Knee osteoarthritis (gonarthrosis)

What is knee osteoarthritis?

Knee osteoarthritis, also known as gonarthrosis, is a normal wear and tear of the joint. It affects not only the cartilage but also the bone, ligaments, capsule, and muscles. It's a gradual process that develops over several years.

Articular cartilage acts like a cushion between bone surfaces. This allows your knee to glide and move smoothly. Over time, this cartilage can gradually wear down.

Osteoarthritis isn't limited to cartilage. All the structures that make up the knee joint can be affected. The bone beneath the cartilage, ligaments, joint capsule, synovial membrane, and surrounding muscles all play a role in this adaptation process.

Structures Affected by Knee Osteoarthritis

Here's the good news: osteoarthritis is not a serious disease that destroys your joint. It's a normal adaptive process that develops slowly over years, even decades. This phenomenon can also affect other joints. To learn more about forms of osteoarthritis affecting the back, consult our guide on lumbar osteoarthritis.

What Are the Symptoms of Knee Osteoarthritis?

Knee osteoarthritis doesn't always cause symptoms. Many people live with osteoarthritis without feeling anything. When it becomes symptomatic, one might experience progressive pain, morning stiffness, and cracking sounds in the knee.

This disconnect between osteoarthritis and pain often surprises people. You can have a lot of osteoarthritis visible on imaging scans and no pain at all. Conversely, you can have little osteoarthritis but many symptoms. To better understand this paradox, read our article Is It Really Your Osteoarthritis Causing Your Pain?

Common Symptoms of Knee Osteoarthritis

Morning stiffness is characteristic of osteoarthritis. It usually improves with movement in less than 30 minutes. This is a distinguishing sign compared to other joint conditions.

If your symptoms persist for several weeks and affect your daily activities, an evaluation can help you better understand your situation. For knee pain, a prompt consultation allows for targeting the right interventions.

What Are the Causes and Risk Factors?

Aging is the primary cause of knee osteoarthritis. From age 50 onwards, it's normal to have it. Certain factors accelerate the process, such as previous injuries, female gender, obesity, and physical inactivity.

Osteoarthritis doesn't develop overnight. It's a process that unfolds over several years, often decades. The body gradually adapts to the demands placed upon it.

Risk Factors for Knee Osteoarthritis

The good news is that two of these factors are modifiable. Regular physical activity and maintaining a healthy weight can positively influence the progression of osteoarthritis. An injury like a knee sprain or ACL tear can increase the long-term risk of osteoarthritis.

How Is Knee Osteoarthritis Diagnosed?

Knee osteoarthritis is diagnosed based on your symptom history and a clinical examination. X-rays are not mandatory. Importantly, up to 85% of adults without pain show osteoarthritis on X-rays.¹

This statistic is revealing. It shows that what is seen on imaging isn't always clinically relevant. An X-ray showing osteoarthritis doesn't automatically mean it's the cause of your pain.

Diagnostic Methods

A healthcare professional can diagnose knee osteoarthritis by asking about your symptoms and examining your joint. X-rays can confirm the diagnosis, but they are not necessary to begin treatment.

When to Consult a Physiotherapist for Knee Osteoarthritis?

Consult a physiotherapist if you have symptoms that limit your daily activities. You don't need to see a doctor beforehand. If your condition requires medical advice, your physiotherapist will inform you.

In Quebec, you have direct access to a physiotherapist without a medical prescription. This accessibility allows for a quick evaluation. To know what to expect, consult our article on what happens during a physiotherapy evaluation.

Signs That an Evaluation Would Be Helpful

Your physiotherapist will assess your situation and determine if physiotherapy can help you. If your condition requires further medical investigation, he or she will refer you to the appropriate professional.

Does Physiotherapy Work for Knee Osteoarthritis?

Physiotherapy is recognized as an effective treatment for knee osteoarthritis, with results supported by scientific research.

Studies show a 70-80% success rate for treating knee osteoarthritis with physiotherapy⁴. The combination of therapeutic exercises, manual therapy, and education is particularly effective in reducing pain and improving function⁵.

Treatment effectiveness depends on several factors: how early you seek consultation (earlier = better results), consistency with home exercises, the severity of osteoarthritis, quadriceps strength, and body weight. A comprehensive evaluation allows us to tailor the treatment to your specific situation.

Most patients notice improvement within the first 4-6 weeks of treatment, with complete resolution typically achieved in 12-16 weeks.

Do you suffer from knee osteoarthritis? Book an appointment for a comprehensive evaluation and a personalized treatment plan.

What Are the Physiotherapy Treatments for Knee Osteoarthritis?

The best treatment for knee osteoarthritis is movement.³ Your physiotherapist will assess why your osteoarthritis is causing pain and will offer mobilizations, specific exercises, and advice on pacing your activities.

Elements Evaluated in Physiotherapy

Physiotherapy Interventions

Osteoarthritis itself cannot be cured, as it's a wear-and-tear process that doesn't reverse. However, treatment can completely eliminate the symptoms associated with knee osteoarthritis, even if the condition remains present in the joint. Discover what to expect during physiotherapy treatment.

What can you do at home for knee osteoarthritis?

The best thing to do is stay active. Start with regular walks and mobility exercises, always respecting your pain levels. Avoid staying in the same position for more than an hour.

Tips based on your current activity level

Practical tips for daily life

• Temporarily stop movements that are too painful, then gradually resume them.
• Change your position regularly. Don't sit or stand for more than an hour.
• Move every day according to your tolerance. This is why regular physical activity is so important.

About Weight Loss

Weight reduction is among the international recommendations for improving knee osteoarthritis symptoms. However, this weight loss should be a side effect of healthier lifestyle habits, not an objective in itself.

Focus on regular physical activity, a balanced diet, and good sleep. For nutritional guidance, consult a nutritionist.

How can I reduce my chances of developing knee osteoarthritis?

Regular physical activity throughout your life is the most important factor. Your joints are nourished by movement, much like a plant needs water. Aim for 150 minutes of cardio per week, strength training twice a week, and maintaining a healthy weight.²

Many people wonder if certain activities, like running, can cause osteoarthritis. Research is reassuring. Consult our article Does running cause osteoarthritis? to learn more.

Canadian Physical Activity Guidelines

These recommendations apply to young adults and older individuals alike. If you already have osteoarthritis, these tips will help reduce your chances of experiencing symptoms.

Other Prevention Factors

Physical activity remains the number one factor. Your joints become stronger and more resilient through regular movement.

To deepen your knowledge of osteoarthritis, you can listen to the 'Parle-moi de santé' podcast created by our physiotherapist Alexis Gougeon.

• Listen on YouTube

You can also find the podcast on major podcast platforms. For an overview of what physiotherapy is and how it can help you, consult our complete guide to physiotherapy.

• Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskeletal Disorders. 2008;9:116.

• Canadian Society for Exercise Physiology. Canadian 24-Hour Movement Guidelines for Adults Aged 18–64 Years. 2021.

• Hsu H, Siwiec RM. Knee Osteoarthritis. StatPearls. 2023.

• Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1:CD004376. doi:10.1002/14651858.CD004376.pub3

• Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589. doi:10.1016/j.joca.2019.06.011