Treatment Options for Knee Osteoarthritis

Knee osteoarthritis develops when the cartilage in the joint gradually wears down, causing pain, stiffness, and decreased movement. This wear and tear can cause the bones in the joint to rub against each other, resulting in discomfort and swelling. Knee osteoarthritis primarily affects older adults, but it can also occur in younger people due to injury or other factors. Treatment for knee osteoarthritis depends on the severity of symptoms and can include lifestyle changes, medications and surgical procedures.

Non-Surgical Treatment Options

Non-surgical treatments are often the first line of management for knee osteoarthritis, particularly in the early stages of the condition, which aim to relieve pain, maintain mobility, and control the progression of the disease.

Assistive Devices

Braces, shoe inserts, or canes may be recommended to help reduce pressure on the knee and improve stability. These devices can be useful for patients who have difficulty walking or balancing. Unloading knee braces, which shift weight away from the affected area, can benefit those with knee osteoarthritis in a specific compartment of the joint.

Medication

Over-the-counter medications such as ibuprofen or paracetamol are commonly used to treat mild to moderate knee osteoarthritis pain and to reduce inflammation. For severe pain, stronger medications may be prescribed; however, long-term use of these medications can lead to significant side effects and should be used under a doctor’s guidance.

Topical Analgesics

Topical creams or gels containing nonsteroidal anti-inflammatory drugs (NSAIDs) or capsaicin can be applied directly to the skin over the knee to relieve pain. These treatments may provide pain relief with fewer side effects than oral medications, making them a suitable option for some patients.

Intra-Articular Injections

In advanced cases of knee osteoarthritis, intra-articular injections into the knee joint, such as corticosteroids or hyaluronic acid, are short-term solutions that provide temporary pain relief. 

Corticosteroid Injections
These injections reduce inflammation and may relieve pain for several weeks or months. They are often used when other treatments have not been effective in controlling pain and swelling.

Hyaluronic Acid Injections
Hyaluronic acid lubricates the knee joint, reducing friction and improving movement. While some patients experience relief from these injections, the effectiveness varies, and not everyone benefits equally from this treatment.

Platelet-Rich Plasma Injections
This treatment uses platelet-rich concentrate from your own blood, which is injected back into the knee joint. The treatment aims to reduce inflammation and pain in the knee and is still experimental. Some patients report good results after receiving this injection.

Physical Therapy and Exercise

Strengthening the muscles around the knee helps improve joint support and can reduce pain. Physical therapy exercises focus on enhancing flexibility, strength, and range of motion. Low-impact activities such as swimming, cycling, and walking are recommended, as they put less strain on the joints while still promoting fitness.

Surgical Treatment Options

Surgery may be considered when non-surgical treatments fail to relieve symptoms. The type of surgery depends on the extent of damage to the knee, aiming to reduce pain, improve function, and increase mobility. 

Arthroscopy

Arthroscopy is a minimally invasive procedure where a small camera is inserted into the knee to treat minor damage. The surgeon examines the inside of the joint and removes loose cartilage, trims damaged tissue, or smooths rough joint surfaces. This procedure can relieve pain and swelling in early osteoarthritis by addressing mechanical issues in the joint. It typically involves smaller incisions, less pain, and a quicker recovery than more invasive surgeries. However, arthroscopy is less effective for advanced arthritis. 

Partial Knee Replacement

Partial knee replacement involves replacing only the damaged part of the knee joint, preserving the healthy areas. This procedure is suitable for patients with osteoarthritis that is limited to one compartment of the knee. The surgeon removes the damaged cartilage and bone, replacing them with metal and plastic components that allow the knee to move more smoothly. Recovery from a partial knee replacement is generally quicker than a total knee replacement, and patients often report more natural knee movement.

Total Knee Replacement

Total knee replacement involves replacing the entire knee joint with artificial metal and plastic components to restore function and reduce pain. This procedure is typically recommended for patients with severe osteoarthritis affecting multiple parts of the knee. While total knee replacement can improve mobility, it requires a longer recovery time and physical therapy to regain strength and movement.

Conclusion

Knee osteoarthritis can considerably affect mobility and daily activities. While non-surgical treatments often provide relief, surgery may be needed if symptoms worsen. Surgical procedures such as arthroscopy, partial knee replacement, and total knee replacement can help manage pain and restore knee function, though they require careful consideration and post-surgical recovery. Consulting with an orthopaedic specialist is necessary to determine the most suitable treatment plan to improve mobility and long-term outcomes.

If you’re experiencing knee pain or considering treatment options, schedule a consultation with Dr Kau to explore the best solutions for your condition.