Knee Arthritis

• Rheumatoid Arthritis. Rheumatoid Arthritis is a chronic autoimmune disorder that can affect the knees along with other joints. It causes painful swelling of the synovial membrane that covers the knee joint and can eventually result in joint deformity and bone erosion. The immune system attacks normal tissues causing damage to the articular cartilage, soft tissues like ligaments and bone.
• Psoriatic Arthritis. This is an autoimmune disease associated with skin psoriasis.
• Post-traumatic Arthritis. This type of arthritis can develop after an injury to the knee, such as a fracture, cartilage lesions, a ligament tear, or a meniscus tear that causes knee instability and abnormal wear.

Common clinical symptoms include knee pain that gradually worsens with activity, knee stiffness and swelling, pain in the morning, pain after prolonged sitting or resting, and pain that worsens over time. Sometimes loose fragments of cartilage can float in the joint space causing the knee to lock or stick, creak or grind.

Symptoms often become more severe, more frequent, and more debilitating over time. The rate of progression also varies.

Development of knee arthritis typically involves a combination of these risk factors.

• It is common in older adults.
• Osteoarthritis is more common in women.
• The tendency to get osteoarthritis can be inherited.
• Occupational factors that involve repetitive stress on the knee joint.
• Other medical conditions such as avascular necrosis can lead to knee arthritis
• Obesity can add stress on the knee joint and accelerate development of arthritis
• Any knee injury; can lead to osteoarthritis.
• Stress from playing sports can increase the risk.
• Certain metabolic disorders like diabetes can increase the risk.
• Joint alignment that causes uneven distribution of weight and pressure on the joint

During your appointment with Dr. Reynolds, he will review your medical history, ask about your symptoms and when they began and perform an orthopedic examination. During the exam he will check for swelling, warmth, redness and soreness; and move your knee through its range of motion to see how well your knee moves. He will test knee stability, how well you walk, and look for signs of injury.

Dr. Reynolds will order knee x-rays to rule out fractures and bone spurs. X-rays won’t show the cartilage but can show the loss of cartilage when the space between the bones is narrowed. In some cases, he may order an MRI to get more detail about the soft tissues including the knee articular cartilage, the meniscus and ligaments. Sometimes, he may draw blood to rule out autoimmune causes.

Nonsurgical conservative treatment is typically the initial treatment for knee arthritis. The goal is to reduce pain and improve function. This includes:

• Physical therapy to strengthen the muscles around the knee, improve flexibility, and reduce pain.
• Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Prescription medications for more severe pain or specific types of arthritis, such as rheumatoid arthritis.
• Topical creams and gels to treat pain.
• Heat and cold therapy can help relieve pain and inflammation.
• Corticosteroid Injections can provide temporary relief from inflammation.
• Hyaluronic Acid Injections can provide lubrication to the joint.
• Platelet rich plasma and stem cell injections are created from your blood and re-injected into the knee to help reduce inflammation and pain.
• Braces, canes, or shoe inserts can provide support and alignment to take pressure off the affected joint.
• Some people find relief with treatments like acupuncture, massage, or herbal supplements.
• Lifestyle Modifications include low impact exercise like swimming or cycling and avoiding activities that exacerbate pain. Weight Loss to reduce the stress on the knee joint.

• Arthroscopy is a minimally invasive procedure that allows Dr. Reynolds to see inside the knee to diagnose and treat torn ligaments and meniscus damage.
• Osteochondral Autografts is a procedure to take healthy cartilage tissue from another part of the joint to fill in small discrete areas of cartilage damage. This procedure is designed to help young and active patients and forestall the need for a knee replacement.
• Knee replacement is a surgery whereby a damaged, worn, or diseased knee is replaced with an artificial joint. The goal of knee replacement surgery is to relieve pain and restore function in severely diseased knee joints.