Knee arthritis: how can it be managed?

Osteoarthritis is a prevalent condition which affects over 10 million individuals in the United Kingdom. This condition encompasses a degenerative process wherein the joint surfaces deteriorate, leading to the exposure of underlying bone. Here to answer your questions about the condition is leading consultant trauma and orthopaedic surgeon Mr Ben Spiegelberg.

What is osteoarthritis and when does it occur?

During weight-bearing activities, these exposed bones come into direct contact, causing discomfort, swelling, and inflammation.

Knee arthritis can sometimes happen occur without a clear reason, although there are several associated risk factors, which are as follows:

• Previous injuries, such as ligament tears or fractures.
• Body weight.
• Previous removal of meniscal cartilage.
• Genetic predisposition.
• Alignment of the limb.
• Inflammatory arthritis.

Symptoms of osteoarthritis generally emerge in patients aged 50 and older, with an increased incidence as individuals age. However, it can occur in younger patients due to trauma or childhood injuries.

Typical symptoms include:

• Pain: typically exacerbated after physical activity, often leading to disrupted sleep.
• Stiffness: more pronounced in the morning or following prolonged periods of sitting.
• Swelling: occasional episodes of joint swelling, frequently accompanied by a flare-up of pain.
• Instability: occasional instability, either due to pain or if the collateral ligaments become compromised.

Over time, symptoms tend to worsen, and their intensity can vary with weather conditions and time.

How can I manage the symptoms of knee oesteoarthritis?

Non-operative approaches are typically sufficient for managing osteoarthritis in its early stages. These methods encompass:

Optimising pain relief through medications, often involving anti-inflammatories:
 

• Weight management to reduce joint stress.
• Avoidance of strenuous physical activities or work.
• Utilisation of walking aids such as sticks, crutches, or knee braces.
• Maintenance of joint mobility and enhancement of muscle strength through physiotherapy-directed exercises.
• Joint injections employing steroids, local anaesthetics, or hyaluronic acid.
• As the joint deteriorates with time or non-operative treatments prove ineffective, joint replacement surgery becomes a viable recommendation.

It may be necessary for the patient to have a knee replacement in the case of knee arthritis.

Partial Knee Replacement:

In cases where only one compartment (medial, lateral, or patella) of the knee displays wear and tear, and the other compartments maintain healthy cartilage and ligaments, a partial (unicompartmental) knee replacement is the preferred option. This procedure offers several advantages:

• Preservation of knee ligaments, leading to improved functional outcomes post-surgery.
• Preservation of bone for potential future surgeries.
• Reduced trauma, enabling quicker recovery and shorter inpatient stays.

Total Knee Replacement:

When multiple compartments of the knee succumb to arthritis and non-operative treatments are insufficent, a total knee replacement becomes necessary. The procedure involves several key steps:

• Instruments are utilised to make precise bony cuts, restoring the knee to its original mechanical position.
• Some ligaments and soft tissues around the knee may be released to achieve a balanced, full range of motion.
• The worn surfaces of the bone are replaced with metal components on the femur and tibia, along with a polyethylene insert on the tibia. If necessary, the patella surface is also replaced.
• Implants are secured to the bone using bone cement.

On the day of the surgery, patients are admitted without food intake for the preceding 6 hours. The anaesthetist will discuss the choice of anaesthesia, with spinal anaesthesia being preferred due to fewer side effects, better pain control, and faster rehabilitation during the hospital stay.

After surgery, patients typically spend 2-4 days as inpatients. They are encouraged to bear full weight on the operated knee on the same day as the surgery and may go home with a walking aid for 1-2 weeks. Most patients experience a significant improvement in knee function within 4-6 weeks following the procedure.

If you are suffering from osteoarthritis and would like to book a consultation with Mr Ben Spiegelberg, do not hesitate to do so by visiting his Top Doctors profile today,