known medically as knee osteoarthritis, occurs when the cartilage and surrounding tissues in the knee joint change over time.
Cartilage is a smooth tissue that helps bones move freely and without friction within a joint. Thinning and deterioration of this structure can make movement between joint surfaces difficult.
The disease does not only affect the cartilage. In advanced stages, changes in bone structure, hardening around the joint, ligament damage, and decreased muscle strength may occur. The World Health Organization defines osteoarthritis as a degenerative joint disease that can affect the entire joint and surrounding tissues.
What causes knee osteoarthritis?
Knee osteoarthritis often doesn’t develop due to a single cause. Age, weight, genetic factors, previous injuries, and prolonged stress on the joint can all contribute.
Advanced Age
As we age, the ability of joint cartilage to regenerate may decrease. However, knee osteoarthritis is not only seen in older people.
Excess Weight
Increased body weight increases the load on the knee joint when walking and climbing stairs. Excess weight can also affect inflammatory processes in the body.
Previous Knee Injuries
Meniscus injuries, ligament tears, intra-articular fractures, and previous knee surgeries can increase the risk of osteoarthritis in later years.
Leg Curvature
In alignment disorders known as bow legs or club legs, one side of the joint may bear more weight than the other. This can accelerate cartilage wear in a specific area.
Intense and Repetitive Loading
Prolonged squatting, heavy lifting, or activities that constantly strain the knees can increase joint wear and tear in some people.
Genetic predisposition
People with a family history of knee osteoarthritis may be more likely to develop the disease.
What are the symptoms of knee osteoarthritis?
Knee osteoarthritis does not cause the same symptoms in every patient. While some people may have clear X-ray findings but limited pain, others may experience symptoms affecting daily life much earlier.
The most common symptoms are:
- Knee pain that worsens while walking.
- Difficulty climbing or descending stairs
- Pain when sitting and standing
- Stiffness after prolonged immobility
- Swelling and tenderness in the knee.
- A crackling or grinding sensation during movement.
- Reduced knee movement
- Curvature or deformity in the leg
- In later stages, rest and night pain.
Pain, stiffness, swelling, and difficulty in movement are common symptoms of knee osteoarthritis.
How does knee osteoarthritis begin?
Knee osteoarthritis progresses slowly in most patients. In the early stages, pain may only occur after long walks, using stairs, or strenuous activity.
These symptoms, which decrease with rest, may become more frequent over time. As wear and tear on the joint progresses, daily walking distance may shorten, knee movement may decrease, and nighttime pain may occur.
Osteoarthritis may sometimes begin only on the inner side of the knee. In some patients, the outer side or the joint surface behind the kneecap may be more affected.
How is knee osteoarthritis diagnosed?
The diagnosis begins with listening to the patient’s complaints and performing a detailed orthopedic examination.
During the examination;
- The area where the pain is located,
- Knee movements,
- Swelling and tenderness,
- Leg alignment,
- Muscle strength,
- Walking style,
- A feeling of looseness or instability in the joint.
It is evaluated.
X-ray
The most commonly used imaging method for evaluating knee osteoarthritis is a standing knee X-ray.
X-rays can be used to examine joint space narrowing, bone spurs, bone surface hardening, and leg alignment.
MRI Imaging
Not every patient needs an MRI. An MRI may be ordered if an additional problem involving the meniscus, ligaments, cartilage, or other soft tissues is suspected.
Computed Tomography
In some patients scheduled for prosthetic surgery, computed tomography (CT) scans can be used to evaluate bone structure in detail. In Mako robotic prosthetic surgery, a patient-specific three-dimensional knee model is created using CT data.
What are the stages of knee osteoarthritis?
Knee osteoarthritis can be classified as mild, moderate, or severe based on imaging findings.
Early Stage Knee Osteoarthritis
Mild narrowing of the joint space and minor bone changes may be observed. Pain usually occurs after prolonged walking or strenuous activity.
Moderate Knee Osteoarthritis
The narrowing of the joint space becomes more pronounced. Pain may increase when climbing stairs, squatting, and standing for long periods.
Advanced Stage Knee Osteoarthritis
Cartilage loss becomes pronounced, and the bone surfaces may move closer together. Pain may persist even at rest, knee movement may be reduced, and leg deformity may develop.
X-ray results alone do not determine treatment. The patient’s complaints and limitations in daily life must also be evaluated.
How is knee osteoarthritis treated?
Treatment for knee osteoarthritis is planned according to the severity of the disease, the patient’s age, weight, mobility, and the impact of pain on daily life.
The goal of treatment is to reduce pain, preserve mobility, and make daily life easier for the patient.
Non-Surgical Treatments for Knee Osteoarthritis
In early and middle-stage knee osteoarthritis, non-surgical methods are primarily used.
Exercise and Physical Therapy
Strengthening the muscles around the knee can help distribute the load on the joint more evenly.
Strengthening the anterior thigh muscles, maintaining range of motion, and engaging in low-impact activities are particularly important. Exercise is one of the fundamental practices recommended for improving pain and function in osteoarthritis of the knee.
Weight Control
In overweight patients, weight loss can help reduce the load on the knee joint.
A weight loss plan should be implemented through a combination of healthy eating and activities that don’t strain the legs, rather than through strenuous and uncontrolled exercise.
Daily Life Arrangements
Prolonged squatting, heavy lifting, and repetitive movements that strain the knees can be reduced.
