Knee osteoarthritis is one of the most common joint diseases and leads to degenerative changes that progress over time in the knee joint. Although the risk increases with age, it can also occur in young and active people. Early diagnosis and correct management are decisive in keeping pain under control and preserving mobility.
Symptoms and changes in the joint
Knee osteoarthritis typically begins with wear of the joint cartilage. Over time, the cartilage surface becomes rough and irregular, the joint loses its smooth movement, and increased friction leads to painful inflammation. In advanced stages, bony projections (osteophytes) form and stiffness develops.
Common early symptoms include:
- Knee pain that appears after rest (start-up pain)
- Pain that begins with exertion or appears during certain movements
- Knee stiffness and restricted movement
- Cracking and crunching sounds in the joint
- Swelling and inflammation in the knee
If these symptoms occur repeatedly, it is recommended to consult a physician.
Stages of the disease
Knee osteoarthritis is divided into four degrees of severity:
- Stage 1: The cartilage partially loses its elasticity; the first pain may be felt under high loading.
- Stage 2: The cartilage thins and the first bony projections form. At this stage, progression can be slowed with exercise, weight management and devices such as orthoses.
- Stage 3: The cartilage is partially lost and the joint space narrows; marked restriction of movement and pain are seen.
- Stage 4: The cartilage is almost completely lost and the joint is deformed and often inflamed; at this final stage, surgical options may be considered.
The vicious circle
Patients often enter a vicious circle: although reducing movement to avoid pain brings relief in the short term, in the long term inactivity accelerates cartilage wear and increases pain. In addition, the unnatural posture adopted to avoid pain also overloads other joints such as the hip.
Diagnosis and treatment approaches
Diagnosis is based on a detailed history and physical examination; imaging methods such as X-ray or MRI may be used to confirm the diagnosis. Treatment is generally considered under three headings:
- Conservative (non-invasive) treatments: Use of orthoses and supports, physiotherapy, light-to-moderate exercise, a balanced diet, weight management where necessary, hot/cold applications and medication on the physician's recommendation.
- Joint-preserving treatments: Intra-articular injections, surgical procedures that correct faulty leg alignment, or interventions such as arthroscopy.
- Joint-replacing treatments: In advanced stages, partial or total replacement of the natural joint with an artificial joint (arthroplasty).
The right approach is determined according to the stage of the disease and the individual's needs.
The role of orthoses
Knee orthoses, individually adjusted by an orthotics specialist in line with a specialist physician's prescription and medical report, aim to relieve painful areas of the joint and reduce the load on the knee. By supporting and stabilizing the joint, an orthosis may reduce pressure on the cartilage; in many people this increases mobility. The most beneficial result is obtained when orthosis use is combined with nutrition and exercise; no single approach is sufficient on its own.
Active management
Although the progression of knee osteoarthritis is irreversible, active management can significantly improve quality of life. This management rests on three foundations:
- Nutrition: A balanced diet based on fruit, vegetables, vegetable oils, nuts and seeds; weight management where necessary reduces joint load.
- Daily exercise: Small habits such as using the stairs and walking short distances make a difference over time.
- Suitable sports: Activities that do not overload the joint, such as swimming, water aerobics, cycling and light walking, support strength and endurance.
This content is for informational purposes only; for diagnosis and treatment, you should consult your physician.
