Osteoarthritis of the knee usually occurs in people who have suffered trauma, infection or injury to the knee. As articular cartilage is lost, the joint space between the knees narrows. The remaining cartilage progressively becomes thinner, grooved and fragmented. The surrounding bones compensate by becoming thicker, which causes them to grow outwards. Spurs

often develop . The synovium produces extra liquid, which causes it to become thickened and inflamed. The extra liquid causes a condition known as ‘water on the knee.’

Over the years, the articular cartilage can be lost completely, so that the bones are rubbing against each other. This causes the bones to slowly begin wearing away, leading to joint deformity.

Initial treatment of osteoarthritis of the knee is geared towards pain management. The first step involves health and behavior modifications. Patient education, physical therapy, weight loss and exercise form the mainstays of these modifications. Bracing may also be applied to the affected area.

Drug therapies range from basic pain relief medications, such as aspirin and non-steroidal anti-inflammatories to Cox-2 specific inhibitors, opiates and stronger drugs.

Corticosteroid injections or injections of hyaluronic acid may also be given. Surgery, including arthroscopy, osteotomy and arthroplasty (joint replacement) will be considered as a last resort.