The knee osteoarthritis, which is not recognized by the patients for a long time due to the slow progress, limits the movement and causes pain.
Osteoarthritis is a degenerative joint disorder, which is more common among the elderly and causes severe pain. Especially the cartilage tissue is affected. The joint cartilage provides a smooth surface and thus enables a frictionless movement between the bones. Moreover, it transfers the load and reduces the stress on the joint. The knee osteoarthritis is a destructive joint disease, which causes prominent degeneration in the structures like ligaments, joint membranes, and menisci. It is not only a passive process with articular aging and function loss but also an active process including the articular repair and destructive events.
As the knee has an important role in body movements, is exposed to heavy loads and to continuous trauma, it is the most commonly affected joint. The knee osteoarthritis does not cause symptoms at the early phase of the disease and has a subtle course, but with time it starts gradually to cause pain and limits the movements. The patient is sometimes symptomless but may experience a sudden increase in pain and attacks with swelling. The pain increases typically during the exposure to load and decrease with rest. Stiffness in the joint is also observed. The knee movements become difficult with the decrease of the range of motion in the joint.
Age is the most important risk factor for knee osteoarthritis. The cartilage structures start to degenerate with the age and the lubricity in the joint decreases. The disease may also start in early ages and not cause any symptoms. Knee osteoarthritis may sometimes emerge depending on the genetic predisposition, obesity, hypermobility, extensive and inappropriate use of the knee, structural deformities from the childhood, trauma, joint rheumatism, intraarticular fracture and in the postoperative period of the knee surgery.
The choice of the treatment may change depending on the functional status and the severity of arthritis. Treatment programs including training, physiotherapy sessions, exercise, drug treatment, intraarticular interventions may be planned for the relief of the pain and recovery of the mobility according to the severity of arthritis and findings during the physical examination.
At the early phase; training, diets, exercise, suitable shoes, and avoidance of the activities like stair climbing and squatting, which aggravate the calcification, may be sufficient for the management of the disease. The patients should be recommended to learn the joint protection techniques.
Analgesics, supportive gait instruments and braces, which reduce the load on the joint, can be used during the attacks. Food supplements (glycosaminoglycan, chondroitin, hyaluronic acid) may be useful in the chronic phase.
In moderate cases; if the medical and physiotherapy are not effective, non-surgical methods like PRP, photoactive PRP, prolotherapy, prolotherapy+PRP, neural prolotherapy, hyaluronic acid injections, and stem cell therapy can be tried.
These techniques are regenerative medical methods that support tissue regeneration and decrease edema and pain. The regenerative medical methods enable the repair and regeneration of the tissues in the knee, which cause pain and limit the movement. Thus, the knee can recover without any surgical intervention.