Low-impact activities such as swimming, stationary cycling, and controlled walking are preferable.
Drug Treatments
Pain relievers or anti-inflammatory drugs can be helpful. However, these medications should not be used for extended periods without a doctor’s recommendation, as they may pose risks for stomach, kidney, heart, and vascular diseases.
Knee Braces and Supports
For some patients, using knee braces, canes, or insoles can help reduce the load on the joint.
If a cane is to be used, it is generally recommended to hold it in the hand on the opposite side of the painful knee.
Intra-articular Injections
For some patients who do not benefit sufficiently from non-surgical treatments, intra-articular injection options may be considered.
Cortisone Injection
It can be applied to reduce inflammation and pain within the joint. Its effect may vary from person to person and may be temporary.
Frequent and uncontrolled application is not suitable for joint tissues.
Hyaluronic Acid Injection
It can be applied to support the lubricating properties of joint fluid. It does not provide the same level of benefit in every patient and its effect may be limited in advanced osteoarthritis.
PRP Treatment
This involves injecting platelet-rich plasma, prepared from the patient’s own blood, into the joint. It can help reduce pain in some early and mid-stage diseases.
It cannot be said that PRP regenerates lost cartilage or completely cures advanced osteoarthritis.
Can knee osteoarthritis completely go away?
Knee osteoarthritis is not a disease where worn cartilage can be completely restored to its original state with medication.
However, with the right treatment and lifestyle adjustments, pain can be controlled, muscle strength can be increased, and the impact of the disease on daily life can be reduced.
The goal of the treatment is not so much to correct the X-ray image, but rather to enable the patient to move more comfortably.
When is surgery necessary for knee osteoarthritis?
Surgical treatment is not recommended simply because calcification is visible on X-rays.
Surgery may be considered in the following situations:
- Pain severely restricting daily life.
- Onset of pain at night and at rest
- Significant reduction in walking distance.
- Development of advanced knee deformity.
- Increased mobility limitations
- Insufficient benefit from medication, physical therapy, and injections.
- Imaging revealed advanced joint wear.
In advanced cases where non-surgical treatments are no longer able to control symptoms, knee replacement may be considered.
Partial Knee Replacement
If osteoarthritis is limited to only one part of the knee and the ligaments are in good condition, a partial knee replacement may be considered.
In this method, the entire knee joint is not replaced. Only the damaged section of the joint is replaced with a prosthesis, while aiming to preserve the healthy bone, ligaments, and cartilage.
Robotic partial knee replacement, performed with the support of the Mako robotic system, is also known as Makoplasty.
Total Knee Replacement
If osteoarthritis has spread to more than one section of the knee, a total knee replacement may be performed.
Damaged joint surfaces are prepared, and prosthetic components are placed on the femur and tibia. The aim is to reduce pain, correct leg alignment, and improve knee movement.
Robotic Knee Replacement
Robotic knee replacement surgery is the personalized planning of total or partial knee replacement surgery with the support of a robotic system.
In the Mako robotic system, a three-dimensional knee model is created from the patient’s computed tomography images. Using this model, the surgeon can plan the size of the prosthesis, the bone cuts, and the placement angle before the operation.
Haptic technology helps the surgical instrument remain within its designated working area. The surgery is performed not by a robot, but by an orthopedic surgeon controlling the system.
Can knee osteoarthritis progress without surgery?
The rate of disease progression varies from person to person. While some patients experience slow progression over years, others may develop significant loss of mobility in a shorter period.
Excess weight, leg deformity, previous injuries, and muscle weakness can affect the progression of the disease.
Being diagnosed with osteoarthritis does not necessarily mean surgery is required. Many patients can live a long life without needing surgery through appropriate exercise, weight control, and regular follow-up.
Knee Osteoarthritis Treatment in Adana
When planning knee osteoarthritis treatment in Adana, the patient’s age, pain level, range of motion, and the areas of the knee affected by the osteoarthritis should be evaluated together.
In the early and middle stages, exercise, physical therapy, weight management, medication, and injections can be used. In advanced osteoarthritis, partial or total knee replacement may be considered.
At Adana Ortadoğu Private Hospital, robotic partial and total knee replacement surgery can be planned for suitable patients thanks to the Mako robotic surgical system.
Knee Osteoarthritis Treatment with Op. Dr. Muhsin Dursun
Op. Dr. Muhsin Dursun evaluates patients with knee osteoarthritis, robotic prosthetic surgery, and other orthopedic diseases at Adana Ortadoğu Private Hospital.
Treatment for knee osteoarthritis is not the same for every patient. In the evaluation conducted by Op. Dr. Muhsin Dursun, the patient’s complaints, X-ray findings, leg alignment, muscle strength, and daily life expectations are considered together.
While conservative treatments are planned for patients for whom non-surgical methods are sufficient, in suitable patients with advanced joint wear, makoplasty, robotic total knee replacement, or traditional surgical options may be evaluated on an individual basis.
When should you see a doctor for knee pain?
If knee pain persists for more than a few weeks, is accompanied by swelling and limited range of motion, or if the pain affects daily activities, an orthopedic specialist should be consulted.
Sudden swelling, redness, warmth, inability to bear weight on the knee, or fever during knee replacement require immediate medical attention.
Early examination doesn’t automatically mean surgery. It allows for the identification of the true cause of the pain and ensures timely initiation of appropriate treatment.
