Early knee arthritis

Early Knee Osteoarthritis

Knee osteoarthritis (OA) is a common disease in the developed world especially in the over 55 years population. About 10% of people aged over 55 years have painful disabling knee OA of whom one quarter are severely disabled with advanced stage osteoarthritis.

Knee osteoarthritis is the wear and tear of the cartilage that lines the surfaces inside the knee joint, this cartilage has to be smooth and lubricated to allow for a full knee joint movement that is pain-free. Knee Osteoarthritis is graded from 1 to 4, stage 1 is early wear and tear in the joint with little symptoms, X-rays can be normal at this stage, Stage 4 is the most advanced stage of arthritis where the cartilage is completely worn out and the bone are exposed without cover inside the knee joint.  The symptoms of early stage knee osteoarthritis (stage 1 and 2) can range from knee pain, knee stiffness and crepitus. In advanced stages symptoms can be disabling and can range from moderate to severe pain that interferes with sleep and not relieved by medications.

Causes and Risk factors:

There are several causes and risk factors for development of knee osteoarthritis, the commonest being;

Genetics; the person has a higher probability of developing arthritis if a first degree family member had arthritis.
Engagement in sports that put a lot of pressure on the knee.
Previous knee injury, knee surgery and fracture around knee joint.
Old age, people above 60 years old are more likely to develop arthritis.
Females are more likely to develop knee arthritis
Overweight and obese people.
Weakness of muscles around the knee and lax knee joint.

Treatment:

There is no medication to-date that can completely cure osteoarthritis. The aim for treatment of early stage knee osteoarthritis is to maintain a good quality of life by reducing the symptoms and improving the function of the knee, the first choice is conservative treatment (non-surgical).

Life style modifications especially weight loss, appropriate exercise and physiotherapy.
Dietary supplements
Pain relief medications such as Paracetamol.
Non-steroidal anti-inflammatory drugs (in forms of tablets, gels or Spray) should be tried if regular paracetamol did not give good relief of pain. Stronger pain killing medications requires doctor prescription.
Knee injections; there are multiple forms of injections which all aim to reduce pain and control symptoms, however the response for injections is variable between people and depend mainly on the stage of the arthritis with people at early stages usually get the longest relief from injections.
Knee arthroscopy (keyhole surgery) involves going inside the knee with a camera, it can diagnose the exact extent  of damage to the cartilage and can also manage treatable causes that can worsen with time such as unstable meniscus tear.