Osteoarthritis is one of the leading causes of knee pain. There has been a significant increase in the number of people with osteoarthritis around the world – up 113% between 1990 and 2019 to around 528 million, according to the Global Burden of Disease Study 2019. The condition, which is a degenerative disease with no known cure, is the leading cause of disability worldwide.
Causes and symptoms of knee osteoarthritis
Knee osteoarthritis develops when cartilage in the knee joint starts to wear away. This cartilage acts as a shock-absorber and allows the bones to glide smoothly over each other as you move your knee. As the cartilage becomes worn, the bones may start to rub together, causing pain, stiffness and loss of movement in the knee. The symptoms may be particularly noticeable after you’ve been sitting for a long time. The knee joint might feel like it could give way or buckle, or the knee might lock up or make a grinding noise when you move it. It might look puffy or swollen.
The precise causes of knee osteoarthritis aren’t known but you may be particularly at risk if you are overweight, if you injure your knee, or if you play sports or have a job that places your knee under repeated stress. Certain types of deformities of the knee and leg or a family history of knee osteoarthritis may also increase your chances of developing the condition.
What is synovitis?
Inflammation of the synovial tissue, which is located inside the knee joint, appears to be strongly linked with levels of pain in knee osteoarthritis. The role of synovial tissue is to create and seal synovial fluid inside the synovial cavity and support chondrocyte nutrition. When there are inflammatory cells in the knee joint, enzymes build up which can cause cartilage breakdown. At the same time, the synovial tissue or fluid may become damaged and the affected tissues inflamed, resulting in more inflammatory cells. Synovial pain is associated with rapid loss of cartilage in knee osteoarthritis.
Conventional treatments for knee osteoarthritis
Conventional treatments focus on managing the symptoms of osteoarthritis and delaying progression of the disease. In the early stages, knee osteoarthritis may be managed by:
- Losing weight to reduce stress on the knee joint
- Painkilling medication to manage the symptoms
- Exercise to keep the joint lubricated, improve flexibility and strengthen the supporting muscles
As the condition develops, you may be offered:
- Therapeutic injections of steroids into the knee joint to relieve pain
- Viscosupplementation, which is an injection of hyaluronic acid into the joint. This thick fluid mimics the fluid coating found in natural cartilage, which helps to lubricate the joint and act as a shock absorber. The injection can help reduce pain and swelling
- Knee braces
- Orthotics
- Physiotherapy
With severe knee osteoarthritis, the most common treatments are surgical, including:
- Knee osteotomy, which involves realigning and reshaping the knee joint to shift your weight from the damaged section of joint to an area where there is more healthy cartilage
- Partial knee replacement, which involves replacing the damaged section of your knee with an artificial implant
- Total knee replacement, where the entire knee joint is removed and replaced with an artificial implant
While surgery is an effective way to treat severe osteoarthritis of the knee, all surgery comes with a risk of complications, including blood clots, infection to the wound site or damage to the nerves or tissue. Surgery also involves a significant period of recovery and recuperation, which can be disruptive and inconvenient. Arthrosamid injections are a new non-surgical treatment for severe knee osteoarthritis. They are performed as a simple outpatient procedure, without the need for surgery.
Arthrosamid injections for knee osteoarthritis
Arthrosamid is a permanent injectable hydrogel that provides in most patients an effective long-term pain relief for knee osteoarthritis without the need for surgery. The treatment uses intra-articular polyacrylamide hydrogel or iPAAG. It is performed under local anaesthetic by a qualified clinician and you can go home the same day. Research shows that Arthrosamid injections provide long-lasting reductions in knee pain even up to three years after treatment. It is a safe and effective alternative to surgery for most people with knee osteoarthritis.
How do Arthrosamid injections work?
Arthrosamid uses innovative non-degradable hydrogel technology for the treatment of knee osteoarthritis. As the body does not break down this substance it is classified as an implant and hence the need to take a single dose of oral antibiotics prior to the implantation injection procedure. Once injected, Arthrosamid combines with the synovial tissue in the knee joint helping to diminish pain, decrease joint stiffness and improve the knee’s mobility. The result is lasting improvement in symptoms and improved quality of life in the majority of patients.
How effective is Arthrosamid?
In studies, Arthrosamid exceeds the MCID (minimal clinical important differences) of nine points 16 and improvement is maintained up to three years after a single injection. The literature suggests that up to 10% of patients may not respond to the injection and hence may derive minimal benefit.
Patients under 70 reported close to an 80% positive response rate following treatment.
What treatment should I choose?
There is now a range of effective treatments for knee osteoarthritis. Your orthopaedic surgeon will advise on the most suitable treatment for you, based on a range of factors including the severity of your condition, your age and general state of health. For more information about Arthrosamid injections and other treatments, contact us.
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We are always happy to provide information and guidance about the various treatment options, both surgical and non-surgical, including Mako robotic arm assisted surgery and conventional surgery.
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