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Osteoarthritis of the knee usually
occurs in people who have suffered trauma, infection or injury to the
knee. As articular cartilage is lost, the joint space between the
knees narrows. The remaining cartilage progressively becomes thinner,
grooved and fragmented. The surrounding bones compensate by becoming
thicker, which causes them to grow outwards. Spurs
often develop . The synovium produces
extra liquid, which causes it to become thickened and inflamed. The
extra liquid causes a condition known as ‘water on the knee.’
Over the years, the articular cartilage
can be lost completely, so that the bones are rubbing against each
other. This causes the bones to slowly begin wearing away, leading to
joint deformity.
Initial treatment of osteoarthritis of
the knee is geared towards pain management. The first step involves
health and behavior modifications. Patient education, physical
therapy, weight loss and exercise form the mainstays of these
modifications. Bracing may also be applied to the affected area.
Drug therapies range from basic pain
relief medications, such as aspirin and non-steroidal
anti-inflammatories to Cox-2 specific inhibitors, opiates and
stronger drugs.
Corticosteroid injections or injections
of hyaluronic acid may also be given. Surgery, including arthroscopy,
osteotomy and arthroplasty (joint replacement) will be considered as
a last resort.
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