Osteoarthritis (OA) of the knee is a degenerative joint disease, identified by various structural abnormalities referred to as the “general wear and tear” of the bone surfaces, forming the joint.
There are various risk factors associated with the development and progression of knee OA. These factors consist of; the increasing of age (45 years and older), female gender, prior knee injuries, overweight/obesity (High BMI), work-related stresses (kneeling, squatting and lifting heavy loads) and variation in alignment of the articulating bones.
Additionally, for those of us that consider ourselves to be active, athletes or participate in contact sports, meniscal tears are considered as one of the leading risk factors for acquiring knee OA. That is because a meniscal deficient knee is subjected to more mechanical stresses like compression, shear and tension.
If you have knee persistent knee pain, it doesn’t mean that it can only be knee OA. This is where a thorough assessment of the knee by a Physiotherapist will be useful. We are able to differentiate symptomatic OA related knee joint problems, such as, inflammatory arthritis, as well as soft tissue conditions such as tendinitis, bursitis, and meniscal or ligamentous injury.
As per NICE guidelines (2014), OA can be confirmed clinically if we are aged 45 or above, have activity-specific joint pain (stairs, walking, kneeling, squatting) and have no or less than 30 minutes of morning stiffness.
An alternative diagnosis can be identified in the presence of atypical features, such as hot, swollen joints, extended morning stiffness and constant bone pains.
During physical assessment, bone enlargement/swelling and positive crepitus (clicking sound) can help in diagnosing knee osteoarthritis.
Functionally, due to pain and reduced physical activity, the quadriceps and hamstrings tend to get weak over time. This is also an indication of OA if you feel you have these symptoms.
The safety and effectiveness of exercise and weight loss have been established with minimal risk of harm, and should be considered as a part of our rehabilitation.
We advise to minimilise the use of anti-inflammatory drugs as pain killers act usually only to mask an issue, not prevent it. Not to mention their gastrointestinal side effects.
Hyaluronic acid and PRP injections can provide symptomatic relief without causing much harm to the joint surfaces.
Total knee arthroplasty has its own medical risks, but is justified in the advanced stages of joint disease, when conservative management cannot relieve symptoms.
Knee replacement (always a LAST OPTION) can be effective in minimizing disability and enhancing quality of life in advanced knee OA.
Most of our patients suffering from chronic knee pain and OA tend to develop fear of movement, anxiety and depression in relation to physical function and movement. Higher anxiety levels have a direct relationship with elevated pain, therefore you must seek professional advice as soon as you feel something isn’t right.
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