Knee Arthritis :

Arthritis is the narrowing of joints due to degrading cartilage.  As this white, smooth material is worn away, the bone below is revealed.  When bone surfaces begin to rub against one another, this typically causes the pain and grinding associated with arthritis. 

Knee arthritis is very common in our population, particularly in those over 50.  Most will complain of achiness in the morning and difficulty getting started out of a chair.  They have to “warm-up” their sore joint but any long distance walking or activity will cause increasing pain.  Some knees will swell and become bowed.

Simple home remedies for these symptoms are icing the knee after activities and at night and applying heat in the morning and before activities.  Anti-inflammatories like ibuprofen, Advil, and Aleve can help with pain and swelling, while Tylenol is purely a pain-reducing agent.  Supplements like glucosamine plus chondroitin sulfate help reduce pain by giving additional nutrition to ailing cartilage.

When these simple strategies no longer provide adequate relief, patients typically seek medical attention.  Your primary care doctor or orthopedist may order x-rays to determine the extent of arthritis.  They may also check for hip arthritis as a cause of pain referred to the knee.  Most will start treatment conservatively with exercise and weight loss programs.  Physical therapy to strengthen leg muscles can greatly reduce joint stresses, and safely decreasing a patient’s weight will lead to a drop in the force the knee must withstand with every step. 

If these measures are not sufficient, various injections can be attempted to alleviate discomfort.  Cortisone injections into the knee joint are often a good way to reduce pain and swelling.  They vary greatly in their efficacy and duration of symptom relief.  Another alternative for mild to moderate arthritis is an injection of joint lubricant.  This is similar to adding oil to one’s car.  Brands like Synvisc and Euflexxa are commonly used to replace depleted joint lubricant with a series of three weekly injections. 

When surgery is necessary for end-stage arthritis, patients typically undergo a total knee replacement.  Many advances have been made in this life-improving operation.  Prostheses are implanted in a more minimally invasive fashion, and technologic improvements are enabling prostheses to last longer.  Typical hospital stay is three nights and most are discharged home for outpatient rehab.  Full recovery typically takes about 3 months. 

For younger patients with select arthritic issues, newer options in cartilage repair and regeneration are being utilized.  It is now even possible to harvest cartilage from one’s own knee, grow it in a lab and re-implant it in an area of cartilage loss.