Early knee arthritis causes knee stiffness, pain with stairclimbing, and pain with prolonged sitting. The symptoms can be gradual or sudden in onset. Often you do not know that arthritis has started until you injure the knee.
Arthritis results from loss of the slick white cartilage covering on the bones in a joint. Knee arthritis comes from old injuries, overuse, bowed legs, being overweight or just having weak cartilage. It shows up on x-rays as narrowed joint spaces and bone spurs. MRI scans, surprisingly, are not as good at detecting arthritis.

Treatments
Anti-inflammatory medications
These medications are chemically related to aspirin. The most commonly used one is ibuprofen, sold without a prescription as Motrin or Advil. Prescription anti-inflammatory medications vary in price, strength, duration, and side effects. Most patients try several to find out which gives them the best relief of symptoms. Some patients take them regularly while others take them only when needed. Side effects are rare, but a blood test is recommended every three to six months. Please tell your medical doctor about any new medications we prescribe. In general, it is safe to take one aspirin a day in addition to taking an anti-inflammatory medication.

Low-impact exercise
Gentle exercises such as walking, cycling, water exercise, and swimming help reduce arthritis pains. The shock-absorbing effect of muscles is improved by exercise. Also, the lubricants and nutrients in the knee are distributed by exercise. Avoid jarring impacts and deep knee bends. Often patients start exercising with a physical therapist and join a wellness center or exercise club to keep up their healthy habits.

Weight loss
The knee is more sensitive than any other joint to your weight. If you are able to lose weight, your knees will hurt much less. Of course, it is tough to lose weight when you can't exercise because your knees hurt. My best suggestion is to try water exercises. Also discuss weight loss with your medical doctor. There are effective weight-loss pills such as Meridia, which are unrelated to the recalled phen-fen medications.

Knee braces
Knee braces help by keeping the knee warm, stabilizing it, and shifting stress away from damaged areas. Braces should be worn for walking and taken off when sitting or resting for more than a few minutes. The brace must be snug to be effective, but if it makes your ankle swell it is too tight. The simplest brace is a neoprene rubber sleeve with a hole for the kneecap. The middle brace is also neoprene but has metal hinges on the side. The heaviest brace is made of fiberglass. The heavier braces help straighten the knees of patients who are bowlegged from arthritis.

Nutritional supplements
Glucosamine and chondroitin sulfate are molecules which give cartilage its cushioning effect. Most pharmacies, such as GNC, Wal-Mart, and Sam's Club, sell this as a daily supplement. It probably helps a little. Every study which has shown a benefit was sponsored by a manufacturer. Also, the quality of brands is unregulated. Try a brand or two but don't spend a fortune. There has not been much reported about side effects, but it is wise to inform your medical doctor if you begin taking this regularly.

Lubricating joint injections
Synvisc and Hyalgan are two synthetic brands of a lubricating material found in normal knee fluid. This material is administered into the knee joint in three to five injections once a week. It is supposed to give six months of relief from mild arthritis. Some patients like it a lot while others say it didn't help. It costs about 0, so check your insurance coverage before trying it.

Arthroscopic surgery
Arthroscopic surgery is accomplished by placing a pencil-shaped TV camera through tiny incisions around your knee. Miniature trimmers and vacuum cleaners can remove loose or torn cartilage pieces. In young athletes removing a torn cartilage pad can give complete relief of pain. However, in early arthritis, the pain relief is not as complete. Arthroscopy cannot cure arthritis yet. The relief comes from washing debris out of the knee. The amount of benefit depends on whether the knee is "clogged with debris" versus "worn out." Most patients get significant, but not complete, relief for some period of time.

Cartilage transplants
Recently, news reports described that cartilage could be grown in a laboratory. This is a promising line of research but has limited use for patients currently. The technique works only for small areas of cartilage damage in young persons. To grow new cartilage requires a surgery to harvest a specimen--an extremely expensive culture process and a second surgery to re-implant the liquid graft. Most surgeons consider the procedure to be experimental at this time.

Moving cartilage within the knee
For localized areas of damage, plugs of cartilage can be moved from non-critical areas of the knee. This is similar in technique to moving the hole around on the golf green. The MRI scan can usually tell whether this would be a feasible option for your knee.

Cortisone injections
Cortisone is a steroid hormone used by your body to stop inflammation. An injection of cortisone into an arthritic knee can give good but temporary pain relief. Cortisone shots usually are not given more often than three times into the same knee in a year. Each cortisone shot is less effective than the previous one. In most cases, cortisone is used as a last resort before knee replacement. It is controversial whether cortisone harms the cartilage or simply allows you to further bang up a damaged knee by numbing the pain. If you don't want a knee replacement and nothing else works, I recommend trying a cortisone injection.

Knee replacement surgery
When nothing else works, knee replacement can restore pain-free mobility. The surgery takes about two hours to remove all bone spurs and cover the bone ends with smooth metal implants. The hospital stay is about one week. The knee really hurts for a month or two, during which time you have to do painful physical therapy. There is a little discomfort for about six to nine months. After that, there is usually no significant pain in the knee. Knee replacement has some risks, such as blood clots, infection, and mechanical problems. In rare instances, the implants can come loose and need re-operation. However, in the majority of cases, walking without pain results in better overall health and vitality.