Knee osteoarthritis (gonarthrosis): Info & specialists for knee osteoarthritis

08.11.2023
Leading Medicine Guide Editors
Author
Leading Medicine Guide Editors

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

Here you will find further information as well as selected specialists and centers for knee osteoarthritis.

ICD codes for this diseases: M17

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Brief overview:

  • What is knee osteoarthritis? The progressive degradation of cartilage substance in the knee due to wear and tear, which can cause the joint bones to rub painfully against each other.
  • Forms: Various areas of the knee joint can be affected. Accordingly, a distinction is made between retropatellar osteoarthritis (on the kneecap), medial knee osteoarthritis (inner knee areas) and lateral knee osteoarthritis (outer knee areas).
  • Causes: Signs of wear and tear occur in all people with advancing age. Other risk factors include hereditary factors, obesity, excessive or one-sided strain and others.
  • Stages: A distinction is made between three stages, with the pain and restriction of mobility increasing as the stage progresses. In the first stage, knee osteoarthritis can only be seen on X-rays; in stage 3, those affected suffer from permanent pain.
  • Diagnosis: A medical history and physical examination are followed by functional tests, pain tests and X-rays. An MRI, CT scan, scintigraphy or arthroscopy may also be ordered.
  • Treatment: In the early stages, conservative treatment is often sufficient to alleviate symptoms and slow down progression. In later 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 substance in the knee joint. The wear and tear results in knee pain and limited mobility.

The diagnosis is made on the basis of a physical examination and evidence of joint changes on an X-ray. In addition to conservative procedures, surgical treatment is also available.

The video provides an overview of the knee joint and its structure with cartilage and ligaments:

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Knee osteoarthritis and its forms

All joints in the body can be affected by osteoarthritis, i.e. the breakdown or wear and tear of the cartilaginous joint surfaces.

The knee is exposed to particularly high levels of stress. This is why it is often affected by osteoarthritis. Osteoarthritis of the knee is also known as gonarthrosis.

Due to the friction of the joint, the cartilage becomes increasingly rough and gradually breaks down. In severe cases, parts of the bone or cartilage can become detached. The video shows how knee osteoarthritis develops with cartilage damage:

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As a result of this degradation process, the joint space becomes narrower. This leads to knee pain and inflammation and swelling in the knee joint. This reduces the mobility of the joint.

Depending on the joint section, a distinction is made between these forms of osteoarthritis of the knee:

  • Retropatellar osteoarthritis: wear and tear in the joint of the kneecap (femoropatellar joint).
  • Medial gonarthrosis: damage to the inner (medial) femorotibial joint (connection between the femur and tibia). If there is an additional bow-leg malalignment, this is referred to as varus gonarthrosis.
  • Lateral gonarthrosis: Damage to the outer or lateral area of the femorotibial joint. With simultaneous knock-knee deformity: valgus gonarthrosis.

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

Causes of knee osteoarthritis

All people experience signs of wear and tear in the knee joint with increasing age (primary osteoarthritis). However, it is not only age that is a risk factor for the development of osteoarthritis of the knee joint, but also

  • hereditary factors
  • being overweight
  • Excessive or one-sided physical or sporting strain
  • Malpositions
  • injuries
  • Inflammation

We speak of secondary knee osteoarthritis if the osteoarthritis is the result of

  • of an injury,
  • illness or
  • excessive strain

is.

Symptoms and stages of knee osteoarthritis

The typical symptoms of osteoarthritis of the knee are knee pain on exertion. At an advanced stage, the mobility of the knee joint becomes increasingly restricted. There is swelling in the knee, the patient limps and adopts a relieving posture.

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

  • Stage 1: No symptoms. Osteoarthritis is usually only recognized by the changes in the X-ray image.
  • Stage 2: Initial pain that increases with movement and improves at rest.
  • Stage 3: Permanent pain, even at rest. Significant restrictions in movement are added.

Diagnosis of knee osteoarthritis

The diagnosis is made after

  • A detailed medical history (patient questioning about symptoms and triggers),
  • physical examination (assessment of the gait pattern, range of motion, leg axis and leg length) and
  • functional tests (e.g. ligament stability),
  • pain tests and
  • X-rays of the knee joint.

In some cases, special examinations such as

are used. An arthroscopy of the knee joint is an important tool for diagnosing and treating the damage at the same time. The video shows the procedure of a knee arthroscopy:

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Treatment of knee osteoarthritis

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

Conservative treatment of knee osteoarthritis consists of several treatment steps:

  1. Lifestyle adjustments (for example, reducing body weight if necessary and avoiding incorrect weight-bearing)
  2. Physical measures (e.g. heat or cold applications)
  3. Physiotherapy
  4. Orthopaedic aids
  5. Medication to relieve pain
  6. Acupuncture if necessary

Surgically, a distinction can be made between joint-preserving, joint-stiffening or joint-replacing knee surgery.

Under certain circumstances, arthroscopy may be sufficient to smooth the cartilage and partially remove any accompanying meniscus damage. This requires the presence of circumscribed cartilage lesions. This procedure can ensure that the patient remains pain-free for years to come.

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

In cases of advanced knee joint arthrosis, prosthetic treatment is often the only option. The patient then receives an artificial knee joint(knee prosthesis).

Who treats osteoarthritis of the knee?

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

Further examinations (MRI, CT) are carried out by specialists in radiology/nuclear medicine.

Knee arthrosis clinics are clinics for

  • orthopaedics,
  • sports medicine,
  • endoprosthetics and
  • knee surgery.
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