Knee Osteoarthritis

In the knee joint, the upper legs and lower legs meet. The leg ends are covered with cartilage that allows them to slide easily against each other. In osteoarthritis, the cartilage becomes uneven. Then it feels like the knee hooks up and it can snap and crack. The risk of getting hurt increases and the area around the knee can feel swollen and hot.

Many different causes interact and increase the risk of osteoarthritis. What they have in common is that they in some way affect how the joint is loaded. The risk of knee joint arthritis increases if you have impaired muscle function in your legs, have injured your knee or are overweight.

Hereditary factors also play a role. Therefore, there is an increased risk of getting the disease if any related relative has osteoarthritis.

Osteoarthritis often develops slowly over many years. It usually comes after age 40, but is more common the older you get. It is not really the age that matters, but how long you have been exposed to the various risk factors. That’s good, too many risk factors can be affected. Everyone who has cartilage changes does not have arthritis symptoms and the degree of complications varies over time.

Symptoms of knee osteoarthritis

The most common first complaint of knee arthritis is that you feel stiff and swollen, and get sore in your knee as you walk. Often, the trouble comes without anything special happening. Sometimes the trouble can come quite suddenly, perhaps in connection with your trampling obliquely, or in the case of an injury that normally would not have caused any trouble. Sometimes a little too much joint fluid is formed, which allows the knee to become swollen and sore, partly due to inflammation in the joint capsule. It is very common for the first symptoms of knee osteoarthritis of knee joint osteoarthritis to appear before the osteoarthritis appears on the X-ray.

If you have more severe osteoarthritis, you may also experience pain in your lap while sitting still, or during the night when you are going to sleep.

You can become slightly wheelbase if the cartilage between the femur and tibia gets thinner on the inside of the knee joint. Then the load increases even more on the inside and this can lead to increasing inconvenience.

When and where should I seek care?

If any of the following is true of you, contact a  health care provider:

  • You are not sure if you have osteoarthritis.
  • You have pain in your knee that does not go over.

What can I do for myself?

In the following section you will be given advice on how to do yourself to reduce your knee joint arthritis.

Exercise reduces pain

The basis for treatment of knee joint osteoarthritis is to inform about the disease, exercise the legs and balance the weight. A physically active lifestyle and physical therapy reduce the arthralgia. It is also important to keep in mind that you may need to change and adapt your way of working and taking care of everyday tasks.

You can go to arthritis school

You often need the help of a physiotherapist to get information and knowledge on how to manage your osteoarthritis. You may need to contact a so-called arthritis school. If there is no one in the place where you live, you can get help through an online arthritis school that you can find online. In arthritis school, you will learn about osteoarthritis and how to best manage your knee. Osteoarthritis schools are usually run by physiotherapists. Your local health center can refer you to your nearest arthritis school.

Strong leg muscles relieve the knee

Appropriate exercise and strength training of the leg muscles reduce the pain from the knee. When you start exercising it can sometimes hurt more, but after a few months the pain usually subsides. It is not harmful for the joint cartilage to move, even if the pain temporarily increases. A cane can relieve the joint. A physiotherapist or doctor gives advice on what is the best workout. You can also get training through an arthritis school.

You can cope with everyday life better and may not need surgery if you exercise regularly, reduce obesity, use relieving aids and take painkillers occasionally. It is also good to avoid heavy work.

You can borrow aids

If you’re stiff and hard to move, using a cane, toilet seat and extra handles on the bathroom wall can help. At the district nurse, you can get advice on where to turn for  help . Some aids can be borrowed or rented.

Medication suppresses pain and inflammation

You may need to take painkillers as it is common to have pain in the knee joint arthritis. There are many different types of drugs.

Inflammation of the joint capsule around the knee joint can often be treated with analgesic anti-inflammatory drugs, so-called NSAIDs. Examples of such drugs are those containing ibuprofen, such as Ipren and Brufen. Another example is the naproxen found in, for example, Naproxen or Pronaxen.

If you are over 75, have any cardiovascular disease or have previously had a stomach ulcer, you should use paracetamol instead of NSAID.

A cortisone syringe in the knee joint can sometimes provide temporary relief.

Scientific studies have shown that glucosamine has no specific effect. Therefore, it is not included in the recommended treatment of osteoarthritis and high-cost protection.

Investigations

A physiotherapist or physician performs an examination of the knee joint and assesses mobility and swelling as well as if some movements hurt more than others.

Sometimes an X-ray examination is done  , but it is not necessary to make a diagnosis. An X-ray examination of the knee can sometimes show severe osteoarthritis, which may have existed for several years but has not caused any problems. Early osteoarthritis is not visible on the x-ray. Magnetic camera examination, also called MRI, is rarely needed.

To get an assessment of whether you need surgery, you are usually referred to an orthopedic clinic. There, a more in-depth examination of your knee problems is done to determine if surgery is a good alternative.

