Understanding Knee Osteoarthritis: Symptoms and Treatments
Knee osteoarthritis manifests itself through mechanical pain and a progressive loss of mobility. Depending on the degree of damage, treatments range from simple anti-inflammatory drugs to knee replacement. A specialized assessment is essential to adapt treatment and maintain quality of life.
Doctors
Topics
Treatments
Advice
- Dr. Jérémie Gozzo
- Definition of osteoarthritis
- Mechanical symptoms
- Functional impact
- Possible treatments
- Importance of the specialized assessment
- Anti-inflammatories
- Infiltrations
- Knee prosthesis
- Physiotherapy
- Make a complete assessment
- Consult a specialist
- Adopt treatment appropriate to the stage
- Preserve mobility
Knee osteoarthritis: essential guidelines
Knee osteoarthritis is a progressive wear of the cartilage that covers the femur, the tibia and sometimes the kneecap. It can affect a single compartment (internal, external or patellofemoral), which explains the great variability of symptoms and progression. Since the knee is a weight-bearing joint, pain occurs mainly when loading and limits walking distance. A specialized assessment can identify the stage of damage, the compartment(s) affected and aggravating factors.
This pathology affects patients of different ages and profiles. It falls along a continuum: transient discomfort, recurrent mechanical pain, then functional restrictions. The challenge is to preserve mobility and quality of life by adjusting treatment to the stage, from simple management to surgical solutions when necessary.
Clinical manifestations
The pain is mechanical: it increases when walking, during prolonged standing, and when going up or down stairs. An effusion may occur after exercise. Morning stiffness is short-lived and resolves with movement, unlike inflammatory conditions. The painful topography varies depending on the compartment affected: internal, external, or anterior (patella).
Physical abilities gradually decline and daily activities become restricted. Observation of gait, the search for limping or varus/valgus deformity guide the examination. Screening for modifiable factors (weight, adaptation of activity) is an integral part of the treatment.
Knee pain is sometimes caused by osteoarthritis, which is the wear and tear of the cartilage.
Specialized assessment
The bilateral clinical examination assesses ranges of motion, ligament stability, and pain. Standard radiography remains the gold standard for characterizing osteoarthritis, specifying the affected compartments and joint space narrowing. MRI is not routine; it is discussed on a case-by-case basis, particularly in the presence of diagnostic doubt or associated lesions. Regular monitoring measures the impact on walking and function, in order to adjust treatment over time.
This structured approach avoids excessive explorations, reassures the patient and prepares, if necessary, a clear and anticipated surgical discussion.
From conservative treatment to surgery
Treatment begins with simple measures: information, adaptation of activities, weight loss if necessary, physiotherapy to maintain mobility and strength. Pain relief treatment is progressive: paracetamol, anti-inflammatories in short courses, then additional options depending on tolerance and comorbidities. Intra-articular injections can provide temporary relief and facilitate rehabilitation.
When pain and functional limitations persist and affect quality of life, surgery is discussed. Depending on the extent of the lesions, a partial or total prosthesis may be considered.
The goal is to be able to remain active without pain and to maintain a good quality of life.
Maintaining mobility on a daily basis
Movement nourishes cartilage and maintains neuromuscular coordination. Regular, well-balanced exercise, working on balance and proprioception, and strengthening the quadriceps and glutes help stabilize the knee. Walking, low-resistance cycling, and aqua training are often well tolerated.
The goal is to remain independent, avoid muscle loss, and delay surgery. Physiotherapy support helps adapt the program based on painful flare-ups.
When to consider a total prosthesis?
Total knee replacement is considered when the disease is extensive, the pain is resistant to well-conducted medical treatment, and a major functional disability persists. The decision is based on a combination of clinical and radiographic arguments, and the patient's expectations regarding walking and activities of daily living.
Clear information about the expected benefits, follow-up, and rehabilitation determines the outcome. Preoperative preparation (mobility, strength, pain management) facilitates recovery and ensures a safe return to activities.
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