What knee osteoarthritis is
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.
Symptoms
- Pain in the knee that worsens with activity and improves with rest
- Stiffness, particularly in the morning or after prolonged sitting
- Occasional swelling around the knee
- Grinding, clicking or crepitus during movement
- Difficulty with stairs, uneven ground or squatting
- Progressive loss of full bending or straightening
What contributes to knee arthritis
- Age-related wear — most common; usually starts after 50
- Previous knee injury — ACL tears, meniscus injuries or fractures can accelerate arthritis
- Body weight — additional load on the knee over years
- Joint shape and alignment — bow-legs or knock-knees concentrate load
- Genetic factors — family history is a recognised risk factor
Which stage of arthritis?
Understanding stage helps decide which treatments may be most helpful. The stage is confirmed after clinical examination and review of imaging.
Early
Mild joint-space changes. Occasional pain after prolonged activity.
Mild
Definite joint-space narrowing and small bone spurs. Pain with stairs.
Moderate
Marked cartilage loss. Regular pain and stiffness.
Severe
Bone-on-bone contact. Pain most days, sleep may be affected.
Non-surgical treatment
Most patients with knee arthritis are managed without surgery, especially in early and mild stages.
Activity and lifestyle modification
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.
Weight management
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.
Structured physiotherapy
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.
Medications
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.
Injections in selected cases
Steroid injections may be used to settle a symptomatic flare. Other joint injections may be considered in selected cases based on clinical judgement.
⚠ Surgical treatment is discussed only when
- Pain limits daily activities despite appropriate non-surgical treatment over an adequate period
- Sleep is affected by knee pain
- Imaging shows advanced arthritis
- The patient has considered the options and has realistic expectations about surgery and recovery
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.
Dr. Vijay Chandar R.
15+ years of clinical practice with a focus on knee replacement, ACL and sports knee injuries, arthroscopy and shoulder surgery. Consultations at VBJ Bone & Joint Clinic, Kanakapura Road. Read full profile →
Explore treatment and rehabilitation
Read about the care options related to this condition. The appropriate treatment depends on your assessment; not every condition requires surgery.
Related information
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