A normal knee glides smoothly because cartilage covers the ends of the bones that form joints. Osteoarthritis of knee damages this cartilage, progressively wearing it away. The ends of the bones become rough like sandpaper. This damaged cartilage can cause the joint to "stick" or lock and your knee may get painful, stiff and lose range of motion.
If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel pain while you're sitting or lying down. Symptoms may include severe knee pain that limits your everyday activities, including walking, going up and down stairs and standing up from a chair. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker. You may also experience:
An additional symptom may be failure to get pain relief from non-steroidal anti-inflammatory drugs. These medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis. Their effectiveness varies from person to person and may become less effective for patients with severe arthritis.
Your surgeon will take your medical history, gather information about your general health and ask you about the extent of your knee pain and your ability to function. A physical examination will be taken to assess your knee motion, stability and strength and overall leg alignment. X-rays may be performed to determine the extent of damage and deformity of your knee. Occasionally, blood tests, an MRI (magnetic resonance imaging) or a bone scan may be needed to determine the condition of the bone and soft tissues of your knee.
Medications, changing your activity level and using walking supports may be helpful but if these are not effective, you may want to consider knee surgery. Inability to tolerate or complications from pain medications or failure to substantially improve with other treatments such as cortisone injections, physical therapy or other surgeries may suggest a knee operation. There are two surgical treatments for osteoarthritis of the knee.
An osteotomy is surgery that reshapes the shinbone (tibia) or thighbone (femur) to improve your knee's alignment. The healthy bone and cartilage is realigned to compensate for the damaged tissue. Knee osteotomy surgically repositions the joint, realigning the mechanical axis of the limb away from the diseased area. This lets your knee glide freely and carry weight evenly. Osteotomies may restore knee function and significantly diminish osteoarthritis pain.
Reviewed by health care specialists at UCSF Medical Center.