How should I treat my knee arthritis?

In this article, a consultant orthopaedic surgeon explains the types of knee arthritis, and the options for treating it.

What is knee arthritis?

Knee arthritis refers to wear or inflammation within the knee joint that leads to pain, stiffness, and loss of movement. The most common form is osteoarthritis, a degenerative condition where the smooth cartilage that cushions the joint gradually wears away. As the cartilage thins, the bones begin to rub against each other, causing discomfort, swelling, and sometimes deformity.

Other types include rheumatoid arthritis, an autoimmune disease in which the body’s immune system attacks the lining of the joint, leading to inflammation and damage. Less common causes include post-traumatic arthritis, following a previous fracture or ligament injury, and gout or pseudogout, caused by crystal deposits in the joint. Age is the most significant risk factor, but genetics, obesity, previous injuries, and certain occupations or sports can all increase the likelihood of developing arthritis in the knee.

How knee arthritis can affect daily life

Knee arthritis can have a profound impact on mobility, independence, and quality of life. Early symptoms often include pain after activity, morning stiffness, and mild swelling. Over time, the pain may become persistent, even at rest or during the night, disturbing sleep.

Simple activities such as walking, climbing stairs, or getting out of a chair can become increasingly difficult. Many people notice a gradual reduction in their walking distance and may develop a limp. In more advanced stages, the knee can become deformed, often bowing inwards or outwards, which can further alter the way a person walks.

Beyond the physical symptoms, chronic pain and loss of mobility can lead to emotional frustration and social withdrawal. Patients may avoid activities they once enjoyed, impacting both mental well-being and general health.

Non-surgical options for treating knee arthritis

In the early stages, treatment focuses on relieving symptoms and preserving mobility without surgery. Lifestyle modifications are often the first step. Weight loss can significantly reduce pressure on the knee joint — excess weight can cause undue force through the knee when walking. Low-impact exercise, such as swimming, cycling, or walking on level ground, helps maintain strength and flexibility.

Physiotherapy can improve joint function and strengthen the muscles supporting the knee. Many patients benefit from tailored exercise programmes supervised by a physiotherapist.

Pain relief medication, such as paracetamol or anti-inflammatory drugs, may ease discomfort, while topical creams can offer local relief. In some cases, joint injections, using corticosteroids or hyaluronic acid, can reduce inflammation and pain for several months, although the benefit is usually temporary. These non-surgical measures can be very effective for managing symptoms, but they do not reverse the underlying arthritis.

Surgical options and what to expect

When pain persists despite non-surgical treatment, or when arthritis severely limits daily life, surgery may be considered. For localised areas of damage in younger or more active patients, keyhole (arthroscopic) procedures can occasionally smooth rough cartilage or remove loose fragments, though their benefits are limited in widespread arthritis.

For more advanced cases, knee replacement surgery is often the most effective option. This involves resurfacing the worn-out joint surfaces with metal and plastic implants, restoring alignment and reducing pain. Depending on the extent of damage, patients may have a partial (unicompartmental) or total knee replacement.

The advantages of knee replacement include reliable pain relief and improved function, with most patients regaining the ability to walk longer distances and return to normal activities. However, the downsides include a period of recovery and rehabilitation, and while most implants last many years, they can eventually wear out or loosen, occasionally requiring revision surgery.

What patients should consider when exploring their options

Deciding how to treat knee arthritis depends on age, activity level, general health, and personal goals. For some, conservative measures may control symptoms for years; for others, surgery offers the best chance of regaining mobility and comfort.

It is important for patients to understand the realistic outcomes of each approach and discuss these carefully with their surgeon. Good surgical results are more likely when the patient is well prepared—physically fit, informed about the recovery process, and motivated to follow rehabilitation advice.

Ultimately, there is no single solution for every case of knee arthritis. The best approach combines individualised care, realistic expectations, and active participation in recovery, helping each patient to regain confidence, movement, and a better quality of life.