Patient guides Musculoskeletal pain
Knee Osteoarthritis: Specialist Summary
Knee osteoarthritis (gonarthrosis) is a common joint disease in which gradual wear of the cartilage in the knee causes pain, stiffness and restricted movement. Exercise, weight control and patient education are the foundation of treatment. Physical therapy and intra-articular anti-inflammatory and regenerative injections also have an important place. Surgery (joint replacement) is considered when the condition is advanced and significantly impairs quality of life despite other treatments.
When to see a doctor
- Knee pain lasting weeks and limiting stairs or walking
- Morning stiffness, swelling or a locking sensation in the knee
- Emergency (red flags): sudden swelling, redness, warmth and fever of the knee (possible joint infection); inability to bear weight after injury; painful swelling of the calf (assess for deep vein thrombosis)
- Night pain and unexplained weight loss
Treatment options
- Conservative: regular exercise, weight loss, activity modification, appropriate medication (topical and oral)
- Physical medicine and rehabilitation: quadriceps and hip muscle strengthening, balance and gait training, orthoses or supports and physical modalities when needed
- Injections: intra-articular steroids in selected patients during flare-ups; the evidence for other injection options varies, is discussed individually and may be helpful in selected cases
- Surgery: joint replacement assessment in advanced disease with marked structural damage that does not respond to conservative treatment
Surgery or not? The degree of arthritis on X-ray does not always match the pain. When unclear, pain severity, night pain, walking distance, adherence and response to exercise, other conditions and the patient’s expectations are considered together. Whether the pain is referred from the back or hip should also be checked.
Frequently asked questions
Is walking harmful with knee osteoarthritis? Walking within your pain threshold is appropriate; distances that trigger pain may not be. Regular activity at the right dose is recommended.
Does knee osteoarthritis go away completely? Cartilage changes are largely irreversible, although regenerative cell-based treatments are promising in selected cases. The aim is to improve pain and function.
Does losing weight help? In people who are overweight, weight loss reduces load on the knee and is recommended.
Is rehabilitation needed after knee replacement? Yes, physical medicine and rehabilitation is part of the post-operative process.
Sources
Turkish version: doktorfizik.com/rehber/diz-kireclenmesi/