Knee Arthritis Treatments Santa Rosa
Redwood Orthopaedic Surgery Associates provides a full scope of orthopaedic services of the knee including:
Our group, of board certified experts, utilizes the most current and proven diagnostic techniques and treatment modalities to deliver the best care to our patients.
Anatomy of the knee
The knee is a “hinge” joint where the thigh bone (femur) and the shin bone (tibia) meet. The knee cap (patella) glides over the femur when the knee moves. In a healthy joint, a layer of smooth cartilage cushions the bone ends, working together with muscles, tendons and ligaments to allow you to bend your knee easily. Arthritis – particularly “wear-and-tear” arthritis or osteoarthritis – as well as certain knee injuries and diseases, can damage the cartilage, causing the bones to rub together and leading to pain and stiffness.
What is Knee Arthritis?
Arthritis is defined as inflammation in one or more of your joints. Pain, swelling, and stiffness are the primary symptoms of arthritis. Arthritis can affect any joint in the body but is especially common in the knee.
Knee arthritis can make simple tasks, such as climbing the stairs or walking the dog, an exercise in pain. It can lead to the person avoiding or fully ceasing to do many of the activities he or she formerly enjoyed.
We treat knee arthritis every day at Redwood Orthopaedic Associates.
What causes knee arthritis?
As mentioned above, the most prevalent form of knee arthritis is osteoarthritis. This is typically simply the wear and tear caused by decades of running, jumping, walking, and otherwise using our knees. Some people are more likely to have this degradation of osteoarthritis, however. Here are some contributing factors:
Although the daily use of our knees and hips is really what leads to osteoarthritis, there are certain factors that can contribute to developing the condition.
Obesity — Simple physics says that adding weight to a joint increases pressure and wear. Overweight people put much greater loads on their joints, causing the cushioning cartilage to break down faster and earlier than in people at or near their ideal weight.
Joint overuse — Overuse of certain joints leads to osteoarthritis. For instance, if a person has to continually bend his or her knees for their job, the knee joints will wear more quickly.
Injury — A past injury in a joint has a higher risk for that joint becoming arthritic. Also, heavy impact sports such as gymnastics lead to a far higher incidence of osteoarthritis in later years.
Genetics — Some people inherit a rare defect in the body’s production of collagen, the protein that makes up cartilage. This can lead to osteoarthritis in people as young as age 20. Also, defects in the joints and the way the bones fit together can accelerate the degeneration of the joints.
Other diseases — People with rheumatoid arthritis (the second most common form of arthritis) are more likely to develop osteoarthritis. Certain other diseases can also increase the odds of developing osteoarthritis.
Doctors don’t know what starts the process in rheumatoid arthritis. But there seems to be a genetic component. Your genes don’t actually cause rheumatoid arthritis, but they can make a person more susceptible to environmental factors, such as infection with certain viruses and bacteria, that may trigger the disease.
What are the Different Types of Knee Arthritis?
Osteoarthritis is the most common form of knee arthritis. Colloquially known as “wear and tear” arthritis, osteoarthritis is simply the result of decades of use. Typical in patients over 50 years of age, with osteoarthritis the cartilage in the knee joint gradually wears away. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can allow bone-on-bone contact, and this results in the formation of painful bone spurs.
Rheumatoid arthritis is much different than osteoarthritis. Rather than the wear and tear of life, with rheumatoid arthritis the body’s own immune system attacks the joints in the body, including the knee. Rheumatoid arthritis is a chronic disease that usually affects both knees. In the knee joint, the immune system attacks the synovial membrane that covers the knee joint. This makes the membrane swell, leading to pain and stiffness in the knee. As it progresses, damage occurs to normal cartilage and ligament tissue, and the bones in the area soften.
What are the symptoms of knee arthritis?
A knee affected by arthritis will be painful and inflamed. This usually develops and then worsens over time. These are specific symptoms:
- The joint may become stiff and swollen, making movement difficult
- Pain and swelling are worse in the morning or after sitting or resting
- Vigorous usage of the knee cause pain to spike
- Loose fragments of cartilage and other tissue can interfere with motion, causing the knee to lock or stick. There may be creaks, clicks, or snaps when moving the knee.
- Pain may cause a feeling of weakness or buckling in the knee
- Atmospheric low pressure, such as with an oncoming storm, can lead to increased joint pain
How is knee arthritis diagnosed?
