Nearly 1 in 6 Australians suffer from arthritis. The knee joint is the largest joint in the body and one of the most commonly affected joints by arthritis.
What is the anatomy of the knee joint?
The knee joint has 3 compartments:
The medial and lateral tibio-femoral joint compartments; and the patellofemoral joint which can all be affected by knee arthritis.
Who is most at risk of developing knee arthritis and what are the most common causes?
Knee arthritis commonly affects people above the age of 45, with a peak incidence in patients between 60-70 years of age. It is more common in females than males. The commonest causes of arthritis affecting the knee include:
What are the symptoms of knee arthritis (OA)?
How is knee arthritis diagnosed?
Diagnosis is made after Dr Khatib’s undertakes a clinical assessment including medical history, physical examination and x-rays of the knee. During the physical examination Dr Khatib will examine the affected joint for swelling, tenderness, and range of motion. X-rays of the affected joint may show a loss of the joint space and bone spur formation. There is no blood test for osteoarthritis.
How is knee arthritis managed?
Conservative Treatment Options
There are several treatments and lifestyle modifications that can help you ease your pain and symptoms. These include:
If the pain is very severe, corticosteroid injection can be given directly into the affected joint to ease the pain.
What surgeries are available for the treatment of knee arthritis?
This can be broadly divided into joint preserving or joint replacing procedures:
Joint preserving surgeries
These are indicated in cases where there is mild or some cases of moderate arthritis, especially when there are mechanical symptoms such as catching or locking due to meniscal tear or loose bodies where knee arthroscopy can be performed. While knee arthroscopy does not cure arthritis, it can relieve some of the pain generated by mechanical impingement.
Other joint preserving surgeries called osteotomies are indicated if the arthritic changes are limited to one part of the joint. Osteotomies aim to offload the pressure on the diseased compartment by shifting the weightbearing axis away from that part. Common osteotomies include high tibial osteotomies to offload the medial joint compartment which is most commonly affected in knee arthritis; and tibial tuberosity osteotomy to offload a diseased patellofemoral joint.
Joint replacement surgery
If the disease is localised to one compartment then limited replacement (or arthroplasty) can be performed. This can be done using a unicompartmental arthroplasty (UKA), or by patellofemoral joint replacement, if the disease only affects the patellofemoral joint compartment. Total knee replacement surgery is by far a more commonly performed procedure in which the femur, tibia are replaced, with or without resurfacing of the patella. Total knee replacements are the commonest type of joint replacement surgery performed in Australia and around the world. Most patients report good-excellent resolution of their symptoms and improvement in their quality of life after total knee replacement surgery.
When you come for your consultation, Dr Khatib will be able to discuss your condition and provide you with all suitable treatment options available.