Knee Osteoarthritis (Gonarthrosis)

Synonym for knee osteoarthritis:

• Gonarthrosis

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What is knee osteoarthritis?

It is the normal wear and tear of the knee joint. Osteoarthritis is often described as the wearing away of cartilage between our bones. This is true, but it's more than just the cartilage. Cartilage is a tissue that acts like a cushion between the surfaces of our bones, allowing our joints to glide and move smoothly.

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With the development of osteoarthritis, it is true that the cartilage will become more worn. However, all the structures that make up the knee joint can be affected by osteoarthritis. Therefore, there can be degenerative changes in the cartilage, bone, ligaments, capsule, synovial membrane, and muscles around the joint.

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What are the symptoms of knee osteoarthritis?

It is important to understand that osteoarthritis does not always cause symptoms. Many people live with osteoarthritis and feel absolutely nothing. Does that surprise you? Read our blog article to learn more (coming soon).

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When osteoarthritis is symptomatic, here is what people may experience:

• Knee pain that appears gradually and persists
• Knee stiffness that is often worse in the morning or after a period of inactivity
  
  • Knee stiffness that generally improves with movement in less than 30 minutes
• Reduced knee flexibility
• You may feel crackling or popping in the knee when you move it.
• Increased difficulty performing your usual activities and hobbies

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What are the causes and risk factors for knee osteoarthritis?

Aging is the main factor that causes osteoarthritis, regardless of the joint. It is normal to have knee osteoarthritis starting at age 50. However, osteoarthritis doesn't develop overnight. It's a process that occurs gradually over several years.

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Here are some risk factors that increase the chances of developing knee osteoarthritis more quickly or severely:

• Having had a previous knee injury or surgery (fracture, sprain, tear, etc.)
• Women are more at risk than men
• Obesity
• Inactivity

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How is knee osteoarthritis diagnosed?

Knee osteoarthritis can be diagnosed based on a review of your symptoms and a physical exam. An X-ray of the knee can also show signs of osteoarthritis, but it is not required for a diagnosis.

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"It's important to know that what we see on X-rays or other types of imaging isn't always relevant. In fact, up to 85% of adults with no knee pain have knee osteoarthritis on X-rays. Yet, they have no pain!"

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When should you see a physiotherapist for knee osteoarthritis?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What are the physiotherapy treatments for knee osteoarthritis?

The best treatment for osteoarthritis symptoms is movement.

Your physiotherapist will conduct an assessment to determine why your osteoarthritis is causing you pain.
To do this, your physiotherapist will assess the following:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Mobilize your knee to reduce pain and improve your movement
• Give you specific exercises to retrain the control of your knee movements.
• Give you exercises to regain mobility, reduce pain and regain your muscle strength.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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"It's important to note that we don't cure osteoarthritis as such, because it's a wear-and-tear process that doesn't reverse. But we can completely eliminate the symptoms associated with knee osteoarthritis with treatment, even if the osteoarthritis is still present in the joint."

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What can you do at home for knee osteoarthritis?

The best thing to do is to stay active.

If you are sedentary, start by taking regular walks and doing mobility exercises for your knee every day, respecting the pain. If you are already active, continue your activities that don't cause too much pain.

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Weight loss is also among the international recommendations for improving symptoms associated with knee osteoarthritis. However, this weight loss should simply be a side effect of improved lifestyle habits (physical activity, diet, sleep). Also, weight loss or changes to your diet should always be supervised by a nutritionist.

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Here are some other tips that may help at home:

• Temporarily stop doing the movements that cause too much pain, and then gradually start doing them again.
• Limit the time spent in the same position to no more than one hour (computer, television, reading). Get up often to move around a bit.
• Do physical activity according to your tolerance each day. This remains the best remedy for osteoarthritis symptoms.

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How can I reduce my chances of developing knee osteoarthritis later in life?

If you are still quite young, you have the power to reduce your risk of developing osteoarthritis later in life. If you are older, these tips will certainly help you reduce your chances of having symptoms, even with your osteoarthritis.

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Here are the best tips to follow from a young age and to continue throughout your life to reduce your chances of developing osteoarthritis:

• Be active regularly and throughout your life
  
  • This is certainly the most important factor. Your joints are nourished by movement and become stronger through movement.
  • Here are some targets to aim for regarding physical activity, according to Canadian recommendations:
    
    • 150 minutes per week of moderate to high intensity cardio activity
    • Stand as often as possible (this counts as light activity)
    • Do strength training with exercises that include large muscle groups 2x/week
    • Limit sitting time to 8 hours/day
• Maintain a healthy weight (this will vary greatly from person to person)
• Avoid accumulating multiple joint injuries such as sprains, fractures, and surgeries
• Adopt healthy eating habits (refer to a nutritionist or the Canadian Food Guide)

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To learn more...

You can listen to the podcast created by one of our physiotherapists, Alexis Gougeon.

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Episode #15 is about osteoarthritis.

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Find the episode on YouTube :

Click below to listen to episodes on podcast platforms:

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Sources

• Canadian Society for Exercise Physiology (25-01-2021). Canadian 24-Hour Movement Guidelines for Adults ages 18-64 years : An Integration of Physical Activity, Sedentary Behaviour, and Sleep. https://csepguidelines.ca/adults-18-64/
• Hsu H, Siwiec RM. Knee osteoarthritis.
• Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC musculoskeletal disorders. 2008 Dec;9(1):1-1.

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