Knee Arthritis

What is Knee Arthritis?

Knee arthritis is the progressive breakdown of the cartilage that lines the knee joint. The knee is formed by the lower end of the femur (thigh bone), the upper end of the tibia (shin bone), and the patella (kneecap), with smooth articular cartilage allowing the surfaces to glide painlessly. In arthritis, this cartilage gradually wears away, leading to bone-on-bone contact, pain, stiffness, swelling, and reduced mobility that tends to worsen over time.

The knee has three compartments — the medial (inner), lateral (outer), and patellofemoral (between the kneecap and femur). Arthritis may affect one, two, or all three. Which compartments are involved influences both symptoms and the treatment options available.

Causes and Types

The most common form is osteoarthritis, the gradual age- and wear-related loss of cartilage. Other forms include:

• Rheumatoid arthritis — an inflammatory autoimmune condition that attacks the joint lining.
• Post-traumatic arthritis — developing after a fracture, ligament injury, or meniscal injury.
• Inflammatory and other arthropathies — less common conditions that can affect the joint.

Risk factors for osteoarthritis include increasing age, previous joint injury, family history, being overweight, and prior surgery to the knee.

Symptoms

• Pain that worsens with activity and eases with rest (though advanced arthritis may cause pain at rest or at night)
• Stiffness, particularly first thing in the morning or after sitting
• Swelling around the joint
• A grinding or catching sensation with movement
• Reduced range of motion and difficulty with stairs, kneeling, or squatting
• Progressive deformity (the leg becoming bow-legged or knock-kneed) in advanced cases

Diagnosis

Diagnosis is based on your history and a clinical examination, supported by imaging. Weight-bearing X-rays are the main investigation and show joint space narrowing, bone spurs (osteophytes), and the pattern of compartment involvement. An MRI is sometimes used to assess cartilage, menisci, and ligaments in more detail, particularly in earlier disease or where another problem is suspected.

Treatment Options

Treatment is guided by the severity of symptoms, the degree of joint damage, and your individual goals. Management generally begins with non-surgical measures and progresses to surgery only when these no longer provide adequate relief.

Non-surgical options

• Activity modification and load management
• Weight management to reduce stress on the joint
• Physiotherapy and targeted strengthening
• Anti-inflammatory and other pain-relieving medications
• Walking aids where appropriate
• Injections (such as corticosteroid) in selected cases

Surgical options

When arthritis is advanced and conservative treatment has failed, surgery may be considered. Options depend on the pattern and severity of disease and may include partial (unicompartmental) knee replacement where only one compartment is affected, or total knee replacement where multiple compartments are involved. The most appropriate option will be discussed with you at your consultation.

Recovery and Outlook

For many people, arthritis can be managed effectively for years with non-surgical measures. Where joint replacement becomes necessary, it is a highly successful procedure for relieving pain and restoring function. Recovery depends on the specific treatment undertaken and will be explained in detail according to your circumstances.

Frequently Asked Questions

Will my knee arthritis get worse over time?

Osteoarthritis is generally a progressive condition, but the rate varies widely between individuals. Many people manage their symptoms well for a long time with non-surgical measures such as exercise, weight management, and medication. Surgery is considered when symptoms become severe and other treatments no longer help.

Do I need surgery for knee arthritis?

Not necessarily. Many patients are managed successfully without surgery. Surgery is usually reserved for advanced arthritis causing significant pain and disability that has not responded to conservative treatment. The decision is based on your symptoms, imaging, and goals rather than on age alone.

Is exercise safe if I have knee arthritis?

Yes. Appropriate exercise is one of the most effective treatments for knee arthritis. Low-impact activities such as walking, swimming, and cycling help maintain strength and mobility without overloading the joint. A physiotherapist can guide a programme suited to you.

Medical Disclaimer
The information on this page is intended as general patient education and does not constitute medical advice. Every patient is different, and treatment decisions should always be made in consultation with a qualified medical professional based on your individual circumstances, health history, and imaging. Outcomes from treatment vary between patients and cannot be guaranteed. If you have concerns about your knee health, please contact Dr Slattery’s rooms to arrange a consultation.