Treatment of knee osteoarthritis

Mild or moderate complaints of osteoarthritis of the knee joint and other joints are best treated at your health care center with the help of a physiotherapist.

Complications that are so difficult that an operation may be appropriate require further examination by orthopedic physicians at a hospital or specialist clinic. You may need to see a general practitioner to get an assessment.

Operation gives new angle to the knee

If you are under 60 years of age, have lighter osteoarthritis and are wheel arched, an operation is sometimes performed which reduces the load on the inner part of the knee. With this surgical method, called osteotomy, angular surgery, the orthopedist removes a wedge of the bone for the knee to function at a normal angle again. No artificial material is inserted into the knee. The operation usually works well but the rehabilitation period takes a few months. The pain gradually decreases and the mobility of the knee joint remains. You can usually expect the surgery to help for ten years.

After an osteotomy operation, it may sometimes be necessary to have a prosthetic surgery. Then a new artificial joint is inserted into the knee.

You may need a new knee joint

The most common operation for knee joint arthritis is to insert new joints, a so-called knee joint prosthesis. The prosthesis is made of plastic and metal that are attached to the upper legs and lower legs with cement. The purpose of a new knee joint is to enable you to move the joint more easily, relieve the pain and thus have a good everyday life. A new knee joint is not a common joint. It is not possible to work hard or put a heavy load on the trail. You may also be prepared for the need for physiotherapy to build up the strength of the leg after surgery.

Most people who get a new knee joint experience that the pain goes away and that it becomes easier to move. The healing takes up to a year, but the improvement is usually noticed after a few weeks. A knee joint prosthesis usually lasts for at least 15 to 20 years. In some cases, the artificial joint can wear out, and need to be replaced by a new operation.

What if you do not receive treatment of knee osteoarthritis?

The disease and the pain sometimes mean that you get a worse quality of life, because it is difficult to walk. You may also have difficulty sleeping at night because of the pain.

It is possible to operate on knee joint arthritis even after many years of trouble. It is important to feel carefully, gather information and, together with the doctor, think about which treatment of knee osteoarthritis is best for you in the life situation you are in. It is always harmless to first try with treatment that you can do yourself. It can never degrade the outcome of a joint prosthesis. On the contrary, studies show that pre-surgery training provides faster rehabilitation.

Having knee osteoarthritis can present a slightly increased risk of type 2 diabetes and cardiovascular disease. That’s probably because many people with the disease are moving less, and many are overweight.

What happens in the body?

The body’s joints are there for you to be able to move. At all joints at least two legs meet. In the knee, the lower part of the femur meets the upper part of the tibia. The parts of the legs that meet in a joint have cartilage on the surface. The cartilage is a living material that has a very smooth surface and very low slip resistance, lower than ice. The joint contains joint fluid that reduces friction and allows the leg ends to slide even better against each other.

In osteoarthritis, the cartilage gradually changes to become uneven and bumpy. Joint cartilage decreases and disappears. The leg ends can come in contact with each other and it feels like the knee hooks up. At the same time, it sometimes cracks and cracks and the risk of you getting hurt increases. Sometimes the area around the knee feels swollen and warm.

It is usually in the inner part of the joint that you get osteoarthritis. The outer part of the knee is usually better. It is common for the joint capsule surrounding the joint to become  inflamed , and the knee joint may become swollen and fluid filled.

Increased risk of bone fractures and injuries

Knee joint osteoarthritis is a disease that develops slowly, often for many years. The cause of the individual is sometimes unknown, but can often be due to known risk factors. What they have in common is that they in some way mechanically affect the load in the joint. The risk increases if you have suffered a  meniscus injury  or a  cruciate ligament injury  in young years, and after a bone fracture that has caused a knee injury. The risk of getting knee joint arthritis increases if you are overweight, have poor muscle function, or exercise at elite level where your knees are particularly stressed. Osteoarthritis is linked to certain work steps that overload the knee. There is also a certain heredity. It is more common that you get sickness if some close relative has osteoarthritis.

The relationship between weight and muscle function is more important than the exact weight. A person who weighs a lot but has good muscle function may have a lower risk of getting osteoarthritis compared to a person who weighs less but has poor muscle function. The more you weigh, the stronger you have to be to support your weight better. In the past, there were theories about being overweight by osteoarthritis. Recent research has shown that it is the opposite, that if you are overweight when you are young, you are more likely to get osteoarthritis when you get older.

Even if you have osteoarthritis, it is not obvious that you have to get worse. If you start to influence the risk factor that may be of the greatest importance to you, there is the possibility of improvement. There is currently no drug that slows down the disease. The one who best treats your osteoarthritis is yourself.

More common among the elderly

Knee arthritis is unusual before the age of 50 and becomes more common the older you are. If you belong to a risk group, that is to say, be overweight, have had a severe knee injury or have a close relative with the disease, there is an increased risk of getting knee arthritis from the age of 40. Actually, it is not the age that matters, but how long you have been exposed to the various risk factors.

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