Osteoarthritis is a common and debilitating condition affecting an increasing number of people in New Zealand and internationally. Although it is more common in older individuals, knee osteoarthritis is not an inevitable part of ageing – many older people are not affected and conversely, it can also affect younger people who have sustained a previous knee injury – the so-called ‘young people with old knees’!
Knee osteoarthritis is characterised by the progressive loss of articular cartilage that covers the joint surfaces. This alteration to normal cartilage can occur as a result of mechanical breakdown from trauma, abnormal knee joint loading, or genetic factors. Unfortunately damaged knee cartilage has a limited capacity to regenerate. Alongside a thinning of the cartilage, other changes to the joint can include bony outgrowths, changes in the shape of the joint, malalignment of the knee and joint laxity.
Joint pain, swelling and stiffness are often the first symptoms people present with when seeking medical advice and treatment for knee osteoarthritis. Diagnosis can be made from symptoms and a physical examination. An x-ray may show narrowing, bony outgrowths and/or changes in the shape of the knee joint but does not tell how much trouble or pain a person will have.
There is currently no cure for knee osteoarthritis therefore treatment options have typically focused on pain relief and preservation of joint function. It is sometimes thought that there is not a lot that can be done but this is incorrect as there are many effective treatments.
A common recommendation if you see a medical professional will be to follow a multi-modal approach to your osteoarthritis rehabilitation. This means using a combination of physical, drug and lifestyle strategies to manage your condition. It is also important to take into account the presence of associated health problems that you may have such as diabetes or heart disease.
Exercise is strongly recommended for all people with knee osteoarthritis, including those with severe disease. There is high quality research evidence showing that therapeutic exercise is beneficial for reducing knee pain and improving physical function (Fransen & McConnell, 2008) and can be as effective as taking analgesic and non-steroidal anti-inflammatory drugs but with fewer side effects (Zhang et al., 2010). There are also a number of other interventions that can be tried including bracing, knee taping, muscle relaxation techniques, manual therapy and footwear modifications.
Your local KneeCare provider is an expert in the assessment and conservative treatment of this condition and will work with you to develop a treatment plan that not only emphasises self-management but also suits your own individual requirements and circumstances.