Arthritis is a disease affecting the joints. Among these knees are commonly affected. In this article, the author discusses the symptoms and stages of knee arthritis.

Knee arthritis

There are around 100 types of arthritis. Among them, arthritis of the knee joint is a very serious, painful disease that worsens with age. The most common types that might affect the knees include osteoarthritis. Osteoarthritis is the most common type of arthritis affecting millions.

In arthritis, there is damage to the cartilage of the joint surface leading to exposing bare areas and causing inflammation. There is a smooth substance called cartilage that covers the ends of the articular surface and then the cushion between the bones keeps away from rubbing together. The synovial membrane, a type of tissue that surrounds the joint, lubricates the cartilage.

The most common symptoms are pain, swelling and stiffness of the knee joint. There are many treatments that might help with the symptoms. Symptoms are initially mild and later on progress worsening the condition.

1. Pain - Knee joint pains initially during walking or excessive movement but progress to pain at rest too.
2. Stiffness - Knee joint stiffness might be most noticeable upon awakening or after being inactive.
3. Tenderness at the inner side of the knee joint
4. Loss of flexibility & easy movements of the knee
5. Grating sensation - This usually is seen in severe-grade osteoarthritis of the knee. Creaking, clicking, grinding or snapping noises (crepitus) are heard.
6. Swelling of the knee joint is seen.
7. Warmth over the knee surface.
8. Skin redness in few.

Stages of knee arthritis

There are four stages of osteoarthritis, the most common type of arthritis that affects your knees:

• Stage 1 (Minor): In this, there is some wear and tear in your knee joint. You probably won’t notice pain.
• Stage 2 (Mild): The mild stage is when the pain starts and stiffness occasionally, but there’s still enough cartilage to keep the bones from actually touching.
• Stage 3 (Moderate): In this moderate stage, there will be more pain, especially when running, walking, squatting, and kneeling. Pain can occur at rest also. Here cartilage has narrowed even further and there are many bone spurs.
• Stage 4 (Severe): Severe osteoarthritis means that the cartilage is almost gone. Then the knee is stiff, painful and possibly immobile.

Case 1

A 58-year-old female housewife having obesity came with a history of pain and swelling in both knees for 5-6 years. She had stiffness of the joint and there was a change in her gait which has led to impairment in her day-to-day activities.

Diagnosis

All these features are suggestive of symptoms related to arthritis. She was evaluated, and her x-ray showed features of mild to moderate arthritis.

Treatment

She was advised to do knee exercises to strengthen the muscles, wear kneecaps, and apply analgesic gel if the pain was severe. She was advised to reduce her weight and to take calcium-rich foods. Also to change her lifestyle, and avoid stair climbing, squatting & cross leg sitting.

Case 2

A 72-year-old retired man presented to the orthopaedician with complaints of swelling and pain in both knee joints, the left side was more than the right. He claimed that long-distance walking made his pain worse.

Diagnosis

He had a history of fall a few years ago after which the pain was dull and gradually progressed over years. He was investigated further, and the x-ray showed severe arthritis with complete loss of joint space. This condition is known as post-traumatic arthritis. The cartilage starts thinning after trauma to the knee, leading to the rubbing of bones together that causes the same symptoms as osteoarthritis: pain, stiffness and limited movement. The symptoms of knee arthritis might not start until years after the trauma.

Treatment

He was having severe arthritis and hence was suggested joint replacement (Total knee replacement).

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Nithin S is a consultant orthopaedic surgeon from Mount Abu, Rajasthan.