Knee Osteoarthritis

Osteoarthritis (OA) refers to the deterioration of the cartilage between two bones and a result they now touch one another. Osteoarthritis can happen between two bones at any joint in the body. The knee joint consists of the femur and the tibia. In between these two bones we have articular cartilage that encases the ends of the bones and in between these two bones we have additional cartilage called the meniscus that acts as a shock absorber for the knee. When knee OA develops the articular cartilage and the meniscus deteriorate and now the tibia and femur are touching. This is the source of pain within the knee from OA. A lot of people tend to get upset when they learn they have OA but in reality it’s a normal finding as we age and all it really means is that we use our bodies. The hip and knees are prone to osteoarthritis because they are weight bearing joints (why we see a lot of knee and hip replacements as opposed to other joints of the body). As we use our legs throughout the course of our lives we put force through our legs when we use our legs to walk, run, jump, navigate up and down stairs, amongst all other activities. This leads to the development of OA and mild levels are normal in everyone as we age. The hallmark sign of severe osteoarthritis is significant pain when getting up to move after a period of staying still and then alleviating as the person moves more. In knee OA the individual will have significant pain when bending the knee or trying to initiate any movement that involves bending the knee such as squatting, going up and down stairs, putting on shoes or socks, etc (because this causes the femur and the tibia to rub one another). Treatment for knee OA in physical therapy varies greatly and entirely depends on the severity of the OA. Mild to moderate knee OA can be resolved in physical therapy. In physical therapy we use techniques to break up scar tissue that has developed around the knee and promote blood flow into the knee for healing. We work on improving the space between the femur and tibia, we work on the mobility of the joint so the joint can move better, and we work on strengthening the muscles around the joint, especially the quadricep, so force and impact is taken off the joints and is absorbed by the muscle. By doing these techniques the individual is less likely to feel pain during movement. In cases of severe knee OA the knee may not respond to physical therapy. It is likely that a total knee replacement is needed. The good news is that most individuals have their pain resolved after this procedure and with compliance to physical therapy the rehab process can be done close to pain free. Please see below for examples of how we treat knee OA in our clinic. If you would like to schedule an appointment please reach out to us.