Types of Arthritis Pain in Knee

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DR. SUNIL RAJAN
Head of Department Apollo Institute of
Orthopaedics, Apollo Hospitals, Indore M.S
Orthopedics, Specialization Joint Replacement
Surgery
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Types of Arthritis Pain in Knee
There are two main types of arthritis in the knee
Osteoarthritis where there is degeneration of
the bones Rheumatoid Arthritis where there is
inflammation in the joint
1. Osteoarthritis Of The Knee
This is commonly known as wear and tear
arthritis. Osteoarthritis is by far the most
common cause of arthritis pain in knees affecting
approximately 16 million people. Usually
osteoarthritis of the knee is related to, but not
caused by aging, most commonly affecting people
over the age of 65. Other common terms used are
"degenerative arthritis knee" or "arthrosis".
In a normal, healthy knee joint, there is a
reasonable sized gap between the bones (tibia and
femur) due to a thick layer of cartilage and
lubricating fluid. 
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The surface of the bones is nice and smooth and
as the knee bends and straightens, the joint
moves easily and painlessly due to the cushioning
from the cartilage. 
With osteoarthritis of the knee, a few things
happen. The cartilage thins and as a result the
bone underneath begins to thicken and lays down
new bone to try and protect itself. 
These spurs stick up so the joint surfaces are no
longer smooth but are all bumpy.  They are known
as osteophytes or knee bone spurs.
As a result of these changes, there is less space
between the bones. This means that as you use the
knee, you can get bone rubbing on bone, causing
arthritis pain in knee joints.  The bone spurs
can also limit the amount of movement in the knee
leading to stiffness.
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2. Rheumatoid Arthritis
Rheumatoid arthritis is a chronic, systemic
inflammatory disorder
Chronic long term Systemic throughout the
body Inflammatory swelling
It causes inflammation as well as excess fluid in
the joints. It often leads to destruction of the
cartilage. Joints become swollen, painful and
warm, and movement is limited by resultant
stiffness.
Rheumatoid arthritis is less common than
osteoarthritis and its incidence is actually
declining.  It affects around 1 of the worlds
population and is three times more prevalent in
women than men. Onset usually occurs between the
ages of 40-50. It will usually affect a number of
joints, especially the hands, feet and neck.
Symptoms can come and go, known as flare ups.
One of the most distinguishing features is
morning joint stiffness which eases with movement.
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Locations of Knee Arthritis
Knee arthritis can develop at either or both of
the joints of the knee
1. Tibiofemoral Arthritis
Tibiofemoral arthritis tends to be what people
typically think of when they talk about
knee arthritis. It affects the tibiofemoral joint
with damage to the cartilage lining the bottom of
the thigh bone and the top of the shin
bone. Tibiofemoral arthritis pain in knee tends
to be felt deep inside the knee joint and tends
to be associated with knee stiffness, weakness
and swelling.
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2. Patellofemoral Arthritis
Here, the arthritis affects the patellofemoral
joint, where the kneecap meets the thigh bone.
The patella sits in the patellar/trochlear groove
on the front of the femur and glides up and down
as the knee moves.   In patellofemoral
arthritis, there is damage to the cartilage on
the back of the kneecap and the cartilage lining
the patellar groove. Pain tends to be felt at the
front of the knee can is worse with activities
such as climbing stairs, getting up from sitting
and squatting.
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