Knee Osteoarthritis Treatment

What Is Knee Osteoarthritis (Gonarthrosis)?

Knee osteoarthritis, or gonarthrosis, is the gradual wearing, thinning, and deterioration of the smooth, slippery cartilage tissue covering the ends of the bones that make up the knee joint. Cartilage acts as a protective cushion that prevents the bones from rubbing against each other during joint movement. As this cartilage tissue wears away, the underlying bone surfaces begin to rub against one another. This leads to pain, swelling, and limited range of motion. As the body’s response to this wear, new bony outgrowths (osteophytes) may form at the joint margins, and changes may occur in the joint fluid. Although osteoarthritis is a progressive condition, its progression can be slowed and symptoms can be brought under control with proper treatment and management.

Causes and Risk Factors of Knee Osteoarthritis

Knee osteoarthritis is usually not caused by a single factor but arises from a combination of several factors. The main risk factors are as follows:

• Advancing Age: As a person ages, the cartilage tissue’s capacity to renew itself decreases and the risk of wear increases.
• Excess Weight (Obesity): Extra body weight increases the load placed on the knee joints, accelerating cartilage wear. Losing weight is one of the most important steps in managing osteoarthritis.
• Genetic Predisposition: People with a family history of knee osteoarthritis may be at higher risk.
• Previous Knee Trauma: Prior fractures, meniscus tears, and ligament injuries (especially to the cruciate ligaments) can disrupt the mechanics of the knee, increasing the risk of developing osteoarthritis later on.
• Repetitive Strain: The risk may increase in people who do heavy manual labor or engage in sports that place continuous load on the knee (e.g., long-distance running, football).
• Joint Structure and Alignment Disorders: Alignment disorders in the legs such as “O” shaped legs (bow legs – varus) or “X” shaped legs (knock knees – valgus) can trigger osteoarthritis by causing excessive load on certain areas of the joint.
• Sex: Knee osteoarthritis is more common in women, particularly after menopause.
• Inflammatory (Rheumatic) Diseases: Certain inflammatory joint diseases, such as rheumatoid arthritis, can also lead to cartilage damage and osteoarthritis as a secondary effect.

What Are the Symptoms of Knee Osteoarthritis?

The symptoms of knee osteoarthritis usually begin slowly and increase over time. The most common symptoms are as follows:

• Pain: The most important symptom. It generally increases with movement, when going up or down stairs, or when squatting, and decreases with rest. As the disease progresses, pain may occur at rest or at night as well. The pain is usually felt deep within the knee.
• Stiffness: Stiffness and difficulty moving the knee are experienced, especially after waking up in the morning or after sitting for a long time. This stiffness usually eases within a few minutes of movement (typically in less than 30 minutes).
• Swelling: Swelling may occasionally occur due to fluid accumulation in the joint.
• Crepitus: Hearing or feeling a “crackling,” “creaking,” or “grinding” sound from the joint during knee movement.
• Limited Range of Motion: Difficulty fully bending or straightening the knee.
• Joint Deformity: In advanced stages, visible deformities of the knee (bowing inward or outward) may develop.
• Feeling of Instability: A sensation of the knee suddenly giving way or catching while walking.

If you are experiencing one or more of these symptoms, it is important to consult an orthopedic specialist for accurate diagnosis and treatment.

How Is Knee Osteoarthritis Diagnosed?

Prof. Dr. Murat Bozkurt performs a comprehensive evaluation at his clinic in Ankara to diagnose knee osteoarthritis:

• Patient History (Anamnesis): Questions are asked in detail about when your complaints began, how they have progressed, the character of the pain, which activities increase or decrease the pain, your lifestyle, and any previous illnesses and surgeries.
• Physical Examination: Your gait, the alignment of your knees (varus/valgus), range of motion, tenderness in the joint, swelling, crepitus (crackling), and ligament stability are carefully checked.
• X-ray: This is the primary and most important imaging method for diagnosing knee osteoarthritis. X-ray films taken specifically while standing (weight-bearing) are requested. On the X-rays;
  
  • Narrowing of the joint space (indicating cartilage loss)
  • Bony outgrowths (osteophytes)
  • Hardening of the bone beneath the cartilage (subchondral sclerosis)
  • Bone cysts may be visible. The severity of the osteoarthritis is graded based on the X-ray findings (e.g., the Kellgren-Lawrence Classification).
• Other Imaging Methods (MRI, CT, Ultrasound): These are generally not required for routine diagnosis. However, Magnetic Resonance Imaging (MRI) may be requested if the symptoms do not fully match the osteoarthritis findings, if additional problems such as a meniscus tear or ligament injury are suspected, or if a special surgery such as osteotomy or partial knee replacement is being planned. Blood tests are generally performed to differentiate osteoarthritis from other inflammatory joint diseases.

