Arthritis is inflammation of one or more of your joints. Pain, swelling, and stiffness are the primary symptoms. The disease may affect any joint in the body, but it is particularly common in the knee. Knee arthritis can make it hard to do many everyday activities, such as walking or climbing stairs. It is a major cause of lost work time and a serious disability for many people. Although there is no cure for arthritis, there are many treatment options available to help manage pain and keep people staying active. The major types of arthritis that affect the knee are osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis. Today, we will be focusing on Osteoarthritis.

Osteoarthritis

Is a degenerative, “wear-and-tear” type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger people, too. In osteoarthritis, the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone, and produce painful bone spurs.

Symptoms

Osteoarthritis develops slowly and the pain it causes worsens over time. There are other symptoms, as well:

• The joint may become stiff and swollen, making it difficult to bend and straighten the knee.
• A knee joint affected by arthritis may be painful and inflamed.
• Pain and swelling may be worse in the morning, or after sitting or resting.
• Vigorous activity may cause pain to flare up.
• Loose fragments of cartilage and other tissue can interfere with the smooth motion of joints. The knee may “lock” or “stick” during movement. It may creak, click, snap or make a grinding noise.
• Pain may cause a feeling of weakness or buckling in the knee.
• Many people with arthritis note increased joint pain with rainy weather.

Physical Examination

During your appointment, your doctor will talk with you about your symptoms and medical history, conduct a physical examination, and possibly order diagnostic tests, such as x-rays or blood tests. During the physical examination, your doctor will look for:

• Joint swelling, warmth, or redness
• Tenderness about the knee
• Range of passive (assisted) and active (self-directed) motion
• Instability of the joint
• Crepitus (a grating sensation inside the joint) with movement
• Pain when weight is placed on the knee
• Problems with your gait (the way you walk)
• Any signs of injury to the muscles, tendons, and ligaments surrounding the knee
• Involvement of other joints (an indication of rheumatoid arthritis)

Non-Drug Treatments

• Exercise. A variety of exercises, such as strength training, aerobics, range of motion and tai chi, can help with both pain and physical function in knee Osteoarthritis. Water-based exercises may improve function in both knee and hip joints, but offer only minor benefits for pain.
• Weight loss. Losing a moderate amount of weight can help reduce pain and disability by taking stress off of the knees.
• Acupuncture. A form of traditional Chinese medicine involving the insertion of thin, sharp needles at specific points on the body, acupuncture has been used as a treatment for osteoarthritis pain.
• Transcutaneous electrical nerve stimulation (TENS). A technique in which a weak electric current is administered through electrodes placed on the skin, TENS is believed to stop messages from pain receptors from reaching the brain.
• Knee braces, sleeves, and other devices may be helpful for reducing pain and joint stiffness and improving function in knee Osteoarthritis, without causing any adverse side effects.
• Canes and crutches. Using a cane may reduce pain and improve function in people with knee Osteoarthritis. However, while it takes the load off the knee, it can add more weight on to other affected joints, such as the hip.

Medications

• Acetaminophen (Tylenol).
•  Nonsteroidal anti-inflammatory drugs (NSAIDs) These medications (aspirin, ibuprofen, naproxen sodium)
• Topical NSAIDs.
• Corticosteroid injections.
• Hyaluronic acid injections.
• Your doctor can prescribe several other prescriptions.

Surgery 

• Joint lavage is one option where a doctor flushes the joint with a sterile saline solution to wash out the contents (blood, fluid or loose debris) inside a joint space.
• Arthroscopic debridement is the surgical removal of tissue fragments from the joint.
• Osteotomy and joint-preserving surgery. For young, active people with knee osteoarthritis, osteotomy (a procedure in which bones are cut and realigned to improve joint alignment) may delay the need for joint replacement.
• Unicompartmental knee replacement also called partial knee replacement is where the surgeon replaces the damaged portions of the knee with plastic and metal parts. This may offer the same improvement and function as total knee replacement but with less trauma and better range of motion.
• Total knee replacement: In this procedure, the knee is replaced with an artificial joint. It requires a major surgery and hospitalization.

If you have knee pain, you may need to see a specialist. Call 713-766-0023 or visit www.wjbryanmd.com to schedule an appointment with Orthopedic Surgeon, Dr. William Bryan. He’s been in practice for over thirty-five years at the Texas Medical Center in Houston.