We all know that keeping active is one of the key ingredients to living a healthy life. In the last year, the recurrent closure of gyms and leisure facilities has made an active lifestyle more difficult, but for some it is a painful knee that prevents exercise. When knee pain interferes with normal activity, it is time to act and seek medical help – but before you do, here are some things you need to know.
A visit to an orthopaedic surgeon can help you get a diagnosis and treatment. The surgeon will determine if your knee pain is caused through injury or a more long-term issue, such as osteoarthritis. When people talk about knee arthritis, it is usually osteoarthritis to which they are referring. Osteoarthritis is characterised by inflammation and ‘wear and tear’ damage to the knee. It develops over time, and can sneak up on you. When symptoms first appear, much of the damage has already been done.
The process of damage and wearing out of the joint cartilage surface eventually results in the bone grinding on bone in the knee, which is a painful and disabling condition. Up to 25% of people with knee arthritis will retire early due to the pain it causes, and in Bristol alone, there are around 9000 people with severe knee arthritis.
Any of the three main parts of the knee – the inner (medial) compartment, the outer (lateral) compartment, and the knee cap (patellofemoral) joint can be affected by osteoarthritis. There are several risk factors for osteoarthritis, including your genes, lifestyle factors, previous injuries, hypermobility and obesity.
Symptoms of knee osteoarthritis
The predominant symptoms of knee arthritis are pain and stiffness, which lead to a loss of mobility. Symptoms range from mild to severe. There can be a mild background ache in the knee, which might interfere with sporting activities or a long walk. In more severe cases, it can be a constant severe disabling pain, which makes walking very difficult or impossible. Pain may also be so severe that sleep can be disturbed and there is pain at rest. The normal activities of daily living may become difficult to perform.
Roughening and fragmentation of the knee joint surface may also lead to catching, clicking, clunking or similar symptoms. Swelling of the knee joint is often seen, and in severe cases, the shape of the knee may change. In the worst cases, loss of mobility can lead to poor cardio-respiratory fitness.
Treatment of knee osteoarthritis
Following a diagnosis of arthritis, you may receive some form of treatment before you see a surgeon. Non-surgical treatments may include simple painkillers, anti-inflammatory tablets, weight loss treatments, modification of activities, or physiotherapy.
If there are symptoms of mechanical locking in the knee, or stiffness, then keyhole surgery (arthroscopy) of the knee may improve this. However, knee arthroscopy treatment cannot reverse the arthritis damage.
For those patients who might be suffering with arthritis but are hoping to avoid surgery, there are less invasive, non-surgical options available, such as injection therapy. This can prove beneficial in managing joint pain to the point whereby the need for surgery is delayed. Steroid injections are an example of this. Another new technique available is Platelet Rich Plasma treatment (PRP), which uses a patient’s own anti-inflammatory cells to promote the healing of injured joints.
If the arthritis pain is severe and you have exhausted non-operative treatment, then you may decide to proceed with a knee replacement. Knee replacement surgery has evolved, with innovative, state-of-the-art robotic-arm technology now available to assist the surgeon with the procedure. This brings a range of enhanced benefits for the patient, including even greater surgical precision, which in turn leads to decreased post-operative pain and faster recovery.
Nuffield Health Bristol Hospital is currently the ONLY hospital in the city to offer robotic-arm assisted knee replacement surgery, highlighting Nuffield Health’s commitment to providing our patients with the best possible treatment. The decision to proceed is made with your surgeon, so that you fully understand the benefits and risks of each procedure.
Since March 2020, Nuffield Health Bristol Hospital has been supporting the NHS through the COVID-19 pandemic. Additional safety measures are in place to make our hospital COVID-19 secure, and our team of Consultant Orthopaedic Surgeons continue to hold regular clinics. Consultants specialising in knee surgery include Mr Jonathan Webb, Mr Richard Baker, Mr Damian Clark, Mr Hywel Davies, Mr Sanchit Mehendale and Mr James Robinson. Call our Enquiries team on the number below, who will be able to assist you in booking a consultation.
Some of the treatments we offer for arthritis: • Physiotherapy • Steroid injections • PRP Injections • Weight loss therapies • Knee replacements
It doesn’t matter if you want to climb a mountain (travel restrictions permitting!) or simply tidy the garden, any symptom that prevents or limits your ability to do the things you love is cause for concern. With a little help, a bad knee doesn’t have to impact your quality of life.