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Knee Osteoarthritis

A Guide to Symptoms, Treatment Options, and Self-Care of Knee Osteoarthritis

What is
Knee Osteoarthritis

Osteoarthritis (OA) is a degenerative joint disease that wears down the cartilage in the knee, leading to pain, stiffness, and loss of mobility.

Who it Affects

It can affect people of any age but is more common in adults over 50 years of age, those with a history of knee injuries or certain genetic predispositions.

Symptoms of
Knee Osteoarthritis

Osteoarthritis (OA) causes the cartilage cushioning the knee joint to wear down, leading to increased friction, inflammation, and pain.

Common Symptoms

  • Pain, especially after physical activity
  • Stiffness after a period of rest / sitting
  • Swelling around the knee joint
  • Reduced range of motion
  • Cracking or popping sounds (crepitus) when moving the knee

Risk Factors of
Knee Osteoarthritis

  • Age: Osteoarthritis (OA) prevalence increases with age
  • Genetics: Family history can increase risk. East and Southeast Asians patients tend to experience a greater incidence of knee OA
  • Obesity: Extra weight puts added stress on knee joints
  • Injury History: Knee injuries, even if healed, can make joints more vulnerable
  • Gender: Women are at a slightly higher risk than men, especially post-menopause

Diagnosis of Knee Osteoarthritis

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Thorough History and Physical Examination

  • Corticosteroid injections are used for acute inflammatory episodes
  • Hyaluronic acid injections are "gel-like" injections used to aid joint lubrication

Imaging Tests

  • X-rays of the knee and lower limbs (ideally performed with the patient standing)
  • On certain occasions, MRIs may be used to evaluate the extent of osteoarthritis and aid in determining appropriate treatment

Lab Tests

  • Blood tests can also be performed when other conditions need to be ruled out
  • Occasionally, joint fluid can be taken from the knee to be tested in a laboratory to help rule out other causes like rheumatoid or septic arthritis
  • Medications: Pain relievers (e.g., acetaminophen, NSAIDs) help reduce pain and inflammation
  • Physical Therapy: Strengthening surrounding muscles, increasing flexibility, and learning proper movement techniques. Do refer to the resources below on suitable exercises for knee osteoarthritis
  • Injections: Various injections are available on the market to aid with knee pain from OA. In general,
  • Corticosteroid injections are used for acute inflammatory episodes
  • Hyaluronic acid injections are "gel-like" injections used to aid joint lubrication
  • (Read our education page on Corticosteroid versus Hyaluronic Acid injections for knee OA)
  • Surgery: In severe cases, whereby the patient's symptoms persists despite non-surgical medical treatment. Dependent on the severity of your condition, your surgeon will recommend the appropriate surgical treatment. Surgical options include knee arthroscopy, partial knee replacement, or total knee replacement.
  • Exercise: Low-impact exercises like swimming, cycling, and walking can improve joint function and reduce pain
  • Modification of daily activities: Avoid
  • Weight Management: Reducing body weight can relieve stress on the knee joint
  • Diet: Anti-inflammatory foods, like omega-3-rich fish, fruits, and vegetables, may help manage symptoms.
  • Symptom Management:
  • Cold therapy (or cryotherapy) helps to reduce inflammation and therefore pain
  • Offloading knee brace: In patients suffering from knee osteoarthritis affecting an isolated part of the knee, an offloading knee brace has been shown to provide symptomatic relief
  • Supportive footwear
  • Maintain a healthy weight. Your ideal Body Mass Index (BMI) should be between 18.5 and 22.9kg/m^2
  • You can calculate your BMI = (Weight in kg) / (Height in metres)^2
  • Read our article on weight management and achieving your ideal body weight
  • Engage in regular low impact exercises. Joint friendly exercises include swimming and cycling
  • Avoid overloading the knee joint with repetitive movements (e.g. repetitive squatting)

When Should You Seek Medical Help

  • When pain becomes persistent, affecting limiting daily activities
  • If swelling or deformity is noticed
  • When home treatments do not provide adequate relief
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Additional
Learning Resources

  1. Overview of knee pain with physiotherapy exercises.
    Source: Health Hub
    Knee Pain
    Knee Pain: Finding Ease for Old Knees.
  2. Physiotherapy Exercises. Source: SGH.
  3. Overview of knee pain with physiotherapy exercises. Source: NTUC Health.
  4. Overview of knee pain from the NHS. Source: NHS UK.
  5. Knee Pain – Symptoms and causes. Source: Mayo Clinic.
  6. Why Women Are at Higher Risk for Getting Arthritis? Source: Hospital of Special Surgery (HSS)
  1. Osteoarthritis of the knee and total knee replacements – Facts and common myths debunked!
  2. What’s Causing my KNEE PAIN? | How I treated Knee Osteoarthritis! – SingHealth Answers All!
  3. Knee Osteoarthritis and Physiotherapy Management – SingHealth Healthy Living Series
  1. Felson, D.T. (2006). Clinical practice. Osteoarthritis of the knee. New England Journal of Medicine, 354(8), 841-848.
  2. Zhang, W., et al. (2010). OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis and Cartilage, 18(4), 476-499.
  3. Loeser, R. F., Goldring, S. R., Scanzello, C. R., & Goldring, M. B. (2012). Osteoarthritis: A disease of the joint as an organ. Arthritis & Rheumatism, 64(6), 1697-1707.
  4. Steinmetz, Jaimie D and GBD 2021 Osteoarthritis Collaborators. (2023) Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet Rheumatology, Volume 5, Issue 9, e508 – e522.

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