Osteoarthritis of Knee is a condition where the cartilage surface of the knee joint wears down. Originally, the knee joint could support body weight and perform various activities well, but it begins to feel stiff, and movement produces a crunching sound. If left untreated for a long time, pain will start to occur. Nowadays, it is increasingly found in young adults, not just the elderly.
“Can osteoarthritis of the knee affect all genders and ages?”
Osteoarthritis results from the wear and tear of the articular cartilage, which is the soft tissue covering the joint surface between two bones. When the cartilage deteriorates and wears out significantly, the bones rub against each other, causing inflammation and eventually pain. The progression of these processes varies depending on each person’s lifestyle and daily activities.
In the past, it was believed that knee joint degeneration was caused by aging. However, nowadays, many people face early-onset osteoarthritis. Common causes of early-onset knee osteoarthritis include knee injuries from accidents (such as fractures around the knee), sports injuries (falls or collisions causing ligament tears), being overweight (obesity), and inflammatory joint diseases such as rheumatoid arthritis.
Osteoarthritis symptoms can be divided into 3 stages:
- Early stage: Patients do not experience pain but may notice abnormal sounds in the knee or difficulty moving the knee, especially after waking up or sitting for a long time. The knee feels stiff and it is hard to stand up, but after some movement, the symptoms subside and walking returns to normal.
- Moderate stage: Pain becomes more noticeable, possibly daily but not severe. Sometimes painkillers or knee supports are needed to relieve symptoms.
- Severe stage: Pain is frequent and intense. Patients may walk less than usual due to pain or fear of falling. They cannot kneel or sit on the floor in other positions, and visible deformities such as bow-leggedness are apparent.
How severe must knee osteoarthritis be to require surgery?
As mentioned earlier, most osteoarthritis symptoms result from age-related degeneration, commonly seen in people aged 60 and above. Patients who require surgical treatment for severe knee osteoarthritis include those who:
- Experience severe or constant pain that affects daily life, requiring frequent pain medication, and some cannot perform normal daily activities.
- Have difficulty walking to the point they cannot care for themselves and need assistance or support to walk, otherwise risking falls.
At the same time, some patients with knee osteoarthritis may not have severe pain but cannot perform desired activities such as sports or traveling comfortably. Some may choose surgery to return to their previous activity levels.
Doctors will explain the surgical procedure, expected postoperative pain, pain management methods, and recovery expectations, such as the time it takes for patients to start sitting, standing, and walking. Patients naturally want to know when they can walk normally again, which activities are allowed, and which should be avoided immediately after surgery to reduce anxiety and understand proper care, benefiting the treatment outcome.
Is it possible to avoid knee replacement surgery? Are there other options?
Patients and their families often ask doctors about alternatives to knee replacement surgery, such as injections or arthroscopic surgery to improve the knee joint without replacing it. The fact is that osteoarthritis severity varies, and there are multiple treatment options. Doctors will recommend the appropriate treatment based on the disease stage for each patient as follows:
- Early stage: May use medications that slow cartilage degeneration or inject synthetic joint lubricants.
- Moderate stage: May use anti-inflammatory medications orally or by injection into the joint.
- Severe stage that does not improve with other treatments: Doctors will recommend knee replacement surgery because using early-stage treatments for severe osteoarthritis is ineffective and wasteful.
Conversely, performing surgery on patients with early or moderate osteoarthritis is unnecessary and may not meet patient expectations. Patients with severe osteoarthritis who undergo surgery often feel satisfied and say, “If I had known this, I would have had surgery much earlier.”
Arthroscopic surgery for osteoarthritis is usually recommended when there is a cartilage tear in the knee with acute pain, but the joint is not yet severely degenerated to require knee replacement.
In all treatments, regardless of the method, patients participate in decision-making based on the doctor’s advice, ensuring that every treatment plan aims to restore the patient’s quality of life.
