About Knee Problems
Causes
Some knee problems result from wear of parts of the knee, such as occurs in osteoarthritis. Other problems result from injury, such as a blow to the knee or sudden movements that strain the knee beyond its normal range of movement.
Arthritis of the knee is a degenerative disease where cartilage in the joint gradually wears away. In rheumatoid arthritis, which can also affect the knees, the joint becomes inflamed and cartilage may be destroyed.
Osteoarthritis may be caused by excess stress on the joint, such as from repeated injury, deformity, or if a person is overweight. It most often affects middle-aged and older people.
A young person who develops osteoarthritis may have an inherited form of the disease or may have experienced continuous irritation from an unrepaired torn meniscus or other injury. Rheumatoid arthritis usually affects people at an earlier age than osteoarthritis.
Symptoms
A person who has arthritis of the knee may experience pain, swelling, and a decrease in knee motion. A common symptom is morning stiffness that lessens after moving around.
Sometimes the knee joint locks or clicks when the knee is bent and straightened, but these signs may also occur in other knee disorders. The doctor may confirm the diagnosis by performing a physical examination and taking X-rays, which typically show a loss of joint space.
Diagnosis
Blood tests may be helpful for diagnosing rheumatoid arthritis, but other tests may be needed as well. Analysis of fluid from the knee joint may be helpful in diagnosing some kinds of arthritis. The doctor may use arthroscopy to directly visualize damage to cartilage, tendons and ligaments and to confirm a diagnosis, but arthroscopy is usually done only if a repair procedure is to be performed.
Treatment
In people with arthritis of the knee, a seriously damaged joint may need to be surgically replaced with an artificial one. (Note: A new procedure designed to stimulate the growth of cartilage using a patient's own cartilage cells is being used experimentally to repair cartilage injuries at the end of the femur at the knee. It is not a treatment for arthritis.)
Prevention
Some knee problems, such as those resulting from an accident, cannot be foreseen or prevented.
However, a person can prevent many knee problems by following these suggestions:
- First warm up by walking or riding a stationary bicycle, then do stretches before exercising or participating in sports. Stretching the muscles in the front of the thigh (quadriceps) and back of the thigh (hamstrings) reduces tension on the tendons and relieves pressure on the knee during activity.
- Strengthen the leg muscles by doing specific exercises (for example, by walking up stairs or hills, or by riding a stationary bicycle). A supervised workout with weights is another pathway to strengthening leg muscles that benefit the knee.
- Avoid sudden changes in the intensity of exercise. Increase the force or duration of activity gradually.
- Wear shoes that both fit properly and are in good condition to help maintain balance and leg alignment when walking or running. Knee problems may be caused by flat feet or overpronated feet (feet that roll inward). People can often reduce some these problems by wearing special shoe inserts (orthotics). Maintain appropriate weight to reduce stress on the knee. Obesity increases the risk of degenerative (wearing) conditions such as osteoarthritis of the knee.
Specialists
Extensive injuries and diseases of the knees are usually treated by an orthopaedic surgeon, a doctor who has been trained in the non-surgical and surgical treatment of bones, joints, and soft tissues (for example, ligaments, tendons, and muscles). Patients seeking non-surgical treatment of arthritis of the knee may also consult a rheumatologist (a doctor specializing in the diagnosis and treatment of arthritis and related disorders).
Find the right physician.
Read what Rajit Saluja, an orthopaedic surgeon at Columbia St. Mary's has to say
about knee replacements.
