Knee arthrosis

In the knee, as in all other joints, the opposing bone parts are covered by cartilage. This smooth, firm and elastic layer ensures that the joint moves easily and without friction. If the cartilage is damaged due to chronic wear and tear, we call it knee joint arthrosis.

There are many factors which lead to arthrosis in the knee: a genetic predisposition, excess weight, missing or abnormal movement and constant abnormal weight bearing or injuries. The person affected does not feel knee arthrosis for a long time and only when the cartilage wear and tear has reached a certain point will it be painfully noticeable.

The joint disease arthrosis (Greek: arthros = joint) is divided into various stages. During mild knee arthrosis, the cartilage is softened. During the middle phase the tissue is frayed and the cartilage looks like crab meat, which is why this state is called "crab meat". During advanced arthrosis the cartilage already has distinct pockets or pot holes. In the worst case the gliding layer is totally missing and so-called bone baldness is then present.

Knee arthrosis normally proceeds in episodes or waves. Phases which are absent of pain are called "silent arthrosis". If the tissue is inflamed we speak of "activated arthrosis".

Primary arthrosis is the case if the cause of the disease is suspected to be genetic. Cartilage wear and tear makes itself noticeable over the course of one's life without an external cause.

One is generally responsible oneself for secondary arthrosis, unlike genetically induced primary arthrosis. Secondary arthrosis is linked to factors which have a lot to do with our lifestyle, career choice, eating habits or free-time behaviour. The following factors may be the cause:

Knee joint arthrosis often appears as the consequence of accidents and injuries – sometimes only after years.

Knee arthrosis can also be triggered by constant overloading and occupational arthrosis is not a rarity. For instance, floor tilers often develop knee joint arthrosis.

Many people develop malalignment during adolesence, for instance in the form of bowlegs. An additional load on the knee joint arises as a result of this condition and this can accelerate the deterioration of cartilage.

It’s well known that: Too many pounds on the ribs are poison for the knee joints. Excess weight can trigger arthrosis in completely healthy knees.

Inflammatory joint diseases can damage the cartilage and facilitate arthrosis.

Arthrosis develops over a long period of time – and those who are affected don't even notice the change. If the cartilage becomes soft and thinned, the body initially finds many ways to compensate for this.

Those who are affected may subtly adopt a different posture and gradually alter the way that they live. Despite this adaptation process, the day will come when the arthrosis will become apparent.

Pain after periods of inactivity is one of the very frequent symptoms of knee arthrosis. It expresses itself in the mornings when getting up and the joints need time to become properly warmed up.

If people are affected by silent arthrosis and know nothing about their injury, an ordinary occurrence such as bumping the knee against the coffee table can initiate a cascade of events leading to the presentation of symptoms. The person affected will protect his/her knee after a bruise which leads to muscle deterioration and the loss of muscle tone and instability. In the past the muscles assumed an important stabilizing function to compensate for the early silent arthrosis. The house of cards now collapses and the pain remains. Many of those who are affected say "But I only bumped my knee against the coffee table". As a matter of fact such minimal traumas can bring knee joint arthrosis to light.

You can sometimes recognize knee arthrosis by looking at the knee: It is simply thicker than before and it no longer looks so slim. Even if bowlegs lean more outward than usual this can be the first sign. The knee's increased tendency to swell is easy to recognize. A bulge as thick as a finger will form above the knee cap. Since this place is the weakest spot of the joint an effusion presses outward. Increased accumulation of fluid in the joint is a distinct symptom of knee arthrosis.

It is like driving a car. When the tires are unevenly worn and the tread depth varies, the wheel suspension is out of alignment. Carried over to the human body this means: the soles, and more importantly the heels, of shoes provide information about whether everything is okay with the knees. To compensate for knee pain at the beginning stage of knee arthrosis, many of those who are affected tend to position their foot crooked and to roll it over from heel to toe. The heels attest to this and the shoes should be taken along to the doctor's visit.

If flexibility decreases in the legs this can indicate knee joint arthrosis. Those who were previously able to touch their heels to their buttocks while standing on one foot but can only go half of the way today should get examined. The thigh muscles have to work harder than before due to knee arthrosis and they cramp, becoming shorter and starting to hurt. These muscles must be stretched and strengthened to recover their full performance ability.

Another sign of knee arthrosis is decreasing muscular strength in the legs. Those affected may notice that they are unable to pedal as strongly on their bike and need to hope for a tail wind to help propel them forward.

Arthrosis transforms cartilage which is smooth as glass into rough tissue, which looks like sandpaper in the early stages. If these surfaces rub together they may hear  rubbing and creaking sounds in the joint. If they place their hands on the joint, they literally feel how the cartilage struggles with movement.

An all-clear signal, regarding sounds, comes if they hear a loud cracking sound in the knee while returning to an upright position from a squat.  This is not a symptom of knee joint arthrosis.