The knee osteoarthritis manifests itself with structural deformities such as the erosion of the cartilage layer of the knee joint, exposure of the bone structure, narrowing of the joint space, friction between the bones, calcification in the bones close to the joint, thornlike protrusions at the edge and corner of the bones. These findings are observable in the x-ray imaging. Knee osteoarthritis leads also to the complaints like knee pain, limited knee movements, sense of friction during of knee movements, joint swelling, deformities in legs (change in the axis of the femur and leg, overpronation in legs), and atrophy in leg muscles. The osteoarthritis develops usually over the years and pain increases gradually.
With aging, the wears accumulate in the load-carrying joints. Although the knee osteoarthritis is encountered usually after the age of 50 years, it may also emerge in younger people. Obesity increases the load on the joints. Injuries in the early ages increase the risk of osteoarthritis in the future. Certain individuals are predisposed to the osteoarthritis, which means that genetics plays also an important role. Works and sports related to heavy load lifting may lead to osteoarthritis in the long term.
The goals of the treatment in knee osteoarthritis are to alleviate the pain, recover the normal knee movements, strengthen the knee and leg muscles, recover the knee flexibility, ensure the correct placement and movement of the patella, improve the agility and balance, facilitate normal gait, sitting and standing movements.
The physiotherapy and rehabilitation specialists should be first visited for the treatment of knee osteoarthritis. The drug treatment, exercise, use of orthoses like braces, physiotherapy, needle treatments, and regenerative medicine should be implemented by the physiotherapy and rehabilitation specialists. If they cannot achieve a satisfactory outcome with these methods, they may refer you to an orthopedist.
First, you should avoid activities which can stretch the knee joints. For example, climbing up stairs and squatting are not recommended. However these recommendations should not lead you to immobility. Being active, going on a walk is useful in knee osteoarthritis. Swimming and cycling, which do not apply stress on the knee joints, may be preferred to the sports like running and tennis, which put heavy loads on knee joints. If you are overweight, your knee will be destressed if you lose weight. Massage may be useful for the relaxation of the muscles and stretching the joint. Certain exercises may strengthen your knee muscles and stretch your knee joint movements. You should consult your doctor for suitable exercises.
The braces may contribute to the joint stability and thus decrease the pain and increase the functionality. Usually the osteoarthritis is more severe in the medial side of the knee. Some braces are designed to reduce the stress especially on this side. Some braces support all parts of the knee joint. Shock absorbing shoes and insoles, aids like walking stick may relax the knee and support a comfortable gait.
Knee calcification is characterized by structural deformations such as abrasion of the cartilage layer in the knee, exposure of the bone, narrowing of the joint space.
Drugs may be useful in the treatment of the knee osteoarthritis. First-line analgesics (acetaminophen), non-steroidal anti-inflammatory drugs are the first choice. You should not use these drugs without the recommendation of your physician due to the risk of side effects and drug interaction.
Glucosamine and chondroitin sulfate are important components of the cartilage. Supplementation of these compounds may contribute to the alleviation of the pain. Positive results were reported for food supplements containing eggshell, curcumin, boswellia, bromelain, and ginkgo. Social health insurance does usually not reimburse these products. Several brands containing these herbal ingredients are available in the market. Not all have the same efficacy and some may cause drug interactions. You should consult your physician for suitable and safe alternatives.
Steroid injections administered to the knee may decrease the edema and pain caused by the osteoarthritis. However the positive effects are not long-lasting and high doses may aggravate the erosion and increase the predisposition to the infections.
Injections called viscosupplementation may contribute to the comfortable joint movements through the increase of the quality of the joint fluid. A lubrication fluid called hyaluronic acid can be administered.
PRP injections became popular in recent years. Blood is taken from the patient and the growth factors are isolated from other components and then injected into the knee joint. It stimulates the regeneration of the tissue.
Stem cell treatments are relatively new and the research is still on-going. However, the preliminary results are encouraging. Stem cells are obtained from the fat tissue surrounding the abdomen of the patient and injected in the knee joint. This method is one of the methods in the regenerative medicine and stimulates the tissue regeneration.
Heat and cold applications, electrotherapy (TENS, electric stimulation etc.), ultrasound therapy, short-wave treatment, magnetic field treatment can be used. Tailor-made special exercises are also one of the components of the physiotherapy.
Thermal baths, acupuncture, prolotherapy, neuraltherapy, ozone therapy, cupping, leech therapy, and several other methods can be experienced as an alternative treatment.
If the complaints related to the knee osteoarthritis are unbearable and physiotherapy cannot provide sufficient relief, joint-protective osteotomy operation can be considered in young people and single-compartment or total joint prosthesis can be preferred in older patients. Surgery may also not alleviate the complaints and infection may develop. However, the success rate of the surgery is fairly high if they are performed in suitable patients. Rehabilitation after the surgery increases the chance of recovery.