Osteoarthritis of the Knee
Knee Osteoarthritis is a degenerative knee condition where the cartilage of your knee joint gradually wears away, exposing the underlying bone.
Early stages of knee Osteoarthritis (OA) is characterised by the onset of pain and mild inflammation around the knee. Usually pain is more severe in the morning and the knee may feel stiff and take a while to loosen up. These symptoms are also exacerbated when living in cooler climates.
So what is going on inside the knee joint?
Knee OA causes inflammation of the tissues in and around the joints. Cartilage, which is a strong and smooth surface that lines the bones and allows the joint to move without friction, can be damaged. Unfortunately for us cartilage does not regenerate.
Bony growths can sometimes develop around the edge of the joints called bone spurs and the alignment of your knee may change as the deterioration takes place. The continual erosion of cartilage can cause alignment problems and this may make you feel as if one leg is shorter than the other or your balance may be compromised.
When the cartilage is very worn (in the later stages of OA) you may feel a grinding in the joint, which is described as the feeling of bone rubbing on bone, or you may hear a clicking noise. Knee OA can be debilitating but there are many treatment options to keep you active and on your feet.
If you think you have OA and would like to know more, see your local GP, they will be able to refer you to have a suitable X-Ray to determine why you are experiencing knee pain.
Symptoms & Causes
There are many diverse causes of knee OA. We commonly see patients over the age of 50 who have lived active lives present with general wear and tear injuries.
Active people who have participated in weight-bearing sports involving lifting, running and directional change are the most likely to develop OA symptoms over their lifetime.
Past (sports) injuries will also play a part in the development of OA, particularly for those who have had prior surgeries for ligament or meniscus damage. In a lot of these procedures the surgeon will clean up and remove cartilage from the joint. As we know, cartilage does not grow back.
Contrary to those active patients, we see people who are overweight and not active enough. They are simply putting more strain through their knees, ankles and feet than the body can adequately deal with. This strain on the joints causes accelerated breakdown of soft tissue in the joint capsule.
Lastly, you could blame your parents… Genetics does play a part in the cause of your OA. Although you do not inherit the condition itself, if your parents have/had OA, you inherit an increased risk of developing the condition.
Treatment & Prevention
Unloader Bracing
Whether you have mild, moderate or severe OA, a knee brace may help to reduce pain by shifting your weight off the most damaged portion of the knee. These braces have hinges designed to push or pull the painful compartment of the knee open for relief. This will improve your mobility and help increase the distance you can walk comfortably. In most cases these braces will provide extra stability and improve balance for the wearer as well.
OA knee braces come in a variety of designs, but most are constructed with a combination of rigid and flexible materials — plastic, metal or other composite material for basic structure and support and mouldable foam for padding and positioning.
You may only need a light single upright brace to get an exceptional result. There are also dual upright braces available and if you have some severe malalignment or if you have an unusual shaped leg, custom bracing is also available.
In some Australian states there is government funding to assist with the cost of these braces, just ask your preferred clinician for more information.
Thermic Knee Braces
Thermic compression braces are designed to keep the knee joint and surrounding area warm and supported. With those affected by OA, heat can help to relax the muscles and in turn can provide some pain relief. These braces are usually knitted or made of neoprene (wetsuit material) and are circumferential in their design to provide a comforting, hugging sensation to the knee..
Orthotics
Orthotics are used to augment foot function and are designed to treat, adjust, support or accommodate various biomechanical foot disorders.
The most effective orthotics are custom-made as they are tailored to meet the specific needs of an individual. Custom orthotics are created using an impression of the foot (called a mould) which duplicates any misalignments in foot structure. Using the cast, scanning and computer technology, an orthotist will then create the foot orthoses to sit under your foot and support the muscles in your feet and legs. These orthotics can realign joints in the lower limbs and lead to decreases in knee, gluteal and lower back pain.
Creams, Topicals, Gels and Anti-inflammatory Tablets.
There are many topical creams and gels you can use for reducing the inflammation associated with knee OA. One you may not be familiar with is FlexiSeq, which is a gel containing very small particles to deliver bio-lubricating vesicles through the skin and directly into joints to coat the surface of the cartilage.
By reducing biomechanical stress and friction, Flexiseq reduces pain and restores joint function. This product does not use any active drugs and hence does not have associated side effects.