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Knee osteoarthritis develops through wear and tear on the knee joint over the years. It affects people more as they get older, though some lucky people never suffer from any significant joint pains. Others might be unfortunate and develop arthritis at a younger age, often after an injury.

The wearing away of the knee joint cartilage produces the pain and swelling of osteoarthritis. This can be shown in most cases with a simple x-ray. The best first line treatment to reduce pain may well be exercise therapy. Surgery usually invovles replacing part or all of the joint.

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Osteoarthritis occurs as a consequence of wear and tear on the knee joint over the years. It tends to affect people more as they get older although some lucky people never suffer from any significant joint pains. Others might be unfortunate and develop symptoms of arthritis at a younger age possibly following an injury. 

In the knee, the end of the thigh bone (femur), the top of the shin bone (tibia) and the underside of the kneecap (patella) are all covered in smooth joint cartilage. This allows our joints to move freely without excess friction or pain. This knee joint cartilage is protected by the meniscus cartilages which act as shock absorbers. It is the wearing away of this joint cartilage that produces the pain and swelling of osteoarthritis.

The joint cartilage can gradually wear away over the years, made worse by high impact activities (such as physical labour or a lot of high impact sport). Obese patients and those who have suffered previous knee injuries have a higher risk of early osteoarthritis.

The most common symptom is pain. This tends to get gradually worse and start to impact sports, daily activities, and even sleeping. 

The knee can feel stiff and look very swollen. This is sometimes from excessive fluid and commonly from the knee growing an extra bone (osteophyte) to cope with the stress placed on it.

The loss of cartilage changes how straight your leg looks when standing – you may see this when looking in a mirror. A bow-legged deformity (varus) is most common, but it can also look knock-kneed (valgus).

Other symptoms can include the knee catching, clicking, locking, or giving way. 

Your GP or physiotherapist will usually diagnose your knee osteoarthritisby asking about your symptoms and examining your knee. The diganosis can be confirmed in most cases with simple x-rays of both knees when standing.  

MRI or CT scans can be ordered if the x-rays are not conclusive, or if anther knee condition is suspected. Ultrasound scans are rarely useful.

There is no cure for knee osteoarthritis, but there are many non-surgical options to manage the pain and reduce its impact on your daily life. Maintaining a healthy weight is the first step and can reduce strain on the knee to alleviate symptoms.

Regular resistance-based exercise is crucial to maintain your strength and maximise function. Low-impact activities such as swimming, yoga, walking and cycling can all help you keep fit and help your psychological wellbeing, but functional resistance work is key.

Click here to learn more about our non-operative osteoarthritis functional recovery programs.

Over the counter pain medications such as paracetamol (Panadol osteo) and ibuprofen (Nurofen) can relieve symptoms. Although your doctor can prescribe stronger painkillers which, they are not recommended for osteoarthritis as they have multiple side effects and don’t work well in the long term.

Cortisone, PRP (platelet rich plasma), and synthetic joint fluid injections don’t work for everyone and only temporarily relieve pain. There is a limit to how often they can be given safely: we use them to settle your knee so you can manage the functional exercises that provide long-term relief.

Some specific patterns of osteoarthritis can be helped with a brace that helps unload the side of the knee with the cartilage damage. We can prescribe these braces and organise for your fitting if we feel you are a good candidate. 

If your knee pain is not relieved by these therapies and is significantly impacting your quality of life, you may be a candidate for surgery. Surgical treatments can include:

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