Knee arthritis occurs when the slippery, protective cartilage that cushions your knee joint begins to thin or change. As this cushion diminishes, the bones can begin to rub more closely together. Your body tries to protect itself by creating extra bone (bone spurs) and increasing fluid, which often leads to the hallmark symptoms: pain, stiffness, and swelling.
Diagnosing knee arthritis isn't just about looking at an imaging picture; it’s about understanding your story.
The Clinical Exam: We start by discussing when your pain occurs and checking your range of motion and joint stability.
Imaging: X-rays are the "gold standard" for diagnosing arthritis. They allow us to see joint space narrowing and bone spurs. However, it is important to remember that we treat you, not your X-ray. Many patients have "bone-on-bone" images but feel great, while others have minor changes on an X-ray but significant pain. Our goal is to match your treatment to your actual symptoms.
The good news is that surgery is rarely the first or only option. There is a wide middle ground of effective treatments designed to keep you out of the operating room:
Movement as Medicine: Strengthening the muscles around the knee, acting like "internal shock absorbers" for the joint.
Lifestyle Optimization: Small changes, such as low-impact activities like cycling and weight management, can significantly reduce the mechanical load on your knees.
Strategic Injections: From steroid injections (cortisone) to longer acting Zilretta to "gel shots" (Hyaluronic Acid) that lubricate the joint to regenerative options like platelet rich plasma (PRP), each of these act differently and can have a role to improve symptoms.
Bracing: Modern unloader braces can shift pressure away from the most painful part of your knee, allowing you to stay active longer.
Pharmacologics: Medications can be used short term as an adjunct to other treatments to alleviate symptoms.