Knee Osteoarthritis (OA): Common Questions
What is Knee Osteoarthritis (OA)?
The term Osteoarthritis specifically means joint inflammation, however just taking anti-inflammatories is not the main treatment nor is inflammation the primary cause. It is a chronic condition affecting the cartilage and bone within the knee joint characterized by pain, reduced function and quality of life.
Symptoms can include:
Persistent knee joint pain related to activity
Limited range of motion
Crepitus / joint noises
Bone enlargement and tenderness
What are the risk factors for developing knee OA?
Advancing age – Increasing risk >45 years of age.
Excessive weight – Not just due to excessive load but also the metabolic factors associated with obesity. With respect to excess weight, every 1kg loss of body weight is roughly equivalent to 2kg off the knees.
Previous knee injures – ACL tears regardless if surgical reconstruction occurred increases risk along with other traumatic injuries.
Occupation – Repetitive squatting and kneeling >2 hours per day at work.
Gender – Women are more at risk than men after the age of 45.
Family history –Genetics play a role in the development.
Sedentary – Muscle weakness particularly through the quadriceps muscles
Is knee osteoarthritis just normal aging and to be expected later in life? No! It can occur earlier in life as well but it is important to know it can possibly be prevented or in the least managed. Reducing your risk factors such as weight management, prevention of serious injuries, maintaining regular activities and strengthening appropriately all help to prevent knee OA.
Is knee OA just wear & tear? No! It is a multi-factorial disease which can be prevented and treated by managing your risk factors.
My knee hurts, do I need x-rays to be assessed and diagnosed? No! An x-ray isn’t always necessary or required with knee pain or even when knee OA is suspected. X-rays do not do a good job of assessing for pain or prognosis if a fracture is not suspected. The Ottawa Knee Rules are the guideline for when to x-ray during acute injuries. Treatment is focused on reducing risk factors, pain and improving mobility/strength which can all affect your quality of life.
Is running bad for my knees? No! It is actually good for your knees to be loaded and let your body adapt to the stress. No loading or unexpected higher loads than normal are more of a risk factor for knee pain. Remember to gradually introduce new activities and avoid too much too soon or else it’ll be too little too late!
I’ve been diagnosed with knee OA, will I need surgery? Most people living with knee OA do not get a knee replacement. This is generally reserved for very advance cases.
What is the best and first line of defense for knee osteoarthritis? Exercise! In addition, weight management and patient education are the most important pillars of rehabilitation for knee OA. This can also extend to many other knee conditions causing pain and restrictions in function.
Does it matter what kind of exercise?
What ever you will adhere to! Many different types of land-based exercises have been shown to help with function and pain with people suffering from knee OA. Regular physical activity will help with stiffness, knee function and reduced disability.
Bottom Line Evidence based guidelines strongly recommend exercise for people with osteoarthritis. Remember that surgery isn’t the most common answer to OA!
It is helpful to be assessed by a physiotherapist to determine what areas to focus on and to find an optimal level of exercise to minimize the risk of flares up and maximize exercise therapy. Your physio may also provide adjunct treatment to facilitate better movement and exercise such as manual therapy or electrotherapy.