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Osteoarthritis is a common problem for many people after middle age. Osteoarthritis is sometimes referred to as degenerative, or wear and tear, arthritis. Osteoarthritis commonly affects the knee joint.  The main problem in osteoarthritis is degeneration of the articular cartilage. Articular cartilage is the smooth lining that covers the ends of the leg bones where they meet to form the knee joint. The cartilage gives the joint freedom of movement by decreasing friction. When the articular cartilage degenerates, or wears away, the bone underneath is uncovered and rubs against bone.  

Osteoarthritis of the knee can be caused by a knee injury earlier in life. It can also come from years of repeated strain on the knee. Fractures of the joint surfaces, ligament tears, and meniscal injuries can all cause abnormal movement and alignment, leading to wear and tear on the joint surfaces.   


Knee osteoarthritis develops slowly over several years.  The symptoms are mainly pain, swelling, and stiffening of the knee. Pain is usually worse after activity, such as walking. Early in the course of the disease, you may notice that your knee does fairly well while walking, then after sitting for several minutes your knee becomes stiff and painful. As the condition progresses, pain can interfere with simple daily activities.  In the late stages, the pain can be continuous and even affect sleep patterns.  


Osteoarthritis cannot be cured, but your surgeon may try the following to ease symptoms and to slow down the degeneration:   

A cortisone injection is a great way to treat knee pain, swelling, inflammation and arthritis. Injections are a very effective way of targeting medication directly to the problem area in the knee and getting to work immediately. They tend to be more effective and have less side effects than oral medication.  Most surgeons use cortisone sparingly, and avoid multiple injections unless the joint is already in the end stages of degeneration, and the next step is an artificial knee replacement. 

Hyaluronic acid injection is medicine that helps lubricate the joint, ease pain, and improve your ability to get back to some of the activities you enjoy. This leads to decreased symptoms of osteoarthritis.  Normal joint fluid contains hyaluronan which acts like a shock absorber and lubricant in your joint and is needed to help the joint work properly. Hyaluronan is highly viscous, allowing the cartilage surfaces of the bones to glide upon each other smoothly. Hyaluronic acid that is used in medicine is extracted from rooster coombs or purified from bacterial fermentation.  Some people have good results for up to eight months after getting a hyaluronic acid injection.    

Physiotherapy plays a critical role in the non-operative treatment of knee osteoarthritis. A primary goal is to help you learn how to control symptoms and maximise the health of your knee.  Range of motion and stretching exercises will be used to improve knee motion. You will be shown strengthening exercises for the hip and knee to help steady the knee and give additional joint protection from shock and stress.  People with knee osteoarthritis who have strong leg muscles have fewer symptoms and prolong the life of their knee joint.  Your physiotherapist will show you how to protect your arthritic knee joint. This starts with tips on choosing activities that minimise impact and twisting forces on the knee. People who modify their activities can actually slow down the effects of knee osteoarthritis.       


In some cases, surgical treatment of osteoarthritis may be appropriate.    The knee has three compartments the medial, the lateral and the patellofemoral. A partial knee replacement involves replacing either the medial or the lateral compartments with an implant. Your surgeon may also suggest osteotomy surgery which is a joint saving procedure for more active patients whose arthritis is at an early stage and in only one part of the knee joint.  A total knee replacement is major surgery that surgeons use to treat patients with advanced arthritis in all compartments of the knee.