Osteoarthritis of the knee
Osteoarthritis is a slowly progressive degenerative condition affecting the knee joint cartilage and the underlying bone and resulting in gradual loss of the articular or chondral cartilage covering the knuckles of the knee.
In its most severe forms the covering cartilage is lost completely allowing the bare knuckles to rub together during normal standing and walking, and producing the bone on bone contact sometimes visible on plain x-rays. The underlying bone gradually stiffens and produces projections or buttresses at the margins of the joint called osteophytes, and these bony lumps can sometimes be felt beneath the skin. Some patients inherit a predisposition toward the development of osteoarthritis, and some develop it as a consequence of past injuries.
In the early stages treatment of osteoarthritis includes exercise, the use of pain killing and anti-inflammatory tablets and gels, and weight loss if appropriate. If early arthritis is associated with the presence of symptomatic loose body or meniscal tear arthroscopic investigation and treatment may have a role. Arthritis involving only one part of the knee may be treated by osteotomy in young active patients or by partial knee replacement in patients who are older and less active. Severe and widespread osteoarthritis is the commonest indication for total knee replacement.