Knee Arthritis in Omaha, Ne
Omaha Knee Arthritis Information by Dr. Ajoy Jana MD
Arthritis refers to any condition that results in the breakdown or degeneration of joint cartilage. There are many types of knee arthritis. The most common types of arthritis include:
- Osteoarthritis (OA), also known as degenerative joint disease (DJD), is the most common type of arthritis. Although OA is typically thought to result from years of wear-and-tear, science does not yet have a complete understanding of this disease. Genetics play an important role, since OA clearly runs in families. Being overweight greatly increases the likelihood of developing OA. However, it remains unknown why OA affects some individuals in their 40’s and others in their 80’s, or why it often affects only one knee.
- Rheumatoid arthritis (RA) is an auto-immune disease and a type of inflammatory arthritis that causes severe inflammation of the lining (synovium) of the joint, which causes destruction of the joint cartilage. It is the second most common cause of joint degeneration. Other auto-immune diseases such as psoriasis, lupus and Crohn's disease are also associated with inflammatory arthritis. RA usually effects multiple joints and it is the second most common cause for knee replacement.
- Post-traumatic arthritis occurs when joint cartilage is directly injured and then deteriorates over time. Patients who have had a knee fracture, a large meniscus tear, or a torn anterior cruciate ligament (ACL) are more likely to develop arthritis later in life.
- Osteonecrosis, also known as avascular necrosis, occurs when the blood supply to part of the bone is disrupted. Without enough blood flow the bone dies and collapses, resulting in both pain and eventual degeneration of the overlying cartilage. Osteonecrosis is not as common in the knee as the hip, but when it occurs, the affected area of the bone dies and collapses, resulting in pain and eventual arthritis.
Osteoarthritis of the Knee
Introduction
Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative, or wear and tear, arthritis. OA commonly affects the knee joint. In fact, knee OA is the most common cause of disability in the United States. In the past, people were led to believe that nothing could be done for their problem. Now doctors have many ways to treat knee OA so patients have less pain, better movement, and enhanced quality of life.
Which parts of the knee are affected?
The main problem in OA is degeneration of the articular cartilage. Articular cartilage is the smooth lining that covers the ends of the leg bones where they meet to form the knee joint. The cartilage gives the joint freedom of movement by decreasing friction. The layer of bone just below the articular cartilage is called subchondral bone. When the articular cartilage degenerates, or wears away, the bone underneath is uncovered and rubs against bone. Small outgrowths called bone spurs or osteophytes may form in the joint.
Osteoarthritis (OA) is a common problem for many people after middle age. OA is sometimes referred to as degenerative, or wear and tear, arthritis. OA commonly affects the knee joint. In fact, knee OA is the most common cause of disability in the United States. In the past, people were led to believe that nothing could be done for their problem. Now doctors have many ways to treat knee OA so patients have less pain, better movement, and enhanced quality of life.
Which parts of the knee are affected?
The main problem in OA is degeneration of the articular cartilage. Articular cartilage is the smooth lining that covers the ends of the leg bones where they meet to form the knee joint. The cartilage gives the joint freedom of movement by decreasing friction. The layer of bone just below the articular cartilage is called subchondral bone. When the articular cartilage degenerates, or wears away, the bone underneath is uncovered and rubs against bone. Small outgrowths called bone spurs or osteophytes may form in the joint.
Knee Arthritis Development

How does knee OA develop?
OA of the knee can be caused by a knee injury earlier in life. It can also come from years of repeated strain on the knee. Fractures of the joint surfaces, ligament tears, and meniscal injuries can all cause abnormal movement and alignment, leading to wear and tear on the joint surfaces. Not all cases of knee OA are related to a prior injury, however. Scientists believe genetics makes some people prone to developing degenerative arthritis. Obesity is linked to knee OA. Losing only 10 pounds can reduce the risk of future knee OA by 50 percent.
Scientists believe that problems in the subchondral bone may trigger changes in the articular cartilage. Normally, the articular cartilage protects the subchondral bone. But some medical conditions can make the subchondral bone too hard or too soft, changing how the cartilage normally cushions and absorbs shock in the joint.
OA of the knee can be caused by a knee injury earlier in life. It can also come from years of repeated strain on the knee. Fractures of the joint surfaces, ligament tears, and meniscal injuries can all cause abnormal movement and alignment, leading to wear and tear on the joint surfaces. Not all cases of knee OA are related to a prior injury, however. Scientists believe genetics makes some people prone to developing degenerative arthritis. Obesity is linked to knee OA. Losing only 10 pounds can reduce the risk of future knee OA by 50 percent.
