Osteoarthritis of the Knee

Oct 7, 2021

What is Osteoarthritis of the Knee?
Osteoarthritis is a condition that people may develop in any joint. This causes joints to become painful, stiff and they can experience intermittent swelling around the joint.

Who gets it?

Some of the risk factors for the development of knee OA are outlined below.

  • Non-modifiable risk factors:
  • Previous trauma to the knee joint.
  • Females are generally are more susceptible than males.
  • Genetic link

Modifiable risk factors: This is what we will work on with you.

  • Obesity (for every 5kg weight gain there is a 36% increased risk of developing OA of the knee)
  • Knee extensor weakness – Quadriceps weakness*

What are the symptoms?

  • Pain around the joint.
  • Joint line tenderness.
  • Course crepitus.
  • Stiffness- reduced range of motion of the joint.
  • Swelling.
  • Muscle wasting.
  • Deformity of the joint.

How is it diagnosed?
Diagnosis is usually done by your GP or physiotherapist. X-rays are not always required to diagnose OA. We usually assess the joint and look for signs and symptoms of OA. We can decide if physio rehab exercises are appropriate or if you require further intervention- we can discuss this with you.

What can I do to help?
Exercise is main treatment for OA – there is a lot of evidence to show that exercise- local knee strengthening and general aerobic exercise can help you improve your quality of life, decrease your pain and increase your function at 2-6 months post treatment.

What type of exercise helps?
Exercise programs that combine strengthening with exercises aimed at increasing flexibility and aerobic capacity seem to be the ‘best’ treatment option that physios can offer people.

What else helps?
High quality evidence suggests that paracetamol results in significant but not clinically important reduction in pain and disability.

Acupuncture may be effective at reducing pain after 12 weeks- this should not be a substitution for exercise.

Things that help include:

Losing weight if you are overweight
Pain management to help with flares- using ice, heat , pacing activities at the start.​

Modifying and pacing your activities to reduce overloading the joint Aerobic exercise to increase your pulse rate, such as swimming, a brisk walk or using an exercise bike may help your condition.

Your Physiotherapist will be able to provide further advice. The exercise below can help:

Grahams’ Story:
Graham is a 72-year-old male that attended our clinic in Oct 2019 complaining of left knee pain and swelling with restriction in his range of motion. He had extensive surgical history of injuries such as rugby injuries, bilateral ankle fusion. He had surgical removal of his knee cartilage years before. He was previously very active climbing and walking. His main

complaints were:

  • Unable to go up and down stairs without pain.
  • Unable to walk without pain.
  • Unable to go rock climbing.

Graham was worried that he would have to have surgery again to help his knee and manage his pain.

On assessment Graham was missing significant range of motion in both ankles and knees. He had swelling around the knee joint, tenderness around the joint line and significant muscle wasting. He undertook a strengthening program designed by our rehab trainer and after a few months he was pain free and has since returned to all his previous activities.

The power of exercise and determination from Graham should not be under-estimated and should be the mainstay to treatment – conservative management should be the first line of treatment – failing this we can look at other treatment options.

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