Knee osteoarthritis

Knee osteoarthritis is the wear and tear of the articular cartilage of the knee. In medical terms a worn knee is also called 'gonarthrosis'.

Knee wear is the result of a reduction in the thickness and quality of the cartilage. Cartilage has an important function as a shock absorber and to prevent friction between the bones. In a worn knee joint, stiffness and pain can occur.

What causes knee osteoarthritis?

The exact cause of a worn knee is not known. In most cases, it is the result of an ageing process that gradually affects the quality of the cartilage. The symptoms are therefore mainly age-related and are particularly seen in people over the age of 60. There are some factors that increase the risk of premature wear:

• Overweight.
• Hereditary predisposition.
• Previous knee operations, such as arthroscopy or meniscectomy.
• Past trauma, for example, a knee fracture.
• Other joint conditions, such as arthritis, gout, and rheumatoid arthritis.
• Physically demanding work with, for example, a lot of heavy lifting, squatting, and kneeling.
• Intensive performance of sports such as ballet and football.

Symptoms of a worn knee

Because a worn knee develops gradually, there may be no immediate symptoms in the early stages. Start-up stiffness and joint pain are usually the first symptoms. These often decrease once you are moving and are therefore mainly "start-up problems".

Over time, symptoms can become more chronic in nature, and knee pain will be present more often. The knee may also be somewhat swollen and feel warm. The knee may be more difficult to move, and "cracking sounds" in the knee may be heard and felt. These are also called crepitus.

Do you want to know yourself whether you have a worn knee? Then do the self-check or have a local physiotherapist examine your knee.

Diagnosis of a worn knee

In many cases, the diagnosis of a worn knee can be cautiously made following physical examination by a GP or physiotherapist. This diagnosis can then be confirmed using X-rays. These images also show the degree of wear in the joint.

On the X-ray, a narrowed joint space can be seen because the thickness of the cartilage has decreased. There may also be osteophytes. These are irregular bony outgrowths.

Through blood tests, the specialist can rule out other causes, for example, rheumatism, being responsible for the symptoms.

Treatment of a worn knee

Wear of the knee joint is an irreversible process, which means a worn knee cannot be cured. But that certainly does not mean it cannot be treated. Treatment aims to reduce the symptoms experienced as a result of the wear.

Which treatment is preferred depends on the stage of wear and the severity of symptoms. In most cases, a conservative approach is taken first. This means a worn knee is not operated on immediately. An important goal here is to keep the function of the knee joint optimal and, where possible, to improve it.

In cases of overweight or obesity, it is wise to lose weight and thus reduce the pressure on the knee joint. In physically demanding work, it is also advisable to perform modified duties where possible.

The physiotherapist is the designated person to set up a treatment to keep the knee mobile, supple, and strong. The physiotherapist uses different treatment options for this. Treating a worn knee is tailor-made and is specifically adjusted to the patient's level.

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If conservative treatment produces insufficient results, the GP will discuss further options. Examples include medication to reduce pain and/or inflammation. The latter can also be achieved with an injection of corticosteroids.

Surgery

As a last resort, there is also the option of placing a knee replacement. Here, (part of) the joint is replaced. This is also called an artificial knee. A knee replacement also wears over time. This means the prosthesis may need to be replaced at some point. For that reason, the operation is generally postponed as long as possible.