Knee anatomy
The knee joint is made up of 2 joints, your “tibiofemoral joint” which joins the femur or (thigh bone), to your tibia or (shin bone). The second joint is the patellofemoral joint which connects the patella or (kneecap) to the femur. The knee joint also has cartilage which is a type of connective tissue that is very strong and flexible and it covers the bones surfaces where they meet to form the knee joint and acts as a protective layer. Articular cartilage has two main purposes to improve the movement and sliding of the joint and as a shock absorber cushioning the joints during weight bearing activities such as walking.
What is OA?
Osteoarthritis (OA) is a chronic condition that affects many of the joints of the body, however the knee is the most common joint that is affected. OA is a degenerative joint disease that is a result of natural age related changes in the knee joint. Osteoarthritis is a process where the articular cartilage which covers the bones that connect to make up your knee joint as mentioned earlier begins to reduce due to age related changes. Articular cartilage is unique to other kinds of connective tissue as it does not have blood vessels coming into the area. This means that the healing process of cartilage is reduced and very limited.
How common is OA?
It is common condition that we see here in the clinic and affects nearly 6% of all adults with a higher percentage of women compared to men. As we get older our prevalence of knee osteoarthritis also raises, with 13% of women and 10% of men aged 60 years or older having symptoms and jumps up to 40% in men and women aged 70 years or older.
Possible causes of knee OA
Knee OA can come on with no known cause however, risk factors that increase your risk of developing knee OA include:
- Age: it becomes more prevalent in older adults
- Obesity: This stresses the knee joint due to more load on the joint and also some fat cells make proteins that can cause inflammation around the knee joint
- Some metabolic diseases such as diabetes
- Decreased stability or Joint hypermobility of the knee joint
- Malalignment of the knee joint
- Prior injuries to the knee
- Family history of knee OA
- Congenital defects
Signs and symptoms
- Knee pain that gets gradually worse the more physical activity you do
- Having a stiff knee with possibly swelling causing a reduction in the amount you can move your knee
- Pain in the knee joint coming on after prolonged sitting or with a period of time spent resting or first thing in the morning when you wake up
- Pain around the knee joint line
How we can help
Primary treatment for knee osteoarthritis starts with treatment from a physiotherapist. Surgery is only considered in certain circumstances or when conservative treatment with a physiotherapist does not work. Specific exercises given by a physiotherapist although not able to reverse the process of knee OA, it can however help to strengthen up your legs to reduce pain and improve function as much as possible for as long as possible.
The benefits of exercise include:
- Strengthening leg muscles to help reduce force taken by the knee joint
- Reducing knee pain and inflammation
- Improving knee joint movement
- Weight loss which reduces both the load on the knee joint and improves the chemical processes going on in the joint to reduce and slow the effects of knee OA
Benefits of Hydrotherapy
At the clinic we also offer offsite hydrotherapy exercise which can help to achieve all of the above benefits of exercise but it is performed in a gravity eliminated way which can feel much gentler on the knee joint. Thus being very effective for a pain free exercise environment and can be used as a stepping stone on your way to recovery as we gradually build more strength and get back into land based exercises.
Surgery as an option
Surgery is considered as a last resort if the OA continues to be painful even after trialing other treatment options.
When to consider surgery:
- After exercise and other treatments have been attempted and no change in pain is achieved
- If the knee pain severely limits everyday activity
- If you have long lasting swelling in the knee that doesn’t get better with rest or medications
However, exercise is still recommended as a first line of treatment as even if surgery is considered down the track the strength improvements and weight loss will help to increase your chances of success of the surgery and result in better outcomes post-surgery.
If you have any questions about Knee Osteoarthritis, the physiotherapists at Back In Motion Como would love to help! Please feel free to contact the clinic!
Website: https://www.backinmotion.com.au/como
Phone Number: 9313 3414