Often the degree of OA of the knee demonstrated on X-ray does not correlate with the amount of pain or the limitation in function experienced by the patient. A patient with relatively minor OA changes on X-ray may be quite incapacitated by pain and stiffness, while a patient with hardly any joint space left on X-ray may be quite functional and not complaining of any pain.
The patient may have knee pain and stiffness, ranging from aching at rest to sharp pain with movement. They may have difficulty going up and down stairs and the knee might feel weak. They might feel clicking or locking or collapsing and they might hear “crunching” as they bend the knee.
Conservative treatment such as physiotherapy, can improve and then maintain the patient’s knee function often for many years. Treatment can include mobilisations, exercises, stretches, hydrotherapy and balance exercises. This can delay the need for arthroscopic joint maintenance surgery and, even if this is eventually required, following a clean-out of the OA joint, physiotherapy rehabilitation can then delay, or even prevent, the need for joint replacement surgery.
The risk factors for Osteoarthritis are obesity, advanced aging and injury. In an overweight or obese patient, achieving a healthy weight positively influences the cartilage composition within the joint in early stages osteoarthritis.
Lower limb injury is found to have a four times greater risk of developing knee osteoarthritis ten years prior to diagnosis. Therefore, early rehabilitation management altering abnormal movement mechanics of the knee joint can prevent symptomatic osteoarthritic detection.
In patients who modify their activity, there is some evidence to suggest that conservative management can result in lower rates of osteoarthritis compared to that of surgical repair.