Knee Osteoarthritis Treatment Options: A Comprehensive Approach in Ankara

The treatment of knee osteoarthritis is personalized according to the stage and severity of the disease, the patient’s age, activity level, expectations, and general health, rather than following a single “correct” method. Prof. Dr. Murat Bozkurt informs his patients about all options during the treatment process and works together with them to create the most suitable treatment plan. Treatment usually begins with the simplest and most conservative methods, moving on to more advanced treatments if these prove insufficient.

Non-Surgical (Conservative) Treatments:

These form the foundation of treatment and are generally the first methods applied.

• Lifestyle Changes:
  
  • Weight Loss: For overweight or obese patients, losing weight is one of the most effective methods for reducing the load on the knees, easing pain, and slowing the progression of the disease.
  • Activity Modification: Avoiding or modifying activities that increase pain (prolonged standing, running, jumping). Turning to low-impact exercises (swimming, cycling, water-based exercises, elliptical trainers).
  • Assistive Devices: Getting support from devices such as a cane (usually used in the hand on the pain-free side) or a walker to reduce the load on the painful knee.
• Physical Therapy and Exercise:
  
  • Exercise programs carried out under the guidance of expert physiotherapists are very important.
  • The goal is to strengthen the muscles around the knee (particularly the quadriceps, hamstrings, and hip abductors), maintain or increase range of motion, improve flexibility, and enhance balance.
• Medication:
  
  • Painkillers: Paracetamol (Acetaminophen) may be the first choice as a simple pain reliever.
  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as Ibuprofen, Naproxen, and Diclofenac reduce both pain and inflammation. However, because they may cause stomach problems and have side effects on the kidneys and heart, they should be used under a doctor’s supervision, at the lowest effective dose, and for the shortest possible time. Topical (applied to the skin) forms are also available.
  • Supplements: The effectiveness of supplements such as Glucosamine and Chondroitin sulfate has not been clearly proven scientifically, although some patients report benefiting from them. It is recommended that you consult your doctor before using them.

Intra-Articular Injections:

These can be applied when an adequate response is not achieved with conservative treatments or to quickly bring pain under temporary control.

• Corticosteroid Injections: These are powerful anti-inflammatory medications. When injected into the joint, they can rapidly reduce pain and swelling. However, their effects are temporary (usually lasting a few weeks to a few months). Because they may have adverse effects on cartilage, frequent repetition is not recommended (generally no more than 3-4 times per year).
• Hyaluronic Acid Injections (Viscosupplementation): Hyaluronic acid, a component of normal joint fluid, is injected into the joint with the aim of “lubricating” the joint, increasing slipperiness, and supporting shock absorption. Its effectiveness varies from person to person and it is usually administered as 1 to 5 injections a few weeks apart. Its effect may begin later than cortisone but may last longer.
• PRP (Platelet Rich Plasma) Injections: This involves injecting plasma rich in platelets and growth factors, obtained from the patient’s own blood through a special process, into the joint. It is thought to have the potential to stimulate healing and reduce inflammation. Scientific evidence is still developing, results vary, and it is not yet recognized as a standard treatment. Prof. Dr. Murat Bozkurt may consider this option in suitable patients.
• Stem Cell Injections: This involves administering stem cells obtained from various tissues in the body (usually fat tissue or bone marrow) into the joint. Their potential to promote cartilage regeneration is being researched. However, there is not yet sufficient, strong scientific evidence regarding their effectiveness and safety in knee osteoarthritis. Caution should be exercised regarding places offering this treatment, and its scientific basis should be questioned.

Surgical Treatment Options:

Surgical treatment is considered if the patient’s pain persists despite trying all other treatment methods, and daily life activities are severely restricted and quality of life is impaired.

