1. Osteoarthritis of the Knee

Arthritis is the name given to conditions affecting our joints. There are many different kinds of arthritis. Osteoarthritis (OA) is one of the most common forms of arthritis and most mainly affects people over the age of 50. This is the type of arthritis that develops through wear and tear in your joints. It is not to be confused with osteoporosis which is a condition where the bones can become fragile.

In a normal joint the ends of the bones are covered with a smooth layer of cartilage that helps the joints move and cushions the ends of the bones. With OA the cartilage thins, the cushioning is reduced and the joint no longer moves smoothly. Surrounding muscles, ligaments and underlying bone are affected as the degenerative changes progress. In more advanced OA, bony spurs (osteophytes) and cysts can develop

Symptoms of OA

OA usually develops slowly, the most common symptoms being pain and stiffness.  These symptoms are usually worse when the joint has not been moved for a while especially in the morning. At times the joint can become swollen and warm. As the joint surfaces wear down the knee can grate, grind and click with movement. Diagnosis is usually made by your doctor based on symptoms, physical examination and x-ray. Depending on which joint is affected, for most people OA does not cause major problems, but can impact on normal activities and lifestyle.


The Knee
The knee joint is a complex of three joints. The main joint is between the femur and the tibia. There is also a joint between the patella (knee cap) and femur, and a smaller joint between the tibia and fibula.  There are two crescent shaped cartilages called the menisci which are located between the femur and tibia and act as shock absorbers.

These x ray images show the changes that are occur with OA. The source of pain around the inside (or outside) of the knee is usually from the main joint. Pain in the front of the knee is usually from the joint behind the knee cap. It is important to realise that joint damage on an x ray does not necessarily equate with disability.

There is no clear cause of OA, however in the knee,  previous injury, being overweight,  and occupations involving prolonged kneeling and squatting are thought to be contributing factors. Poor biomechanics, such as over pronation of the feet and poor stability around the pelvis can aggravate the OA changes that may already exist.

How Can You Help Yourself?

  • Keep exercising as if helps reduce pain and maintain your general health.
  • Try low impact activities- cycling, walking, water exercise, tai chi
  • Always respect pain – back off if you notice extra or unusual pain while exercising
  • Maintain good general fitness and lower body strength and flexibility, especially calf, quadriceps (front of thigh) and hamstrings (back of thigh)
  • Maintain good posture-good alignment  as it distributes the load more evenly through your joints
  • Take care with lifting – carrying heavy shopping and grandchildren puts an extra load through your joints
  • Avoid sustained bending of the knees when gardening or doing housework
  • Avoid breastroke swimming as it stresses the inside knee joint
  • Taping (the knee cap) and  knee supports can assist to unload a painful joint and allow you to keep exercising safely.
  • Watch your weight – the knee is a weight bearing joint and being overweight can lead to more pain and damage to joints affected by OA.
  • Wear shoes with good shock absorption and adequate arch support. This can help to take load off the knee cap and the main knee joint, especially when exercising.

 

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