Knee Osteoarthritis After Injury - What To Do

Knee osteoarthritis is a common condition that affects millions of people worldwide. It is characterized by the wearing down of the cartilage in the knee joint, causing pain, swelling, and limited mobility. While knee osteoarthritis can occur naturally with age, it can also develop as a result of an injury. In this blog, we will explore knee osteoarthritis after injury, including its causes, symptoms, and treatment options.

Before we get started, let me introduce myself.  My name is Stephen Uhrbach and I am a physical therapist at MOMENTUM Physical Therapy & Sports Rehab in Okotoks, Alberta.  At our physio clinic, we have been treating people with knee osteoarthritis for 8+ years and I am pleased to share with you today some of the tips and tricks that we use everyday to help people like you!

Anyway, back to the topic at hand – knee osteoarthritis.  First, let’s discuss how knee injuries affect the long term health of a knee joint.    

Knee injuries can occur in a number of ways – such as overuse, trauma, or degenerative conditions. Some common knee injuries we see include sprains, strains, kneecap dislocations, and tears to the ligaments and meniscus in the knee. When a knee injury occurs, it can sometimes cause damage to the cushioning mechanisms (aka the knee cartilage and meniscus) deep in the knee joint.  Damage to these internal knee cushions cause the internal knee  to wear down, leading to knee osteoarthritis.

Ok – so once the damage occurs, how do I know if I am developing osteoarthritis in the knee?

The symptoms of knee osteoarthritis after injury can range from mild to severe and typically include:

1. Pain: Knee osteoarthritis after injury can cause pain and discomfort in the knee, especially when walking or standing for long periods of time.  The pain will often feel like a deep ache that is sometimes accompanied by a catch.
2. Swelling: The knee may become routinely swollen and tender, making it difficult to move the joint.  When the knee joint is unhappy, it might even feel warm to the touch.  
3. Stiffness: The knee may feel stiff and rigid, making it difficult to bend and straighten the joint.  People often report that the stiffness is the worst first thing in the morning or after a prolonged period of rest (such as watching a movie)
4. Limited mobility: The knee may not be able to move as easily as it used to, leading to limited mobility and a decreased ability to perform daily activities.  People often report difficulty crouching down, kneeling, or squatting when mobility becomes difficult.  

Yikes – so how do I know if I am developing knee osteoarthritis?

Diagnosis of knee osteoarthritis after injury typically involves a physical examination (by a trained physical therapist) and imaging tests such, as an X-ray.  Often, this will be enough to make a highly accurate diagnosis of the severity of your osteoarthritis. Your physical therapist will also review your medical history and discuss any knee injuries you may have had in the past that may be contributing to your current knee osteoarthritis.  

At this point, many people naturally start asking what their options are for managing knee osteoarthritis.  

Treatment for knee osteoarthritis after injury will depend on the severity of the condition and the extent of the cartilage damage. Non-surgical treatments for knee osteoarthritis is always the first course of action and highly effective at managing symptoms.  Treatment options include:

1. Physical therapy: Physical therapy is a powerful tool to help manage knee osteoarthritis.  A physical therapist will provide hands on therapy to loosen the tightened muscles and the stiff joint, they will provide you with essential strength and mobility exercises, and can help reduce any pain or swelling that your might be feeling in your knee.  People often feel relief from their knee osteoarthritis with physical therapy in the first few sessions.
2. Assistive devices: Knee braces or walking aids can help reduce the strain on the knee, providing support and reducing pain.  Custom offloading knee braces have been highly effective tools to help take pressure off of the arthritic compartment of your knee.  A physical therapist can let you know if you might benefit from one of these.    
3. Pain relief medications: Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve knee pain.  Please consult with your pharmacist or physician before trying any new medications.
4. Weight management: Did you know that your knees feel 6 times your body weight when walking up the stairs?  Maintaining a healthy weight can help reduce the pressure on the knee, reducing pain and slowing the progression of knee osteoarthritis after injury.  Learning about how to manage and maintain bodyweight is a powerful tool to help slow and stop the progression of osteoarthritis in the knee.  

Sometimes, in more severe cases and after conservative care of knee osteoarthritis has not been successful, surgery may be necessary to treat knee osteoarthritis.  In instances like this, your physical therapists will refer you back to your family doctor or to a sports medical doctor in order to determine if you are a surgical candidate. Surgical options for knee osteoarthritis after injury include:

1. Joint replacement: This procedure involves removing the damaged cartilage and replacing it with a metal or plastic implant.  
2. Arthroscopy: This is a minimally invasive procedure that involves using a small camera and instruments to remove damaged tissue and repair the knee joint.
3. Osteotomy: This procedure involves cutting and repositioning the bones in the knee to reduce the pressure on the joint and slow the progression of knee osteoarthritis after injury.

At the end of the day, knee osteoarthritis after injury can be a painful and debilitating condition, but there are many treatment options available to help relieve pain and improve your function, and maintain your quality of life. It is always recommended that you try non-surgical treatments before opting for surgery.  By working closely with your physical therapist, you can learn how to manage your knee osteoarthritis and maximize your quality of life.