Stock image of bent knee with a red mark depicting knee pain.

Ask an AMH Expert: What is Knee Arthritis?

with Dan Caputo, MS, PA-C

Osteoarthritis of the knee is the most common type of arthritis of the knee and can effect one or both knees. When left untreated, pain and loss of joint space progress over time. At Ashe Orthopaedic Surgery & Sports Medicine, we are committed to providing comprehensive, high-quality care, offering a full range of orthopaedic and sport medicine treatment options. For more information or to schedule an appointment, please call 336-846-0222.

What is knee arthritis?

The diagnosis of knee arthritis can cover a wide variety of conditions. There are over 100 types of knee arthritis. The most common form and the one that comes to our minds when we are on the topic of Orthopedic Surgery is osteoarthritis. Osteoarthritis of the knee is a condition where the covering cartilage at the ends of our bones wears away and leaves us with exposed bones which rub on each other when we stand or sit.

What causes knee arthritis?

Knee arthritis can be caused by many reasons. Like most health issues we encounter, there is typically a combination of predisposing factors that contribute to a condition. There is typically never one thing we can put our finger on and say, “That’s it.” In general, Osteoarthritis of the knee can be caused by the following, prior injury to the joint, lack of exercise, weakened leg muscles, increased weight, poor diet, and inflammatory changes in the body.

Who is most at risk?

The people most at risk for knee arthritis are ones with poor dietary habits which contribute to weight gain. Smokers increase their inflammatory states which contributes to a combination of health problems. Anyone who has suffered prior injury to the knee especially if that injury required surgery. Weak leg muscles can also predispose a person to osteoarthritis of the knee. Anatomical factors such as wide hips and knocked knees can cause issues with knee biomechanics contributing to arthritic changes.

What are the symptoms of knee arthritis?

People with osteoarthritis of the knee typically tell me certain things. Morning stiffness relieved with movement is a common complaint. Sometimes, depending on the location of the arthritis in the knee, pain with going up and down steps and prolonged sitting can raise concern for osteoarthritis of the knee. Night pain and pain that wakes people up can also be a common complaint. Pain relieved with over-the-counter treatments such as NSAIDS and Tylenol can raise concern for that as well.

What makes knee arthritis pain worse?

Unfortunately, knee arthritis is progressive. Left untreated, pain and loss of joint space progress over time. Sometimes, depending on how long symptoms can go unchecked, conservative treatment is less likely to be effective. Ignoring pain, leaving modifiable risk factors unaddressed, and not proactively treating the progression of arthritis can worsen symptoms over time.

How is knee arthritis diagnosed?

There are many ways to diagnosis osteoarthritis of the knee. The most common and easiest imaging to diagnose knee arthritis is with weight bearing x-rays. There are several views we examine when people bear wight that give us an understanding of their joint space during activity. MRI can be useful at times but is not always helpful. High resolution MRI can give us a good picture if there is a cartridge injury. Conversely, they can mislead us because they are so specific we may focus on a finding that coexist with osteoarthritis of the knee. It is also very important to correlate symptoms with image findings. A proper examination is the cornerstone of a solid diagnosis. Sometimes concurrent back pain can be mistaken for knee pain. Most of us have experienced sciatica! How many of us had back pain that radiated down our leg and we thought something was wrong with our hip or knee. Physical examination can help differentiate between the two issues.

What are the treatment options for knee arthritis?

There are multiple treatment options available for knee arthritis. When considering treatment, my preference is to work with patients and consider their goals. Treatment varies depending on age, activity level, coexisting medical conditions, current medications, and lifestyle. In general, lifestyle changes and weight loss are important to decreasing load on the joint and relieving symptoms. In an Orthopedic Surgical setting, there are multiple conservative treatment options that can ease symptoms and slow progression. These options consist of Formal Physical Therapy, Cortisone injections, Hyaluronic Acid injections, Platelet Rich Plasma, total knee replacement, and sometimes partial knee replacement. Each one of these treatments has their place and are based on the goals of the patient and coexisting conditions. Sometimes people only want relief of pain, increase stability, maintenance therapy, or we have some patients that “just want to be fixed.” At Ashe Orthopedic and Sports Medicine, we now utilize ultrasound. We are able to use this modality for both diagnostic examination and guided injections.

When should I seek professional care for knee arthritis?

One should seek evaluation of knee pain when there is a change in activity due to the pain. If one can walk a mile but now finds themselves stopping every few minutes because of knee pain, a proactive search for a cause should be made. Waiting for months and sometimes years can limit the effectiveness of conservative treatment options. Moreover, both knees should be considered, even if there is no pain. It is not uncommon for one knee to be more symptomatic and the other knee. At times, the non-painful knee has a more impressive x-ray and advanced arthritic changes than the knee that actually hurts!

About Dan Caputo, MS, PA-C



Dan Caputo is a certified physician assistant with more than 15 years of experience in Orthopedic and Trauma Surgery. Dan earned his bachelor’s and master’s degree in sports science and athletic training from Long Island University in Brooklyn, N.Y., in 2001. In 2007, he earned his bachelor’s degree in physician assistant studies from York College in Queens, N.Y.