Knee Arthritis

What is Knee Arthritis?

Joint surfaces are covered by a smooth covering called cartilage. This allows pain-free, smooth movement between the bones.

Knee osteoarthritis, also called degenerative joint disease, is the most common form of arthritis. Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out or becomes damaged. Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out or becomes damaged. This can be caused by genetics, increased age, overuse, trauma and/or obesity. In knee arthritis, the cartilage of the end of the femur (thighbone) as well as top of the tibia (shinbone) becomes damaged and worn out, causing pain, swelling, stiffness and restricted movement.

Symptoms of Arthritis

When the articular cartilage wears out, the bone ends rub on one another which causes pain. Bone spurs or excessive bone can also build up around the edges of the joint. This leads to stiffness and decreased mobility of the joint. The joint can be inflamed and can become swollen with excess joint fluid. The combinations of these factors can limit activities due to pain or fatigue.

Diagnosis

Arthritis is diagnosed with a medical history, a physical examination, and x-rays of the affected knee joint. An x-ray of the joint will typically show a loss of the joint space and bone spur formation. During the physical examination, Dr. Eccles will examine the affected joint for swelling, pain, tenderness, and assess the joint’s range of motion.

Treatment

There are several lifestyle modifications and treatments options that may help you ease your pain and symptoms.

• Conservative
  • Lifestyle modifications:
    • There is strong evidence showing that a self-directed exercise or supervised physical therapy program keeps the joints flexible and strong.
    • This also has the benefit of potentially decreasing body weight going through the joint which helps immensely with pain control.
    • Every single pound of weight loss can remove 4 to 6 pounds of pressure of the knees and hips!
• Medications:
  • There is strong evidence showing good arthritic pain and inflammation control with non-steroidal anti-inflammatory drugs (NSAIDs). These are medications such as:
    • ibuprofen (Advil® and Motrin®)
    • meloxicam (Mobic®)
    • celecoxib (Celebrex®)
    • diclofenac (Voltaren®)
    • naproxen (Aleve®)
  • Topical NSAID creams can typically be used in patients that are unable to take the pill forms.
  • Tylenol (acetaminophen), which is not an NSAID, has been shown to reduce pain and improve function and typically is safe to take 1000mg three times a day along with an anti-inflammatory medication above.

  Other options include steroid injections into the joint to decrease inflammation, bracing or using walking aids such as a cane.

• Surgical: Surgery can be considered if non-surgical treatment fails to provide sufficient relief. So, when is the right time to do this? Joint replacement can be a good option when the pain is so severe that it affects your ability to carry out normal activities and you are medically optimized/safe to have surgery.
• What doesn’t work: The American Academy of Orthopaedic Surgeons (AAOS) have produced guidelines based on scientific studies and have shown that hyaluronic acid (gel) or any other forms of injections (ex. stem cells), glucosamine/chondroitin supplementation, acupuncture, and narcotic medications are not effective or recommended for arthritis treatment.

Knee Osteoarthritis Treatment Recommendations

Why Choose Dr. Christian Eccles for Knee Arthritis

Knee arthritis care should start with your goals, not a rush to surgery. Here is what sets our approach apart:

• Specialized in knees and hips: Dr. Eccles completed a five-year orthopaedic surgery residency at the University of Louisville and an Adult Reconstruction Fellowship in hip and knee replacement at Indiana University.
• Non-surgical options first: Most patients start with exercise or physical therapy, weight management, anti-inflammatory medication or acetaminophen, bracing or a cane, and steroid injections when appropriate.
• Guideline-based recommendations: We follow AAOS guidance and do not recommend treatments shown not to help knee arthritis, such as gel or stem cell injections, glucosamine/chondroitin, acupuncture, or narcotics.
• Advanced knee replacement when it's time: If your knee still limits daily life, Dr. Eccles offers technology-assisted knee replacement, including the TMINI® handheld robotic system, and same-day surgery for appropriately selected patients.
• Research-driven care: Dr. Eccles has published and presented research on knee replacement, including robotic-assisted surgery and reducing opioid use after surgery.

Knee Arthritis FAQs

What are the early signs of knee arthritis?

You may notice pain with walking, stairs, or standing up, stiffness after sitting or first thing in the morning, swelling, or a grinding feeling. If these symptoms are limiting your activities, an exam and X-rays can confirm what is going on.

Do gel or stem cell injections help knee arthritis?

Based on current AAOS guidelines, hyaluronic acid (gel), stem cell, and similar injections are not recommended for knee arthritis. Dr. Eccles offers cortisone (steroid) injections, which can reduce inflammation and pain for many patients.

Will a knee brace help?

A brace or a cane can take some stress off a painful knee and is one of the non-surgical options we may suggest. It tends to work best alongside strengthening exercises and weight management.

When is it time to consider knee replacement?

Knee replacement may be a good option when pain affects your ability to do normal activities despite non-surgical care and you are medically ready for surgery. Age alone doesn't decide it; your health, goals, and quality of life all matter.