Knee osteoarthritis, also known as “wear and tear” arthritis is a common condition particularly in the older patient. The joint becomes roughened and this leads to pain, stiffness and swelling of the knee. Some patients may also notice that they become increasingly more bow-legged or knock-kneed.
Symptoms of Knee Osteoarthritis
The initial symptoms are usually mild with an ache felt in the knee with activity. Sometimes this is accompanied by swelling which may be visible but sometimes can only be noticed by stiffness in the knee. As the knee gets more worn, increasing stiffness and pain are noticed and the pain becomes more frequent. When severe, pain can be felt at rest and at night, disturbing sleep. As the condition worsens, it may become difficult to fully straighten the knee or to kneel.
Treatments for Knee Osteoarthritis
In mild cases, often the symptoms can be controlled with pain killing tablets or anti-inflammatory tablets. A stick can be used to aid mobility and activity modification or losing weight may also help. Physiotherapy can help to maintain the muscle strength around the knee, alleviating symptoms.
Injections can sometimes be useful for short-term relief of symptoms but don’t usually provide long-term improvement. When simple measures such as these are no longer working, a partial or total knee replacement should be considered. Other terms used for partial knee replacement are unicondylar knee replacement or patello-femoral joint replacement. The operations aim to replace the worn out part or parts of the joint with artificial components made of metal and plastic. Whenever possible a partial knee replacement would be performed, replacing only the worn out parts, either the inner part or outer part (unicondylar knee replacement) or the joint between the kneecap and thigh-bone (patello-femoral replacement). The recovery is usually quicker than a total knee replacement, requiring only 2-3 days in hospital and a short period of time on crutches, possible only a week or two.
When the damage is more widespread, a total knee replacement (TKR) would be considered. The operation takes about 2 hours and an inpatient stay of 4-5 days is required. Crutches are required for about 4 weeks and once the wound pain has settled, most patients find that they are left with a knee with greater movement and a lot less pain than previously. Not all patients are able to return to kneeling but many resume non-impact activities without problems.
As with a natural knee, the replacement doesn’t last forever and can wear out or become loose. This could require a further procedure, a revision knee replacement. The great majority are however good for ten years or more.