Osteoarthritis of the knee Osteoarthritis of the knee is a chronic bone and joint disorder caused by the degeneration of knee cartilage and osteophytes, also known as proliferative arthritis of the knee, degenerative arthritis and osteoarthrosis. The disease occurs mostly in middle-aged and elderly people, but can also occur in young people; it can develop unilaterally or bilaterally. Clinical manifestations and diagnosis 1. Slow onset, mostly seen in middle-aged and elderly obese women, often with a history of exertion. 2. The pain is aggravated by knee joint activities, characterized by paroxysmal pain at first, then persistent pain, more so at night and during exertion, and obvious pain when going up and down stairs. 3. Restriction of knee movement, or even limping. Very few patients may develop interlocking phenomenon or knee joint effusion. 4. There may be popping and grinding sounds when the joint moves, and some patients have swollen joints. 5. Knee pain is a common complaint of patients with this disease. The early symptoms are pain when going up and down stairs, especially when going downstairs, unilaterally or bilaterally, and joint enlargement, mostly due to bony hypertrophy, or joint effusion. Synovial hypertrophy is rare. In severe cases, internal derangement of the knee may occur. Diagnosis 1. History of repeated strain or trauma. 2. Knee pain and stiffness, more pronounced when waking up in the morning, relieved by activity, aggravated by more activity, and relieved by rest. The pain persists in later stages, with marked restriction of joint movement, quadriceps atrophy, joint effusion, and even deformity and intra-articular free bodies. 4. Friction sounds can be detected during knee flexion and extension activities. 5. Frontal and lateral photographs of the knee joint show lip-like osteophytes on the joint edges of the patella, femoral condyles, and tibial plateau, sharp tibial intercondylar elevation, narrowing of the joint space, dense subchondral bone, and sometimes intra-articular free bodies are seen. Treatment 1. Non-surgical treatment (conservative treatment) includes physiotherapy, drugs, injection therapy and Chinese herbal medicine treatment. 2. Surgical treatment (1) Knee arthroscopy is a safe and practical new technique for diagnosing and treating knee diseases, resulting in less pain, fewer complications, faster recovery, and more effective treatment. (2) Knee joint replacement is a surgical procedure to replace the damaged knee joint partially or completely with an artificially manufactured joint component, which involves removing the worn and damaged joint surface and implanting an artificial joint like a dental brace to restore a normal smooth joint surface.