Arthritis treatment7 min read
Knee arthritis: causes, types and the treatment options available today
Knee arthritis is one of the most common reasons for pain when walking, climbing stairs or getting up from a chair. It is not a single disease: cartilage wear, autoimmune inflammation, gout and old injuries can all lead to it. This guide explains the causes and types, how the diagnosis is made, which treatments are used and when to see a doctor without delay.
The main points in 30 seconds
- Knee arthritis is not one disease: cartilage wear, autoimmune inflammation, gout, old injuries and infection can all lead to it.
- An accurate diagnosis comes first: an examination, X-rays, ultrasound or MRI, and blood or joint fluid tests when needed.
- For every type, treatment starts with exercise that strengthens the thigh muscles and with losing excess weight.
- PRP and SVF injections from your own tissue are used once a flare has settled, as part of a plan, not instead of a rheumatologist.
- A suddenly hot, red, swollen and very painful knee, especially with fever, needs urgent care: infection can damage the joint within days.
Knee arthritis: what it is and how it is treated
Arthritis means inflammation of a joint. The knee is affected more often than almost any other joint because it carries body weight with every step and bends thousands of times a day. Inside it, smooth cartilage covers the ends of the thigh bone and shin bone, and a thin lining (the synovium) produces fluid that keeps movement easy.
In arthritis this system is disturbed. Cartilage may thin and crack, the lining may become inflamed and swollen, and the bone underneath may change shape. The result is pain, stiffness and reduced movement.
Treatment depends on the type of arthritis and how far it has progressed. It usually combines several steps: exercise and weight control, pain relief, treatment of the underlying disease and, for suitable patients, injections into the joint. Surgery is considered when other options no longer help.
Causes and risk factors
Knee arthritis usually develops through a combination of factors rather than one clear cause. The most common are:
- Age and wear – cartilage becomes less resilient over the years;
- Excess body weight – every extra kilogram increases the load on the knee when walking and on stairs;
- Previous injuries – torn menisci, ligament injuries and fractures near the joint raise the risk years later;
- Autoimmune diseases – in rheumatoid or psoriatic arthritis the immune system attacks the joint lining;
- Metabolic disorders – in gout, uric acid crystals are deposited in the joint;
- Infections – bacteria can reach the joint through the blood or a wound, and some infections elsewhere in the body trigger reactive arthritis;
- Heredity and leg alignment – family history, bow legs or knock knees, and repetitive heavy work or sport.
Knee osteoarthritis is more common in women than in men, especially after menopause.
Main types of knee arthritis
What happens
- Osteoarthritis
- Gradual wear of cartilage and changes in the bone
- Rheumatoid arthritis
- The immune system attacks the joint lining
- Psoriatic arthritis
- Joint inflammation linked to psoriasis
- Gout
- Uric acid crystals in the joint
- Post-traumatic arthritis
- Joint damage after an injury
- Septic arthritis
- Bacterial infection inside the joint
Typical features
- Osteoarthritis
- Pain on movement and after activity, short morning stiffness, most common after 50
- Rheumatoid arthritis
- Often both knees and other joints, long morning stiffness, tiredness
- Psoriatic arthritis
- Skin or nail changes, swollen joints
- Gout
- Sudden attack of severe pain, redness and swelling
- Post-traumatic arthritis
- Develops months or years after a fracture or a ligament or meniscus injury
- Septic arthritis
- Hot, swollen, very painful knee, often with fever; needs urgent care
The same knee can show more than one process, for example osteoarthritis that develops after years of inflammatory arthritis. That is why an accurate diagnosis comes before any treatment plan.
Symptoms, stages and how doctors diagnose it
Common symptoms
- pain when walking, on stairs or when standing up, and in inflammatory types also at rest and at night;
- stiffness in the morning or after sitting;
- swelling, warmth and sometimes redness over the joint;
- grinding or creaking, a feeling that the knee gives way or locks;
- difficulty bending or fully straightening the leg.
Stages
In osteoarthritis doctors often describe stages from early to severe. At an early stage the cartilage is only slightly thinned and pain appears after heavy load. At a moderate stage the joint space narrows on X-ray, bony spurs form and pain becomes regular. In severe cases much of the cartilage is lost, the leg may change shape and pain limits everyday life. Inflammatory arthritis is assessed differently, by disease activity and by the damage visible on scans.
Diagnosis
The doctor asks about your symptoms, injuries and other diseases and examines the knee. Depending on the findings, the assessment may include:
- X-rays to see the joint space and bone changes;
- ultrasound or MRI to assess soft tissue, fluid, menisci and cartilage;
- blood tests for markers of inflammation, autoimmune disease or raised uric acid;
- analysis of joint fluid when infection or gout is suspected.
