Progressive wear of the cartilage in the knee joint. Many patients with knee arthritis can be managed without surgery — treatment is individualised.
Knee osteoarthritis is the gradual wearing of the cartilage that cushions the knee joint. Over years, the cartilage becomes thinner and less smooth; the underlying bone reacts by forming small extra bone spurs; and the surrounding tissues may become inflamed. The result is pain, stiffness, occasional swelling and — over time — difficulty with stairs, walking or squatting.
An X-ray showing arthritis does not automatically mean surgery is needed. Many patients with visible arthritis on imaging live comfortably with non-surgical care. Surgery is considered only when pain and functional limitations no longer respond to appropriate conservative treatment.
Symptoms of knee arthritis vary between patients and often progress over years rather than weeks. Common symptoms include:
Diagnosis is based on clinical examination and appropriate imaging. Standing (weight-bearing) X-rays of the knee are usually the first investigation and are often sufficient. MRI may be used in selected cases, for example when soft-tissue injury or an alternative diagnosis is suspected.
The severity of arthritis on imaging does not always correlate with the intensity of symptoms. Two patients with similar X-rays can have very different experiences of pain and function. Treatment is guided by both clinical findings and imaging, not by imaging alone.
Understanding stage helps decide which treatments may be most helpful. The stage is confirmed after clinical examination and review of imaging.
Mild joint-space changes. Occasional pain after prolonged activity. Typically well-managed with conservative treatment.
Definite joint-space narrowing and small bone spurs. Pain with stairs or prolonged standing. Physiotherapy and lifestyle changes often control symptoms.
Marked cartilage loss. Regular pain and stiffness. Structured non-surgical protocols may provide meaningful relief.
Bone-on-bone contact. Pain most days, sleep may be affected, deformity may be visible. Surgical treatment may be considered.
Most patients with knee arthritis are managed without surgery, especially in early and mild stages. Non-surgical treatment usually combines several elements:
Adjustments such as reducing high-impact activities, using a walking aid when appropriate and pacing activity through the day can reduce joint stress while other treatments take effect.
Every kilogram of body weight increases the load through the knee with each step. For patients above healthy weight, weight reduction can meaningfully improve symptoms.
Targeted strengthening of the muscles around the knee and hip helps distribute load through the joint. Under supervision, meaningful improvement over several weeks is a realistic goal for many patients.
Simple analgesics or anti-inflammatory medications, either oral or topical, may be used for short periods to control pain. Long-term daily painkiller use is generally avoided.
Steroid injections may be used to settle a symptomatic flare. Other joint injections may be considered in selected cases. These are used based on clinical judgement and are not routinely offered to every patient.
Whether surgical or non-surgical treatment is appropriate for a specific patient is decided together with the surgeon after clinical examination, imaging review and discussion of options. Not every knee condition requires surgery.
Bring any recent X-rays, MRI reports or medication list. We’ll examine you, review your imaging and recommend an appropriate treatment path.