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KNEE ARTHRITIS

Knee arthritis can either be osteoarthritis where there is gradual progressive destruction of the joint due to a combination of mechanical and genetic factors, or inflammatory such as rheumatoid arthritis where there is an inflammatory disease process occuring.

Rheumatoid arthritis is initially managed by a rheumatologist, a specialist doctor using specific medications. Sometimes it can be a picture where there is combined osteoarthritis. Surgery is an option in advanced disease.

The management of early through to late stages of osteoarthritis is through your GP and a referral to the MSK (musculoskeletal) services which can aid in diagnosis and start important physiotherapy and reconditioning. In later stages additional lifestyle adaptation may be required before a knee replacement is considered.

Support is available, click on the links below to see what is available in Bristol and your area in the My Joint Health Hub, and how the NHS and the UK charity Versus Arthritis can help you:

In the BLOG section there are some summary slides on the diagnosis, management and referral pathways for early knee arthritis.

Once you have made the decision to have a knee replacement it is important to use the time whilst waiting for the day of surgery to make sure you are as fit and healthy as possible.

  • There is evidence that starting a programme of pre-operative rehabilitation strengthening and range of motion exercises can improve your knee function both before the operation and in the months afterwards 1.
  • These can also significantly shorten your hospital stay 2.
  • These are important factors to help you recover quicker and avoid post-operative complications and you may benefit from seeing a physiotherapist before your operation.
  • Being overweight can increase your risk of complications such as infection 3. The best way to ensure that you minimise these risks is to improve fitness levels through physical activities or exercises that are attractive and feasible4, these in turn may lead to healthy weight loss. 

References

    1. Gränicher P, Mulder L, Lenssen T, Scherr J, Swanenburg J, Bie R de. Prehabilitation Improves Knee Functioning Before and Within the First Year After Total Knee Arthroplasty: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther 2022;52(11):709–725.
    2. Su W, Zhou Y, Qiu H, Wu H. The effects of preoperative rehabilitation on pain and functional outcome after total knee arthroplasty: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2022;17(1):175.
    3. Zusmanovich M, Kester BS, Schwarzkopf R. Postoperative Complications of Total Joint Arthroplasty in Obese Patients Stratified by BMI. J Arthroplasty 2018;33(3):856–864.
    4. Kunutsor SK, Whitehouse MR, Blom AW. Obesity paradox in joint replacement for osteoarthritis — truth or paradox? GeroScience 2021;44(2):651–659.