Knee osteoarthritis (gonarthrosis): Information and specialists for knee osteoarthritis

Leading Medicine Guide Editors
Leading Medicine Guide Editors

As the largest joint, the knee bears the load of the entire body. Depending on the activity, this load increases even further. In a healthy joint, the cartilage surfaces and the menisci act as buffers to protect the bony parts of the joint. If knee osteoarthritis occurs, these cartilage structures are damaged. Joint wear and tear causes pain and limited mobility. 

Here you can find additional information and selected specialists and centers for the treatment of knee osteoarthritis.

ICD codes for this diseases: M17

Recommended specialists

Brief overview:

  • What is knee osteoarthritis? The progressive wear-related degradation of cartilage substance in the knee can cause the bones of the joint to rub against each other painfully.
  • Types: Different areas of the knee joint can be affected. Accordingly, a distinction is made between patellofemoral osteoarthritis (at the kneecap), medial tibiofemoral osteoarthritis (inner knee areas), and lateral tibiofemoral osteoarthritis (outer knee areas).
  • Causes: Signs of wear and tear occur in all people as they age. Other risk factors include hereditary factors, obesity, excessive or one-sided loads, and others.
  • Stages: There are three different stages; the pain that occurs and the restrictions on mobility increase as the stages progress. In the first stage, knee osteoarthritis can only be seen on an X-ray, in the third stage, the affected individuals suffer from permanent pain.
  • Diagnosis: A medical history and physical exam are followed by function tests, pain tests, and X-rays. If necessary, an MRI, CT scan, scintigraphy, or arthroscopy may also be performed.
  • Treatment: In the early stages, conservative treatment is often sufficient to relieve symptoms and slow progression. In late stages, joint-preserving surgery can be useful, and even later the use of a knee joint prosthesis can help.

Article overview

Knee osteoarthritis is the breakdown of cartilage in the knee joint. The wear and tear causes knee pain and limited mobility.

It is diagnosed based on a physical exam and evidence of joint changes on an X-ray. In addition to conservative procedures, surgical treatment is also available.

An overview of the knee joint and its structure with cartilage and ligaments is shown in the video:

Please accept additional external content to watch this video.

Knee osteoarthritis and its forms

All joints of the body can be affected by osteoarthritis, i.e., the degradation or wear of the cartilaginous joint surfaces.

The knee is subjected to particularly high stresses. That is why it is often affected by osteoarthritis. Knee osteoarthritis is also called gonarthrosis.

Due to the friction of the joint, the cartilage becomes increasingly rough and gradually degrades. In severe cases, parts may detach from the bone or cartilage. The video shows how knee osteoarthritis including cartilage damage develops:

Please accept additional external content to watch this video.

As a result of this degradation process, the joint cavity narrows, resulting in both knee pain and inflammation and swelling in the knee joint. This reduces the mobility of the joint.

Depending on the affected area of the joint, a distinction is made between these types of gonarthrosis:

  • Patellofemoral osteoarthritis: Wear and tear in the joint of the kneecap (patellofemoral joint).
  • Medial tibiofemoral osteoarthritis: Damage to the internal (medial) tibiofemoral joint (the joint between the femur and tibia). This is referred to as varus gonarthrosis if there is additional varus malalignment.
  • Lateral tibiofemoral osteoarthritis: Damage to the external or lateral aspect of the tibiofemoral joint. If there is simultaneous valgus malalignment, it is referred to as valgus gonarthrosis.

In knee osteoarthritis, the joint cartilage is worn © Henrie / Fotolia

Causes of knee osteoarthritis

In all people, signs of wear and tear in the knee joint (primary osteoarthritis) occur with increasing age. However, not only age is considered a risk factor for the development of knee osteoarthritis, but also

  • Hereditary factors
  • Being overweight,
  • Excessive or one-sided physical or athletic strain,
  • Deformities,
  • Injuries, and
  • Inflammation. 

One speaks of secondary knee osteoarthritis when the gonarthrosis is the result of

  • An injury,
  • Illness, or
  • excessive load. 

Symptoms and stages of knee osteoarthritis

The typical symptom of gonarthrosis is knee pain that occurs with exertion. In the advanced stage, the mobility of the knee joint becomes increasingly limited. Swelling occurs in the knee, the patient limps and assumes a relieving posture.

Depending on the symptoms, knee osteoarthritis can be divided into three stages:

  • Stage 1: No symptoms. Osteoarthritis is usually detected only by the changes on the X-ray.
  • Stage 2: Start-up pain that increases with exercise and improves at rest.
  • Stage 3: Persistent pain, even at rest. There are also significant restrictions on movement.

Diagnosing knee osteoarthritis

The condition is diagnosed based on 

  • A detailed anamnesis (patient consultation regarding the symptoms and triggers),
  • A physical exam (assessment of gait, range of motion, leg axis, and leg length),
  • Functional tests (e.g., ligament stability),
  • Pain tests, and
  • X-rays of the knee joint.

In some cases, special examinations such as

are performed. An arthroscopy of the knee joint is an important tool for the diagnosis and the simultaneous treatment of the damage. The video shows a knee arthroscopy procedure:

Please accept additional external content to watch this video.

Treating knee osteoarthritis

Depending on the stage, therapy is either conservative or surgical.

Conservative treatment of knee osteoarthritis consists of several treatment steps:

  1. Lifestyle adjustment (for example, reducing body weight, if necessary, and to avoid incorrect loading),
  2. Physical measures (e.g., hot or cold treatment),
  3. Physiotherapy,
  4. Orthopedic aids,
  5. Medication for pain relief,
  6. Acupuncture, if necessary.

In terms of surgery, knee surgery can be divided into joint-preserving, joint-stiffening, or joint-replacing knee surgery.

In some circumstances, an arthroscopy may be sufficient for cartilage smoothing and partial removal of concomitant meniscal damage. Clearly-defined cartilage lesions must be present for this to occur. This procedure can provide years of pain relief for the patient.

Axis corrections can lead to a more favorable distribution of pressure in the knee joint at earlier stages of osteoarthritis.

In the case of advanced knee osteoarthritis, the only remedy is often prosthetic treatment. The patient then receives an artificial knee joint (knee prosthesis).

Who treats knee osteoarthritis?

Specialists for knee osteoarthritis are usually specialists for orthopedics, sports medicine, or rheumatology.

Other exams (MRI, CT scans) are performed by specialists in the fields of radiology/nuclear medicine.

Clinics for knee osteoarthritis are clinics for

  • Orthopedics,
  • Sports Medicine,
  • Endoprosthetics, and
  • Knee Surgery.
Whatsapp Facebook Instagram YouTube E-Mail Print