• Arthroscopy (Keyhole Surgery): This is not the primary treatment for knee osteoarthritis. It may only be beneficial in cases such as a meniscus tear or a loose body (a free fragment of cartilage) accompanying the osteoarthritis and causing mechanical symptoms such as locking or catching. Arthroscopy performed to “clean out” an osteoarthritic joint has not been shown to provide long-term benefit.
• Osteotomy (Bone Realignment Surgery): This is generally performed on patients under 60 years of age who are active, have an alignment disorder (bow legs or knock knees), and whose osteoarthritis is concentrated mostly in a single compartment (inner or outer). The tibia or femur is cut to correct the angle, thereby transferring the body’s weight from the damaged area to the healthy area. It can delay or prevent the need for a prosthesis.
• Partial (Unicompartmental) Knee Replacement (UKA): This is performed on selected patients whose osteoarthritis is confined to only one compartment of the knee—inner, outer, or under the kneecap—and whose ligaments are intact. Only the damaged joint surface is replaced. Compared to a total prosthesis, it offers the potential for a smaller incision, faster recovery, and a more natural knee feel. However, proper patient selection is very important.
• Total Knee Replacement (Total Knee Arthroplasty – TKA): This is the gold standard surgical treatment for patients with severe pain and loss of function in the advanced stages of knee osteoarthritis. The worn joint surfaces of the femur (thigh bone), tibia (shin bone), and sometimes the patella (kneecap) are removed and replaced with an artificial joint (prosthesis) made of metal and polyethylene (durable plastic) materials. It is an extremely successful operation for relieving pain and restoring function. Prof. Dr. Murat Bozkurt successfully performs total knee replacement surgeries in Ankara.

Knee Osteoarthritis Surgeries: Risks, Benefits, and the Recovery Process

Expectations and the process are particularly important after total knee replacement (TKA) surgery:

• Benefits (TKA):
  
  • Severe knee pain is largely eliminated (in over 90% of cases).
  • Increased mobility (such as walking, climbing stairs).
  • Correction of knee deformity.
  • A noticeable improvement in overall quality of life.
• Risks (TKA):
  
  • Infection: One of the most serious complications (around 1-2%). Preventive measures are taken during and after surgery.
  • Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE): Formation of a blood clot in the leg veins and the clot traveling to the lungs. Blood-thinning medications and early mobilization reduce the risk.
  • Prosthesis Problems: Over time, the prosthesis may loosen, wear, or break (especially after 15-20+ years). Revision (second) surgery may be required.
  • Nerve or Vascular Damage: Rare risks.
  • Anesthesia Risks: As with any surgery.
  • Persistent Pain or Stiffness: Some patients may not achieve the full recovery expected.
• Recovery Process (TKA):
  
  • Patients usually stay in the hospital for a few days after surgery.
  • Early mobilization and physical therapy are vitally important. Walking is usually started the day after surgery.
  • Range of motion, muscle strength, and walking function are regained through an intensive physical therapy program. This process continues for several months.
  • Full recovery and reaching maximum function can take 6 months to 1 year.
  • Modern prostheses generally last 15-20 years or longer, although this varies depending on the patient’s activity level, weight, and the type of prosthesis.

Knee Osteoarthritis Treatment in Ankara and Prof. Dr. Murat Bozkurt’s Approach

Knee osteoarthritis is a health issue faced by many individuals living in a large, active city like Ankara. Effective management of this condition requires an accurate diagnosis and a personalized treatment plan.

Prof. Dr. Murat Bozkurt provides comprehensive care in Ankara to patients with knee osteoarthritis:

• Patient-Centered Evaluation: He carefully listens to the patient’s complaints, expectations, and lifestyle, and establishes the correct diagnosis through a detailed physical examination and necessary imaging.
• Presentation of All Treatment Options: He explains all treatment alternatives to the patient, from conservative methods (lifestyle changes, physical therapy, medications) to intra-articular injections and surgical options (osteotomy, partial and total knee replacement), together with their advantages and disadvantages.
• Shared Decision-Making: He collaborates with the patient throughout the treatment process to jointly decide on the most suitable treatment plan. Especially when deciding on surgery, he answers all of the patient’s questions and helps establish realistic expectations.
• Expert Surgical Practice: When surgical treatment is required, he performs operations such as osteotomy, partial knee replacement, and total knee replacement using modern techniques and extensive experience.
• Post-Operative Follow-Up: He closely monitors the recovery process after surgery, providing the guidance necessary for a successful rehabilitation.

Prof. Dr. Murat Bozkurt provides reliable, expert support in Ankara to patients with knee osteoarthritis throughout the entire process, starting from the initial diagnosis through to surgery and subsequent rehabilitation.

Knee osteoarthritis is a manageable condition, and modern medicine offers many options to reduce your pain and restore your mobility. To determine the right treatment path for you, it is important to consult an experienced orthopedic specialist such as Prof. Dr. Murat Bozkurt in Ankara.

For detailed information and appointments, you can contact Prof. Dr. Murat Bozkurt by phone at 0312 502 70 74.