- Patients with knee pain, swelling, or stiffness
- Patients reviewing an arthritis diagnosis
- How the knee is organized
- Why symptoms vary
- Which treatments are commonly considered
- The knee has three compartments.
- Symptoms should match examination and imaging.
- Exercise remains valuable even with arthritis.
- Arthroscopy rarely helps advanced arthritis.
How the Knee Works
The knee includes the femur, tibia, and patella. Cartilage covers the joint surfaces, while ligaments and muscles provide stability and control.
The knee is commonly described as having three compartments: medial, lateral, and patellofemoral. Arthritis may affect one compartment or the entire joint.
What Is Knee Osteoarthritis?
Osteoarthritis develops as cartilage wears down. The joint may narrow, form bone spurs, become inflamed, and gradually lose motion or alignment.
Pain can come from the worn surfaces, inflamed tissues, bone stress, stiffness, weakness, or a combination of these factors.
Common Symptoms
- Pain with walking or stairs
- Swelling
- Stiffness after rest
- Grinding or catching sensations
- Difficulty rising from a chair
- Loss of motion
- Bowing or knock-kneed alignment
- Reduced confidence in the knee
How Knee Arthritis Is Diagnosed
Your history and examination help determine where the pain is coming from and whether the knee is stable. Standing X-rays show joint-space loss, alignment, bone spurs, and which compartments are involved.
MRI is usually unnecessary when weight-bearing X-rays clearly show arthritis. It may create confusion by identifying age-related meniscus tears that are not the main cause of symptoms.
Exercise and Weight Management
Exercise does not wear out an arthritic knee. Appropriate strengthening and low-impact activity can reduce pain, improve confidence, and maintain function.
For patients carrying excess weight, even modest weight loss may reduce the load across the knee and improve symptoms.
Non-Surgical Treatment
- Activity modification
- Strengthening or physical therapy
- Anti-inflammatory or pain medication when safe
- A cane or walking stick
- A brace in selected patients
- Corticosteroid injection
- Other injections after discussing evidence and cost
Does Arthroscopy Help?
Arthroscopy is generally not effective for pain caused by advanced arthritis. Cleaning out the knee or trimming a degenerative meniscus usually does not change the underlying joint disease.
Arthroscopy may still have a role for a small number of patients with a different mechanical problem, but it is not a substitute for arthritis treatment.
Questions Patients Commonly Ask
Why does my knee hurt more on stairs?
Stairs increase force through the knee, especially the patellofemoral compartment, and require more muscle control.
Does a meniscus tear mean I need arthroscopy?
Not necessarily. Degenerative meniscus tears are common with arthritis and often do not benefit from surgery.
Will exercise make the arthritis worse?
Appropriate exercise generally improves symptoms and function. Activity may need to be adjusted, but complete rest usually leads to more weakness and stiffness.
When is replacement considered?
When pain and functional loss remain substantial despite reasonable non-surgical care, and the examination and imaging support arthritis as the cause.
A knee MRI can show many abnormalities that are common with age. The important question is not simply what the scan shows, but which finding actually explains your symptoms.