The first step toward diagnosis is a thorough physical examination of the joints in question, testing range of motion. Special attention is given to areas that are tender, painful, or swollen.
Beyond the physical exam, other tests can reveal the condition:
The fluid is drawn from the joint. This fluid is then examined for evidence of crystals or joint deterioration. This can help to rule out other possible causes or medical conditions.
X-rays can show damage and changes in the joint.
Magnetic resonance imaging does a better job than x-rays at showing the cartilage and other structures.
knee arthritis Treatment Options
Patients with arthritis of the knee may find relief in a number of non-surgical and surgical treatments before considering joint replacement surgery. The goals of these treatments are to relieve pain, to increase mobility and restore quality of life. Patients often undergo some combination of the following:
- Exercise and Life Changes
- Assistive Devices – Orthotics, Cane
- Injections – Cortisone, Viscosupplementation (Lubricants)
Steroid and viscoelastic supplementation injections are advanced treatment options for patients with arthritis and other sources of joint pain that have not responded well to exercise and oral medications. These injections deliver relief directly to the source of the pain and are considered safe for nearly all patients.
Corticosteroid injections consist of cortisone and provide immediate anti-inflammatory relief directly to the affected joint. Some injections may be administered with a local anesthetic to reduce any potential discomfort. Results can vary significantly from a few days to a few months.
Viscoelastic supplementations such as Synvisc and Supartz are made from hyaluronic acid, a substance naturally found in healthy joint fluid, to help cushion, protect and lubricate the knee for significant symptom relief. These injections are administered on a weekly basis and can relieve pain for up to six months, although results may vary depending on the individual and the type of injection.
Knee Replacement surgery
Knee replacement may be recommended if the pain and stiffness of the joint is severe and other treatments have not brought sufficient relief. Our doctors will conduct a thorough medical examination that includes a series of questions, x-rays, and strength and range-of-motion tests to determine if total knee replacement is right for you.
The total knee replacement procedure is performed in a hospital under general anesthesia. During the procedure, an incision is made in the knee to access the joint and allow your surgeon to remove the damaged bone and cartilage on the end of the femur and tibia. Precise removal is essential to achieving successful results for each individual procedure.
Once the damaged tissue is removed, the prosthetic device is inserted and may be cemented into place. These artificial parts allow the joint to move smoothly so the patient experiences pain relief and a better quality of life. Knee replacement can also help restore motion to the joint, straighten the leg and improve stability.
After the procedure, the patient rests in a recovery room and then in a hospital room. A short hospital stay is likely needed, depending on the type of procedure performed and the overall health of the patient. Patients usually experience immediate relief from the joint pain suffered before the replacement. However, there will be some post-operative discomfort, which can be managed with pain medication provided by your doctor.
Physical therapy starts right away in the hospital to speed healing and to ensure that the patient enjoys full use of the joint. Therapy progresses from use of walkers and crutches to walking on stairs and slopes, with home exercises to supplement formal sessions. In addition, continuous passive motion (CPM) machines can reduce recovery time and the risk of muscle contracture without straining the joint.
Knee replacements today last about 20 years in 85-90% of well-selected patients. Patients can enjoy effective pain relief and restored motion that allow them to resume an active life. Like natural joints, these devices will wear out over time and frequent use, at which point patients may require an additional procedure.
What happens if I don’t treat my knee arthritis?
Osteoarthritis won’t “get better with time.” The damage that has been done to degrade your cartilage and allow the formation of bone spurs is done. Lack of treatment will only allow the situation to become exacerbated. Pain will increase, and it will impact more and more of your life. You’ll need to eliminate more and more activities that you may have formerly loved to do, such as hiking or even walking the dog.
With rheumatoid arthritis, the immune system will continue to attack your knee joints (and likely other joints). This will lead to more and more damage and decreasing mobility.
There’s no reason to not treat your knee arthritis. Conservative treatments, such as physical therapy, are the usual first course of treatment. Corticosteroid injections can be quite effective at reducing inflammation. Various medications have proven to be effective for decreasing inflammation and pain. Surgical solutions such as arthroscopy can clean up the knee and treat issues such as a torn meniscus. Even knee replacement procedures have come a long way from just a decade ago.