Knee Arthritis
Knee arthritis is a common degenerative condition most commonly associated with ageing, that causes swelling, stiffness and pain in the knee joints.
Knee arthritis is significantly worsened by obesity and remains a major burden for the obesity epidemic.*1
The most common type of arthritis is osteoarthritis which occurs mostly in people over age 50. However younger people also develop arthritis.
Women are are more likely than men to develop knee arthritis. Often hormonal factors are linked to this*2, particularly causing issues around the menopause.
Dr Markham also commonly treats rheumatoid arthritis which is when the body’s immune system mistakenly attacks the joint lining, causing swelling, joint deformity and pain.
Common types of arthritis Dr Markham sees include
Osteoarthritis – associated with ageing and obesity
Rheumatoid arthritis – autoimmune condition
Gout – a painful crystal build up in the joint
Psoriatic arthritis – which impacts people with skin psoriasis
Trauma or acute arthritis – caused by fracture, tear and sporting injury
Septic arthritis – infection in the joint.
Arthritis can come on suddenly, although it usually develops slowly, with pain gradually increasing over weeks, months and sometimes years. Other telltale symptoms of arthritis include.
- Pain and swelling which may worsen in the morning or after sitting or resting.
- Joints may become stiff and swollen, making bending and straightening the knee difficult.
- Redness of the skin and swelling of the knee.
- Activity may cause the pain to increase.
- Loose fragments of cartilage can interfere with the joint’s smooth movement.
- During movement, the knee may creak, click, pop, or grind (friction sound).
- Pain may result in a feeling of weakness or knee bending.
- Many people with arthritis find that joint pain worsens as the weather changes.
He may also order diagnostic tests such as standing X-rays or other blood/pathology tests to confirm the condition, as well as an Magnetic Resonance Imaging (MRI) test or a Computed Tomography (CT) scan.
There is no cure for arthritis, nor a one-size fits all approach, however there are several treatments that can help relieve the disability and pain caused by this chronic disease.
Non-surgical knee arthritis options include
- Lifestyle changes such as weight loss, exercise and joint load reduction, for instance getting in and out of a car with both feet on the ground and sliding in bottom first on a plastic bag.
- Injections such as steroids
- Medications such as anti-inflammatories or paracetamol
- Physiotherapy
- Assistive devices
- Hot or cold compresses
- Wearing an elastic bandage to provide support for the knee may relieve pain
- Compression and cryotherapy devices
- Alternative Therapies (Acupuncture)
Surgical Treatments
Total or partial (unicondylar) knee replacement (arthroplasty). The surgeon will remove the damaged cartilage and bone and then place a new metal or plastic joint surface to restore function to the knee.
In younger patients cartilage transplantation (cartilage repair) is a minimally-invasive option, where there are smaller areas of damage to cartilage.
Another procedure known as a synovectomy, removes the joint’s lining damaged by rheumatoid arthritis to reduce pain and swelling.
An osteotomy is a procedure that relieves pain and significantly improves the function of the arthritic knee by shifting your weight away from the damaged side of the joint.
Dr Markham will assess the optimal procedure for your knee anatomy and condition.
A total knee replacement usually entails a 5 day stay in hospital followed by an intensive 6 week period of outpatient rehabilitation. Patients are usually much more comfortable by 6 weeks after surgery and can often return to driving at this stage. Improvements are frequently noticed up to 6 months after surgery.
A partial knee replacement usually has a quicker recovery, with patients often being 4 weeks ahead of the equivalent recovery stage of a total knee recovery. Initial inpatient stay is often only 1 or 2 days, but improvements are frequently noticed for up to 3 to 4 months from surgery.
Knee realignment osteotomy usually entails a 6 week period of reduced weight bearing using crutches with a full recovery taking as long as 3 months.
Dr Markham does the majority of his knee replacement surgeries at Gosford private Hospital which offers onsite outpatient rehabilitation services for joint replacements, including a gym and hydrotherapy pool. These facilities help patients accelerate their recovery after knee replacement in Gosford. There is also an onsite inpatient rehabilitation facility available for more elderly or infirm patients who may require a longer inpatient stay.
Depending on the surgery, you may need to wear a knee brace, crutches or a cane for a while.
By six months most patients have regained considerable strength and functionality and should normally experience little pain and swelling with regular physiotherapy and adherence to special rehabilitation exercises Dr Markham will provide you.
Like any surgical procedure, knee surgery has side effects which include pain and swelling around the joint, bruising and redness which should fade after a week or so.
Temporary stiffness can occur which is why exercises are important.
Uncommon side effects include infection (red flags are discharge, swelling and redness near the surgical site), as well as blood clots, nerve or vascular injury, rarely allergic reactions to the materials used and loosening of the joint over time, which may require a revision surgery.
