Knee Arthritis

The knee is made up of three bones: femur (thigh bone), tibia (shin bone), and patella (knee cap). The knee joint has three main articulations or compartments, which are the between the femur and tibia on the inside and outside of your knee (medial and lateral compartments) and between the patella and femur (patellofemoral compartment). The ends of these bones are lined with a specialized tissue called articular cartilage. Cartilage does not have a blood supply, so when it is damaged or starts to break down, it does not grow back. The process of cartilage breakdown is called arthritis.

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When cartilage loss starts to occur, inflammatory enzymes are released into the joint. These cause further breakdown until ultimately, the underlying bone is exposed. When bone rubs on bone, this causes significant pain and sensation of cracking in the joint. Pain often leads to limited range of motion and weakness, which can lead to difficulties with activities of daily living and decreased quality of life. Once conservative treatment fails to meet a patient’s expectations for pain tolerance and function, a total or partial knee replacement can be considered. This surgery can be very successful in alleviating pain and helping patients regain their quality of life.

The cartilage can break down in one, two, or all three compartments of the knee. When only one compartment is involved, patients may be a candidate for a partial knee replacement. However, when all of the compartments of the knee are involved, a total knee replacement leads to better outcomes.

  • Symptoms

  • Treatment

Symptoms

  • Knee stiffness and decreased range of motion
  • Knee weakness from lack of use
  • Pain at night
  • Morning stiffness
  • Audible cracking or popping upon movement
  • Knee buckling
  • Pain worsening over time

Frequently Asked

Questions

How do I know if I have knee arthritis?

Knee arthritis causes a deep ache in the knee joint that is often worse at night. Patients also frequently experience a cracking or grinding in the knee with movement that is called crepitus. The pain starts insidiously, which means it usually starts without any trauma or specific event. After taking a detailed history and a physical exam, x-rays will be obtained. This is a diagnosis that is usually made with x-rays, which show narrowing of the space between the bones that make up the knee joint and can show the bone rubbing on bone.

How do I know if I need surgery or can just manage with conservative treatment?

Conservative treatments are always recommended first. When patients have persistent pain/dysfunction that interferes with their quality of life and they have pain every day, surgery is recommended.

What are the risks associated with not treating my knee arthritis?

The most common risks are stiffness, persistent pain, and weakness. The arthritis will gradually worsen over time. As the pain progresses, range of motion typically gets worse and this leads to limited use and function that can interfere with the ability to walk.