Everything You Need To Know About Knee Osteoarthritis
Medically Reviewed By:
Knee osteoarthritis (OA) is one of the most common orthopedic conditions. Pain and discomfort related to knee OA may negatively impact a person’s day-to-day activities and quality of life.
The treatment for knee pain associated with osteoarthritis has typically included physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs), hyaluronate, or corticosteroid injections, and surgery. Most of these treatments, however, may present challenges. NSAIDs, for example, can cause ulcers and may increase the risk of heart problems.
Read on to learn more about knee OA and all the treatment options to discuss with a physician.
What Is Knee Osteoarthritis?
OA, also called degenerative joint disease, is the most common form of arthritis that affects the knee. In contrast to rheumatoid arthritis (RA) and other autoimmune diseases, knee OA is caused by small amounts of damage over time to the smooth cartilage covering the bones.
As cartilage wears away, bones are more susceptible to bone spurs or lumps. These bony growths can change the shape and structure of the knees. Without the protective cushioning of cartilage, the bones rub against each other, which may cause swelling and pain.
Knee osteoarthritis stages range from normal to severe (also known as bone-on-bone). Below is a list of all of the stages:
- Stage 0 (Normal): Your knees are healthy if you are at stage 0. There is no arthritis in your knees.
- Stage 1 (Minor): There may be some wear and tear on your knee joint, but you might not feel any pain.
- Stage 2 (Mild): Joint pain and stiffness may begin in the mild stage along with small amounts of lost cartilage, but the remaining cartilage keeps the bones from rubbing together.
- Stage 3 (Moderate): As cartilage thins, bone spurs may develop. You can experience more pain due to swelling. You may have pain when performing weight-bearing activities. Activities like kneeling, climbing stairs, running, walking, and even standing stress your joints. The pain becomes more pronounced after you have rested your knees for a while.
- Stage 4 (Severe): Cartilage is almost all gone once this stage is reached. Leg range of motion may often be affected. This stage impacts people differently, with some patients being able to work out and experience only slight swelling afterward, while others may become unable to bend their knees due to pain and swelling.
Recognizing The Signs And Symptoms
Chronic pain is one of the many symptoms of arthritis of the knee. Symptoms of knee arthritis can include the following:
- Gradually increasing pain during activities
- Swelling
- Crackling sounds
- Buckling and locking
- Limited range of motion
- Deformed knee
- Morning joint stiffness
- Knee Hyperextension: Knee hyperextension occurs when the knee bends backward beyond its normal range, often due to ligament laxity or injury. It may cause pain, swelling, and instability, increasing the risk of further joint damage. Read More About Knee Hyperextension.
Common Causes And Risk Factors
Osteoarthritis can be classified as either primary or secondary. Primary osteoarthritis is also called degenerative joint disease and is the most common form of arthritis. Secondary osteoarthritis often results from another disease, infection, injury, or deformity.
These are some of the most common causes and risk factors for knee arthritis:
- Heredity
- Aging
- Obesity
- Repetitive stress injuries
- Strenuous physical activities
- Past surgeries
- Other joint-related illnesses
Examining And Diagnosing Knee Arthritis
To diagnose knee arthritis, the physician typically performs a physical examination, a health history, lab work, and imaging.
- Physical Examination: During the physical examination, your doctor will typically look for signs of swelling, tenderness, and deformity in the joint. The doctor will also assess your knee’s range of motion and see if it hurts or feels stiff. Your doctor may also perform special tests to check for knee stability and eliminate other possible causes of knee pain.
- Imaging Tests: The doctor may order X-rays to check for bone spurs or other signs of arthritis, such as loss of joint space. In addition, you may need an MRI or CT scan to better view your knee joint.
- Laboratory Tests: Depending on your symptoms and family history, the doctor may order blood tests to check for inflammatory markers associated with arthritis. If necessary, the doctor may take a fluid sample from your knee joint and examine it under a microscope. Synovial fluid, or joint fluid, can show signs of infection or inflammation. If there is lab work, the doctor reviews the test results and helps to make a diagnosis.
Conventional Treatment Options
When treating knee arthritis, the goals are to relieve symptoms and to improve joint function, muscle strength, and quality of life. An individual and their physician can decide on a combination of treatment options for the best results.
Nonsurgical
Conservative treatments are often the first line of care for managing pain and improving function without surgery. These approaches may help reduce symptoms, may help promote healing, and may help support long-term mobility.
- Using support / Brace: Braces or supports can stabilize the affected area and limit movement that might worsen the condition. They also help reduce pain by offloading stress from joints or muscles.
- Physical therapy: A customized exercise program strengthens muscles, improves flexibility, and restores movement. It also helps correct posture and body mechanics to prevent further injury.
- Occupational therapy: Focuses on helping patients manage daily tasks more easily and safely. It includes ergonomic adjustments and strategies to protect joints during routine activities.
- Weight loss: Losing excess weight reduces strain on weight-bearing joints, especially the hips, knees, and lower back. Even small weight loss can lead to significant improvements in pain and mobility.
