Osteoarthritis (OA) of the knee is a “wear and tear” phenomenon, involving by thinning and wear of the cartilage inside the joint. It is therefore part of the natural “ageing” process of the knee, but is accelerated by factors such as being overweight or significant previous injury.

In the early stages, pain may be the only symptom, but in more advanced arthritis, there may also be swelling, stiffness, deformity and loss of function. The pain is typically worse during or after weight-bearing activity, but can also disturb sleep at night.

Diagnosis is usually easy, based on examination and Xrays. Initial treatment is symptomatic, with anti-inflammatory painkillers, weight loss if needed and modification of activities, but dietary supplements such as Glucosamine/Chondroitin sulphate or Cod Liver Oil may be useful. Your specialist may recommend a knee support or brace.

When these measures fail, or symptoms are severe, you may require surgery. Occasionally keyhole surgery may be recommended to “buy time”, although the effects are temporary. In the more advanced stages of arthritis, a knee replacement is usually necessary – either a Total or Unicompartmental knee replacement (TKR or UKR). In young patients with arthritis, it is beneficial to delay TKR as long as possible, and it is sometimes possible to “buy” further time with an “osteotomy” (to change the alignment of the knee), a UKR, or with other “joint-sparing” techniques.