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In arthritis the cartilage that naturally cushions the joint wears away. This causes the bones in the joint to rub together, triggering inflammation and pain. Over time the lining of the joint thickens, bony spurs grow at the edges and cysts develop under the joint surface. Sometimes this process only affects a specific part of the knee such as the inner side or the area under the kneecap, but often the whole joint becomes arthritic.

Find out more.


  • Genetics. You are more likely to develop osteoarthritis if you have family members suffering from it.

  • Age. The older you are the more likely that you will develop the disease, but it is far from inevitable.

  • Female sex.

  • You are more likely to develop osteoarthritis if you are overweight or obese. You can check your BMI here.

  • Occupation. Heavy manual work and repeated high impact activities may lead to osteoarthritis in later life.

  • Previous injury to the knee such as a fracture, ligament injury or meniscal tear.

  • Pronounced bow or knock knee deformity.

  • Diseases like rheumatoid arthritis and other systemic inflammatory conditions may lead to similar destruction of the knee joint.


  • Pain. Most people localise the pain over the affected compartment, most commonly on the inner side. It may be worse going down the stairs in the kneecap is worn. At the onset of the disease you may only feel it after a longer walk or strenuous activity, but later it can become constant including at night.

  • Stiffness. The range of movement gradually decreases and you may not be able to full straighten the knee. This leads to difficulty putting on socks and shoes and getting in and out of the car.

  • Swelling can come and go. It is typically worse after walking.

  • Giving way in arthritis is caused by the inadvertent offloading of the knee due to pain rather than actual instability.

  • You may feel or even hear creaking or grinding from the joint in advanced bone-on-bone arthritis.

  • Limited mobility. The usual walks become shorter and shorter and in the end you may only be able to walk a few hundred yards with significant limp.


  • A history and the typical symptoms are usually sufficient to make the diagnosis.

  • The clinical examination confirms the pattern of pain, limited movement, swelling and potential instability. Examination of the other knee, the hip and the spine provides further information for the planning of your treatment.

  • An x-ray is necessary if surgical treatment is considered and also to exclude other conditions.


Depending on the severity of your symptoms you may be able to manage your knee arthritis without an operation. If your symptoms still persist and you feel limited by your knee you may wish to consider a partial or total knee replacement.

Conservative treatment consists of a combination of lifestyle changes, exercise and taking medication such as pain killers and anti-inflammatories. You can find more information on this here.

An injection can be considered in mild to moderate arthritis.

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