- Acupuncture: This traditional technique uses thin needles to stimulate specific points in the body to relieve pain. It may also promote relaxation and reduce inflammation.
Therapeutic Injections
Injections can offer targeted pain relief and improve joint function when other treatments fall short. They are minimally invasive and often used alongside other therapies.
- Hyaluronic Acid: A substance that already exists in the joints, it is believed to provide lubrication and cushions the joint, potentially reducing pain and improving mobility. However, recent studies have shown they may have mixed results and also that they may yield improved outcomes when combined with PRP.
These types of anti-inflammatory medication can reduce swelling and pain in the knee. Despite the fact that they can provide short-term relief from knee OA, they may not be a good long-term solution as steroid injections have been shown to be ineffective and cause further destruction of knee cartilage, among other side effects.
- Platelet-Rich Plasma (PRP): Platelet-rich plasma (PRP) injections use a concentration of platelets from a patient’s own blood to support the natural repair process, helping address various musculoskeletal conditions, including joint and tendon injuries. Read More About PRP Injections.
PRP injections are made from concentrated platelets from a patient’s own blood. Platelets release growth factors that may reduce swelling and stimulate repair within the joint. Compared to other therapeutic injections, they may be associated with fewer side effects and potentially longer-lasting outcomes. How PRP is injected is crucial for the best clinical outcomes.
PRP placement is often performed with image-guided injections. Blind injections may be considered less precise because there is less assurance of the PRP reaching the targeted tissue.
Physicians in the licensed Regenexx network use Regenexx SCP, a proprietary formulation of PRP that is designed to be more concentrated than many preparations from non-Regenexx providers achieve. See how a procedure using Regenexx injectates helped Stephanie with her chronic pain from knee arthritis in the video below.
*Individual outcomes may vary. For more information about patient outcomes, please visit our Patients’ Results page: https://regenexx.com/results/.
Regenexx Approach For Knee Osteoarthritis
Procedures using the Regenexx approach are typically less invasive than typical surgery, may require less downtime, and may help reduce the need for pain medications or prescriptions.
Physicians use ultrasound-guided technology to precisely inject an individual’s own bone marrow concentrate, which contains stem cells, directly where it’s needed in the knee joint to support the body’s natural healing abilities, potentially offering an alternative to surgery or medication.
Once an individual has been thoroughly evaluated, the physician can customize a treatment plan based on their specific needs.
Surgical Procedures
Surgery can be an effective last-resort treatment for severe knee OA, particularly in cases where other more conservative treatments have not been successful. The most common surgical procedures are:
- Osteotomy, or cutting of bone in the knee
- Partial knee replacement
- Total knee replacement
- Cartilage implantation or transplantation
- Synovectomy or removal of joint fluid
However, surgery may not be the best solution for all individuals with knee OA for several reasons:
- Like any surgical procedure, knee surgery carries some risks, including infection, bleeding, blood clots, and anesthesia complications.
- It can take several weeks (or even months) for someone to recover from knee surgery, during which time they may experience pain, swelling, and limited mobility.
- While knee surgery may alleviate some symptoms of knee OA, it is not always a cure. Knee replacement surgery, for example, involves removing the damaged joint and replacing it with an artificial joint. However, even after surgery, about 20% of patients experience residual pain or limited mobility.
- The cost of knee surgery can be high, and not all insurance plans cover it fully.
What Can You Do To Help Prevent Knee Arthritis?
With healthy lifestyle factors, individuals may be able to slow the progression of the disease.
Maintain a Healthy Weight
Obesity is a risk factor for knee OA because excess weight puts extra stress on the knees. Therefore, maintaining a healthy weight may help lower the risk of getting the disease.
Exercise Regularly
Regular exercise can help strengthen the muscles around the knee joint and improve flexibility. Low-impact activities like walking, biking, and swimming can help reduce your risk of knee OA symptoms.
Help Reduce Inflammation
Eating anti-inflammatory foods as part of a balanced diet can help prevent or reduce inflammation. Consuming fruits and vegetables that are rich in antioxidants is essential. In addition, supplements like omega-3 fish oil, turmeric, and curcumin have anti-inflammatory properties and are available without a prescription.
FAQs
While cartilage is important for maximal functioning, its loss is not what causes pain. The most consistent MRI finding associated with pain is swelling in the bone called bone marrow edema (BME) or a bone marrow lesion (BML). Research on knee pain due to arthritis has shifted from cartilage loss to bone marrow swelling.
Arthritis is a general term that describes joint inflammation. There are two types of arthritis:
1. Osteoarthritis (OA) – also called degenerative joint disease, is the most common type of arthritis and happens when the cartilage in your joints breaks down, often in your hips, knees, and spine.
2. Rheumatoid arthritis (RA) – is an autoimmune disorder where the immune system identifies the lining of the joints (synovium) as a threat and attacks it.
To talk one-on-one with one of our team members about how Regenexx may be able to help your orthopedic pain or injury, please complete the form below and we will be in touch with you within the next business day.
Medically Reviewed By:
