Knee osteoarthritis

Knee osteoarthritis is the wear and tear of the articular cartilage of the knee. In medical terms a worn knee is also called 'gonarthrosis'.

Knee osteoarthritis is the result of a decrease in the thickness and quality of the cartilage. Cartilage plays an important role as a shock absorber and in preventing friction between the bones. With a worn knee, joint stiffness and pain can occur.

What causes knee osteoarthritis?

The exact cause of a worn knee is not precisely known. In most cases, it is the result of an aging process that gradually impairs the quality of the cartilage. The symptoms are therefore mainly age-related and are especially observed in people over 60 years old. There are several factors that increase the risk of premature wear:

• Overweight.
• Hereditary predisposition.
• Previous knee surgeries, such as arthroscopy or meniscectomy.
• Past trauma, for example a knee fracture.
• Other joint conditions, such as arthritis, gout, and rheumatoid arthritis.
• Physically demanding work involving a lot of lifting, squatting, and kneeling.
• Intensive participation in sports such as ballet and soccer.

Symptoms of a worn knee

Because a worn knee develops gradually, there may be no immediate symptoms or complaints in the early stages. Start-up stiffness and joint pain are usually the first symptoms to appear. These often decrease once you are moving and are therefore mainly 'start-up problems'.

Over time, the symptoms can become more chronic in nature and knee pain will be present more often. The knee may also be somewhat swollen and feel warm. The knee may be more difficult to move, and 'crackling sounds' in the knee may be heard and felt. These are also called crepitus.

Want to check for yourself whether you have knee osteoarthritis? Take the self-check or have a local physical therapist take a look at your knee.

Diagnosis of a worn knee

In many cases, the diagnosis of a worn knee can be cautiously made based on physical examination by a primary care physician or physical therapist. This diagnosis can then be confirmed using X-rays. These images also show the degree of wear in the joint.

On the X-ray, a narrowed joint space can be seen because the thickness of the cartilage has decreased. Osteophytes may also be present. These are irregular bony overgrowths.

Through blood tests, the specialist can rule out other causes, for example rheumatoid arthritis, being responsible for the symptoms.

Treatment of a worn knee

Wear of the knee joint is an irreversible process, which means a worn knee cannot be cured. But that certainly does not mean it cannot be treated. Treatment aims to reduce the symptoms experienced as a result of the wear.

Which treatment is preferred depends on the stage of wear and the severity of symptoms. In most cases, a conservative approach is taken first. This means a worn knee is not operated on immediately. An important goal here is to keep the function of the knee joint optimal and, where possible, to improve it.

If you are overweight or have obesity, it is wise to lose weight and thus reduce the pressure on the knee joint. In physically demanding jobs, it is also advisable to perform modified duties where possible.

The physical therapist is the right professional to develop a treatment plan to keep the knee mobile, flexible, and strong. The physical therapist uses various treatment methods. Treating a worn knee is customized and is specifically tailored to the patient's level.

Medications
If conservative treatment produces insufficient results, the primary care physician will discuss further treatment options. Examples include medication to reduce pain and/or signs of inflammation. The latter can also be achieved with an injection of corticosteroids.

Surgery
As a last resort, there is also the option of placing a knee replacement. Here, (part of) the joint is replaced. This is also called an artificial knee. A knee replacement also wears out over time. This means the prosthesis may need to be replaced at some point. Therefore, the operation is generally postponed as long as possible.