Osteoarthritis of the knee?
Woodland Hospital's Consultant Orthopaedic surgeon David Stock has a specialist interest in sports medicine and problems affecting the hip and knee.
Here David talks about arthritis of the knee and what can be done to treat the problem. The aim of treatment is to improve a patients’ quality of life as much and as quickly as the underlying condition will allow.
What is osteoarthritis?
Osteoarthritis (OA) is one of the five leading causes of disability among elderly men and women. It affects approximately 8 million people in the UK. The risk for disability from osteoarthritis is as great as that from cardiovascular disease. Arthritis is called many different names including, arthrosis, osteoarthritis and degenerative joint disease.
The ends of the bones of the knee joint are covered in a beautiful smooth surface (articular cartilage) that allows them to glide over each other like ice on ice. In arthritis, this covering is lost so instead of gliding like ice on ice it moves like concrete on concrete, catching, giving way and causing pain.
The lining of the knee (synovium) becomes inflamed and thickened, producing producing extra fluid and swelling. Additional bits of bone grow (osteophytes) often causing stiffening of the joint.
The ligaments around the knee slowly thicken and contract reducing movement of the joint, often preventing the knee from fully straightening.
Patients usually present with pain. Initially this is intermittent, aggravated by putting weight through the leg. As the condition deteriorates the pain increases and can be present when resting, getting out of chairs, climbing stairs and at night. The knee can swell, lock, give way and feel unstable.
What can be seen?
There may be little to see when examining the knee but often the knee is slightly bowed, there may be swelling and a reduced range of movement, especially full straightening. Grating is often heard as the end of the bones rub together.
X-rays show the bones of the knee, femur(thigh bone), tibia (shin bone) and patella (knee cap)). It can also show swelling in the knee and a reducition in the space between the bones as the cartilage covering is worn away.
The extra growth of bone ( osteophytes) may also be seen.
There are a number of non- surgical measures which should be undertaken before surgery is contemplated to help minimise symptoms. The National Institute for Clinical Excellence (NICE) has produced a paper outlining recommended management. www.nice.org.uk/guidance/CG177 Osteoarthritis:care and management.
It is important to maintain a healthy weight so extra pressure is not put through the knee. Regular exercise is important to help reduce weight . Low impact activities such as swimming ( with a straight leg kick), cycling and the use of a cross trainer are recommended. Strong muscles help protect the joint. Physiotherapy helps maintain movement and muscle strength. Painkillers and injections can also offer pain relief.
Walking aids help take pressure off the knee but vanity needs to be overcome.
David Stock has a clinic at Woodland Hospital every Tuesday, GP referrals are not always necessary, you can book an appointment direct with the hospital on 01536 210019.
Hear what patients are saying about David Stocks practice :
I recently had an ACL reconstruction due to a sporting injury. Mr. Stock and his team were very professional throughout and the level of attention I received was second to none. During my experience every stage was thoroughly explained and I was made to feel that nothing was too much trouble. I wouldn’t hesitate to recommend him.