Knee osteoarthritis is a chronic disease combining degradation of the articular cartilage, damage to the bone located under the cartilage and inflammation of the synovial membrane, it therefore affects the entire knee joint.
1) WHAT IS KNEE OSTEOARTHRITIS, OR GONARTHROSIS?
Rather common, osteoarthritis of the knee remains a pathology poorly understood by the general public. It is the most frequent joint pathology, its onset being more and more precocious. It is therefore not just a “disease of old people”, even if its frequency increases with age and if it is one of the main causes of disability in the elderly.
Knee osteoarthritis can affect the joint:
Femorotibial (between the femur and the tibia)
Patellofemoral (between the femur and the patella)
2) WHERE DOES OSTEOARTHRITIS PAIN COME FROM?
The knee joint is made up of three bones: the femur (the femoral condyles being the lower part of the bone), the tibia (the tibial plateau being the upper part of the tibia), and the patella (held by the quadriceps) .
These structures are covered with cartilage, a dense and elastic membrane, very flexible and resistant but poorly vascularized.
Due to various mechanical (such as excessive pressure) or biological (particularly age-related) phenomena, the cartilage gradually disappears. It is wear and progressive disappearance of the cartilage that causes pain in osteoarthritis patients.
are induced and amplified by movement, and are more or less relieved by rest.
return chronically each time the joint is stressed.
gradually increase throughout the day.
can be the source of nocturnal awakenings in the inflammatory phase.
3) WHAT ARE THE RISK FACTORS?
There are several:
Age and natural degeneration of the joint.
Overweight (overweight and obesity).
Anatomical abnormalities of the joint.
The sequelae of joint trauma, common in sports activities.
Repetitive strain injuries such as can be encountered in contact sports or certain repetitive professional activities.
4) IS IT SERIOUS?
Osteoarthritis is not serious in itself. Its evolution is slow, and interspersed with acute painful phases.
In severe cases, however, the pain caused can become difficult to control.
It is also important to understand that there is no cure for this pathology. Once detected, the treatment put in place will essentially serve to slow down its development in order to learn to live with it and not have to give up daily physical activities.
5) IS SURGERY MANDATORY?
Surgical intervention is not prophylactic in case of gonarthrosis. The treatment will always aim to seek options ranging from the least invasive, such as physiotherapy, to more invasive options (infiltrations, then surgery if initial treatments fail).
In more severe cases, surgery may be considered. It will be offered to patients with permanent pain, and/or a physical disability caused by the pain.
It will consist of “replacing” the joint via the installation of a total knee prosthesis (PTG).
Following this intervention, a physiotherapy treatment can then start.
6) WHAT IS PHYSIO REHABILITATION?
Conservative and post-PTG treatment are similar on many points. The difference will be mainly in the first weeks following the possible surgery.
While respecting the healing process, the work will focus on:
Recovery of normal joint amplitudes
Gradual rehabilitation of the joint
Recovery of a correct gait pattern
Overall muscle strengthening (strength, neuromuscular control, stability, etc.)
7) CAN I KEEP MOVING?
Unlike acute trauma, knee osteoarthritis does not require cessation of activity.
Apart from the very painful and acute phases, maintaining controlled and appropriate physical activity also plays a positive role in slowing the progression of the disease.
It is therefore strongly advised to move, even if it can sometimes seem paradoxical.