What is KNEE arthritis?

 

Knee arthritis is a condition where the thigh bone (femur) and the tibia (leg bone) join together to make a joint. The joint is lined with articular cartilage and a meniscus that holds the femur and the tibia in place. Arthritis is a condition where the cartilage wears down which contributes to pain, swelling in the joint, and eventually narrowing of the bones when no cartilage exists.

There are many types of arthritis, but osteoarthritis is the most common type of arthritis. A combination of trauma, shape of your knee, meniscus, and normal aging process contributes to the development of osteoarthritis.

How do I know if I have Knee Arthritis?

Patients report pain in the knee which can be on the inside of the knee (medial joint), outside of the knee (lateral joint), or in front of the knee (patella arthritis). Patients can have arthritis in one of these joints or all three. X-rays and a history and physical exam can confirm the diagnosis.


What are the treatments of Knee Arthritis?

Nonsurgical and noninvasive options include activity modifications, weight loss, physical therapy, and anti inflammatories. Physical therapy focuses on strengthening the hip abductor muscles (gluteus minimus, gluteus medius) and quadriceps muscles to take pressure off the knee joint.

If physical therapy does not improve you pain or ability to perform activities, the next step is to consider injection. There are cortisone injections and orthobiologic injections. Cortisone is covered by insurance and decreases inflammation in the hip joint so you can strengthen the hip muscles in physical therapy. Cortisone can be short term and you do not want to repeat it more than 3 times in a year. Other injections to consider are orthobiologics. Orthobiologics include Viscosupplementation (gel injection in the knee to lubricate the knee), Platelet Rich Plasma (PRP), and microfragmented fat. Please speak with your physician to see if you are a candidate with these procedures. They can help with reducing pain and increasing function.

If injections do not provide relief, the next procedure to consider is a knee replacement. 20% of Americans are not happy with a knee replacement so really want to consider this as a last resort.

Many well designed single and double blinded studies support PRP and there is some emerging evidence for micro fragmented fat. Click below on the studies below.

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Knee Arthritis PRP
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488405/pdf/13018_2020_Article_1919.pdf
https://pubmed.ncbi.nlm.nih.gov/32302218/
https://pubmed.ncbi.nlm.nih.gov/33278533/

Knee Arthritis Adipose
https://pubmed.ncbi.nlm.nih.gov/33822274/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211497/pdf/SCI2021-9921015.pdf