Treatment options: from medication to regenerative injections
Basic measures for everyone
Whatever the type, guidelines put exercise first: strengthening the thigh muscles, low-impact activity such as cycling or swimming, and keeping the knee moving. Losing excess weight reduces the load on the joint. A physiotherapist can plan exercises, and supportive footwear or a walking aid may help on bad days.
Medicines
Painkillers and anti-inflammatory medicines, including gels applied to the skin, are used to ease pain. For rheumatoid, psoriatic and other inflammatory types, a rheumatologist prescribes treatment that controls the underlying disease, and gout needs its own long-term treatment. Steroid injections into the knee can calm a severe flare for a while. Medicines are always chosen individually by a doctor; this article does not replace that advice.
Injections of your own tissue: PRP and SVF
Platelet-rich plasma (PRP) is prepared from a small amount of your blood and injected into the joint. It contains growth factors and may help calm inflammation and support tissue repair. Cell therapy with the stromal vascular fraction (SVF) uses a small sample of your adipose tissue, processed and combined with your plasma. These methods are used as part of an overall plan once an acute flare has settled, and they do not replace a rheumatologist's care for a systemic disease. Research on them continues, and the response differs from person to person. How City Medical Centre uses them is described on our arthritis treatment page.
When surgery is discussed and when to see a doctor urgently
Surgery is usually considered when pain and loss of function remain severe despite other treatment. Options include arthroscopy for selected mechanical problems, osteotomy to shift load away from a worn part of the joint in younger patients, and partial or total knee replacement in advanced osteoarthritis. The decision is made with an orthopaedic surgeon after weighing the benefits and risks.
See a doctor urgently if:
- the knee suddenly becomes hot, red, swollen and very painful, especially with a fever;
- you cannot put weight on the leg after an injury;
- the knee is visibly deformed or locked and cannot be straightened;
- knee swelling comes together with pain or swelling in the calf, which may point to a blood clot.
Septic arthritis can damage the joint within days, so it should never be treated at home.
Preventing flare-ups
Arthritis often comes in waves, with calmer periods and flare-ups. You can make flare-ups less frequent:
- stay active every day and keep up the exercises your physiotherapist recommends;
- keep a healthy weight;
- warm up before sport and avoid sudden jumps in training load;
- take the treatment prescribed for inflammatory arthritis or gout regularly and never stop it on your own;
- with gout, limit alcohol and the foods that trigger attacks, as your doctor advises;
- see a doctor early when a new pattern of pain or swelling appears.
Getting a personal plan at City Medical Centre
City Medical Centre works with international patients. The first consultation is free and can be held online: send your X-rays, MRI or ultrasound results with a short description of your symptoms, and a doctor will review them. If PRP or SVF suits your type and stage of arthritis, the doctor explains the plan and names the cost, which is then fixed in the contract. A personal coordinator stays with you from the first message to the follow-up visits, and scans and questions can be sent by WhatsApp. Find out more on the arthritis treatment page.
Sources
Frequently asked questions
What causes arthritis in the knee?
The most common cause is gradual wear of cartilage (osteoarthritis), often linked to age, excess weight and old injuries. Other causes include autoimmune diseases such as rheumatoid or psoriatic arthritis, gout, infections and the after-effects of fractures or ligament and meniscus injuries.
How is knee arthritis diagnosed?
A doctor asks about your symptoms and examines the knee. X-rays show narrowing of the joint space and bone changes, while ultrasound or MRI show soft tissue and fluid. Blood tests and analysis of joint fluid help identify inflammatory arthritis, gout or infection.
Can PRP or SVF help knee arthritis?
In suitable patients they may help ease inflammation and pain and support the tissues inside the joint. They are used as part of an overall plan once an acute flare has settled and do not replace care from a rheumatologist. Results differ between people, and a doctor decides whether they fit your case.
When is knee arthritis an emergency?
Seek urgent care if the knee suddenly becomes hot, red, swollen and very painful, especially with a fever, because this may be an infection. The same applies if you cannot put weight on the leg after an injury, the knee is locked, or pain and swelling appear in the calf.
How can I prevent knee arthritis flare-ups?
Stay active with regular muscle-strengthening exercise, keep a healthy weight and increase training loads gradually. If you have inflammatory arthritis or gout, take the prescribed treatment regularly and do not stop it on your own. See a doctor early when new pain or swelling appears.
Have a question about your case? Get a free consultation
Send your name and phone number, and a coordinator will call you back. You can also send photos and questions on WhatsApp.
- The first consultation is free, online consultations are available
- The doctor names the cost after the assessment, and it is fixed in the contract
- A personal coordinator guides you from the first message to recovery
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