Treatment for Osteoarthritis of the Knee

Osteoarthritis (OA) is characterized by degenerative inflammation of the joints. Knee OA occurs when cartilage in the knee becomes inflamed. Healthy cartilage is sturdy, but flexible. It absorbs shocks and allows the leg bones to slide over each other smoothly. As you move the slider from left to right, you’ll see the ligaments, bones, and cartilage that make up the knee joint, as well as the inflammation and degeneration of cartilage within the knee.

Pain and stiffness are the most common symptoms of knee OA. At worst, knee OA can progress to the point that bone grates on bone; a painful condition that severely limits mobility..

Knee OA is usually progressive, but several treatments may slow or halt the symptoms of OA. Exercise is a great start. Although activities like walking can be uncomfortable with OA, strengthening and aerobic exercises actually strengthen supporting muscles and help reduce pain and inflammation. Studies have consistently shown that exercise can reduce pain and improve function in patients with knee OA. The risk of developing OA rises for those who are overweight or obese, so weight reduction can also help control progression of the disease.

Oral anti-inflammatory drugs are first-line treatments for knee OA. Common over-the-counter drugs, including ibuprofen, naproxen, and aspirin, relieve the pain and stiffness of OA by reducing inflammation. Known as NSAIDs (non-steroidal anti-inflammatory drugs), this class of drugs works by interrupting COX-2, a key enzyme involved in inflammation. Acetaminophen is not a NSAID and does not reduce inflammation but does effectively reduce pain.

Corticosteroid drugs, such as prednisone, can be injected directly into the knee by your physician. These injectable anti-inflammatories can provide relief for six months.

If exercise and/or oral anti-inflammatory drugs fail to provide significant relief from the pain and stiffness of knee OA, your physician may suggest a relatively new therapeutic option; injection of a liquid viscosupplement.

These consist of lubricating compounds similar to those found in healthy cartilage, and in the (synovial) fluid that bathes healthy joints. Studies show that injection of hyaluronic acid, for instance, can help improve lubrication of the joint and reduce pain and inflammation for at least three months.

Research suggests that it may take longer for viscosupplements to take effect than corticosteroids, but improvements may ultimately last longer.

Surgery is an option for the treatment of advanced knee OA. Procedures run the gamut from simple, minimally-invasive arthroscopic repairs of irregular cartilage, to partial knee replacement (unicompartmental arthroplasty), or total artificial knee replacement surgery (knee total joint arthroplasty). Joint replacement may be the only viable option for some patients with severely curtailed mobility due to knee OA. In these instances, surgeons replace worn cartilage with artificial components called prostheses. These may be made of metal, plastic or ceramic, or some combination of two of these materials. Prostheses may be cemented directly to the bone.

Osteoarthritis (also called degenerative joint disease) does not have a cure. It affects more than 27 million people, making it a leading cause of disability in American adults. The goal of treatment is to manage pain, then reduce contributing causes that make the symptoms of OA worse. This is often initially done with a combination of medicines, exercise, and physical therapy as well as adopting lifestyle changes that can prevent OA symptoms. Learn more about treating OA of the knee.