Knee osteoarthritis
Understanding this condition
Knee osteoarthritis is the progressive wear of the knee cartilage. Cartilage is the smooth layer that covers the bone surfaces inside the joint and allows the two bones — the femur above and the tibia below — to glide without friction.
Over the years, through repeated microtraumas, a previous injury (meniscal or ligamentous), or an alignment defect, this cartilage wears down, cracks, and then disappears. The bones then rub directly against each other, causing pain. Knee osteoarthritis can affect one of the three compartments of the knee (medial, lateral, or patellofemoral) or several simultaneously.
Symptoms
The pain is mechanical: present when walking, climbing and descending stairs, rising from a low chair, and relieved by rest. It is generally located at the front or side of the knee.
The knee progressively stiffens, especially in the morning on waking or after prolonged sitting. Walking distance shortens. Inflammatory flare-ups (swollen, warm knee) can occur.
How can it progress?
The natural progression is slow but constant: over several years, pain intensifies, range of motion decreases, and the knee may deform (bowing inwards or outwards).
Eventually, walking even a few minutes becomes difficult, independence diminishes, and quality of life declines. Hip or back pain may appear as a consequence.
Treatment options
When symptoms are moderate, simple measures are tried first: painkillers, anti-inflammatory drugs during flare-ups, physiotherapy to maintain mobility and strengthen the muscles, injections (corticosteroids, hyaluronic acid), and weight loss when indicated.
When arthritis affects only one compartment and the ligaments are intact, a partial knee replacement (unicompartmental knee arthroplasty, UKA) is sufficient. When wear affects several compartments or the knee is deforming, a total knee replacement (TKA) is the solution. A consultation helps assess the right time to consider surgery.