Scientists believe that problems in the subchondral bone may trigger changes in the articular cartilage. Normally, the articular cartilage protects the subchondral bone. But some medical conditions can make the subchondral bone too hard or too soft, changing how the cartilage normally cushions and absorbs shock in the joint.
What does Knee Osteoarthritis feel like?
Knee OA develops slowly over several years. The symptoms are mainly pain, swelling, and stiffening of the knee. Pain is usually worse after activity, such as walking. Early in the course of the disease, you may notice that your knee does fairly well while walking, then after sitting for several minutes your knee becomes stiff and painful. As the condition progresses, pain can interfere with simple daily activities. In the late stages, the pain can be continuous and even affect sleep patterns. How do doctors identify OA? The diagnosis of OA can usually be made on the basis of the initial history and examination. X-rays can help in the diagnosis and may be the only special test required in the majority of cases. X-rays can also help doctors rule out other problems, since knee pain from OA may be confused with other common causes of knee pain, such as a torn meniscus or kneecap problems. In some cases of early OA, X-rays may not show the expected changes. Magnetic resonance imaging (MRI) may be ordered to look at the knee more closely. An MRI scan is a special radiological test that uses magnetic waves to create pictures that look like slices of the knee. The MRI scan shows the bones, ligaments, articular cartilage, and menisci. The MRI scan is painless and requires no needles or dye. If the diagnosis is still unclear, arthroscopy may be necessary to actually look inside the knee and see if the joint surfaces are beginningto show wear and tear. Arthroscopy is a surgical procedure in which a small fiberopticTV camera is inserted into the kneejoint through a very small incision, aboutone-quarter of an inch long. The surgeon canmove the camera around inside the joint whilewatching the pictures on a TV screen. Thestructures inside the joint can be poked andpulled with small surgical instruments to see ifthere is any damage. |
What can be done for Knee Arthritis?
Nonsurgical Treatment - OA can't be cured, but therapies are available to ease symptoms and to slow down the degeneration. Recent information shows that mild cases of knee arthritis may be maintained and in some cases improved without surgery.
Nonsurgical Treatment - OA can't be cured, but therapies are available to ease symptoms and to slow down the degeneration. Recent information shows that mild cases of knee arthritis may be maintained and in some cases improved without surgery.
- Exercise: Arthritic knees usually feel better if you exercise. It's important to keep your muscles strong and maintain your flexibility. Choose any low-impact exercise that you enjoy and that you can do without too much discomfort. Consider walking, cycling, water aerobics, swimming, or elliptical machines. Do take time of from exercising if your knee becomes too painful, but try to return to it once you feel better. Your doctor can also prescribe physical therapy
- Weight Loss: If you are overweight, losing weight is one of the most effective ways to decrease knee pain from arthritis. Weight loss is so effective because normal activities such as stair climbing multiply the force on your knees by 2-5 times your body weight. While losing weight is not easy, the benefits to your knee and general health are substantial.
- Medicines: Acetaminophen (Tylenol) is a good first choice for pain control, but limit yourself to 3000 mg per day to avoid risk of liver damage. Anti-inflammatory medications, such as Ibuprofen, Aleve, or Celebrex, are the second choice for most patients. These medications can be very effective, but they can also have side effects, so inform your doctor if you are using them. Anti-inflammatory medications can raise blood pressure, increase water retention, and cause stomach ulcers. Narcotic painkillers such as Vicodin or Percocet are rarely used because they are habit-forming, have numerous side-effects and only are designed for short-term relief of pain.
- Supplements: Glucosamine and Chondroiton supplements are popular, but most studies show minimal benefits. If you want to try them, go ahead for six-weeks and then judge for yourself. Fish Oil has been shown in some studies to help arthritis pain in addition to being protective of heart disease. Capsaicin cream, available over-the-counter, has been found to decrease pain.
- Shoes: Comfortable, well-cushioned shoes are helpful. Special orthotics are usually not helpful.
- Injections: There are two kinds of medicine that can be injected into an arthritic knee joint. The first is steroid, also know as Cortisone, and it is a powerful anti-inflammatory that can provide a few weeks or months of pain relief. The second is synthetic joint fluid that nourishes and lubricates the joint. It is given as a series of 3 weekly injections that may provide 6 to 9 months of pain relief. Keep in mind that no medication slows or reverses arthritis.
- Cane or Walker: Even though many people resist using a cane or walker, they can provide extra support to help decrease pain and improve walking distance. Canes should be used in the hand opposite of the affected knee.
Surgical Treatments
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Support Groups: Learn strategies for managing your arthritis from instructors and peers. Group education programs are available at the Arthritis Foundation, call or visit http://www.arthrits.org.
This website is brought to you by Dr. Ajoy Jana MD.
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Parts of this document were reproduced with permission from eorthopod.com Osteoarthritis of the Knee Patient Guide