March 21, 2016Health Library
The information in this booklet has been assembled to help you
better understand the structure and function of the knee and the
degenerative changes associated with arthritis, to prepare you for
total knee replacement surgery, and to provide guidelines for post-
operative care. The long-term goal of total knee replacement
surgery is to provide relief of pain, restore normal activities of daily
living, and enhance your quality of life.
INTERNAL STRUCTURE OF THE KNEE
The knee is the largest and longest joint in your body which is made
up of the lower end of the thighbone (femur), of the Shinbone (tibia),
and the kneecap (patella). The Ends of these three bones where
they touch are covered with articular cartilage that provides smooth
movements and shock absorption to the knee during weight-
bearing activities such as walking or stair climbing. The knee is a
major weight-bearing joint that is held together by muscles,
ligaments & cartilage (soft tissues). Normally all these components
work in harmony. But disease or injury can disrupt this harmony,
resulting in pain, muscle Weakness, and reduced function.
The knee joint is surrounded by a thin lining called the synovial
membrane that releases a ﬂuid that lubricates the cartilage and
An x-ray of the knee normally shows space (the “joint space”)
between the femur and the tibia as well as between the femur
and patella. This is not empty space but represents the cartilage
(Which does not show up on X-Ray).
CAUSES OF JOINT PAIN:-
ARTHRITIS OF THE KNEE
Arthritis is inﬂammation of one or more of your joints. Any joint in the body may
be affected by the disease, but it is particularly common in the knee.
Knee arthritis occurs as a result of degeneration of the cartilage in your knee.
The most common types of knee arthritis are osteoarthritis and Rheumatoid,
but there are more than 100 different forms.
Osteoarthritis is commonly referred as “wear and tear” arthritis or
degenerative arthritis. It is a disease in which the cartilage in the knee joint
gradually wears away. As the cartilage wears away, it becomes frayed and
rough, and the protective space between the bones decreases. This can
result in bone rubbing on bone, and produce painful bone spurs. It occurs
most often in people 50 years of age and older, but may occur in younger
people, too. Such damage can lead to joint Weakness, instability and
Interfere with the most basic daily Tasks such as walking, climbing stairs etc.
Osteoarthritis occurs most often in knees, and hips.
Rheumatoid arthritis is a disease in which the synovial membrane that
surrounds the joint becomes inﬂamed and thickened. This chronic
inﬂammation can damage the cartilage and eventually cause cartilage
loss, pain, and stiffness. Rheumatoid arthritis is the most common form of a
group of disorders termed “inﬂammatory arthritis.”
Sign and symptoms
A knee joint affected by arthritis may be painful and inﬂamed. Generally, the
pain develops gradually over time, although sudden onset is also possible.
There are other symptoms, as well:
the joint may become stiff and swollen, making it difﬁcult to bend
and straighten the knee.
pain and swelling may be worse in the morning, or after sitting or
vigorous activity may cause pain to ﬂare up.
loose fragments of cartilage and other tissue can interfere with the
smooth motion of joints. The knee may “lock” or “stick” during
movement. It may creak, click, snap or make a grinding noise
pain may cause a feeling of weakness or buckling in the knee.
For every Kg of extra
weight you have, you are
putting four Kg of pressure
on your Knees, so
weight loss is crutial for
Non- surgical treatment of the arthritic knee
As with other arthritic conditions, initial treatment of arthritis of the
knee is non-surgical. Your doctor may recommend a range of
1. Lifestyle modiﬁcation: losing weight, avoiding aggaravating
activities, modifying exercise to low impact activities only.
2. Exercises: speciﬁcally prescribed exercises to improve strength
and ﬂexibility without exacerbating your pain.
3. Anti-inﬂammatory medications: designed to decrease swelling in
the joint, and provide temporary pain relief.
4. Corticosteroid injection: powerful anti-inﬂammatory agent
injected directly into the joint.
5. Joint ﬂuid therapy: a series of injections directly in to your knee,
designed to improve lubrication in the joint.
6. Glucosamine / chondroitin: dietary supplement that may relieve
7. Bracing: used to provide external stability to the knee joint.
8. Arthroscopic surgery: minimally invasive procedure to remove
debris or repair torn cartilage.