Gonarthrosis (knee osteoarthritis): symptoms, stages and what you can do

The knee joins the femur to the tibia. Between the two bones, cartilage works as a cushion. When that cartilage wears down, the space between the femur and the tibia narrows and, in the most advanced cases, there can be bone-on-bone contact.

The wear can affect three areas (compartments) of the knee: the inner part (medial), the outer part (lateral) and the area between the femur and the kneecap (patellofemoral). The shape of the legs plays a part: when the legs tend to form an “O”, the inner compartment is usually affected; when they tend to form an “X”, the outer one.

Gonarthrosis is usually linked to several factors, and some of them are within your control:

• Excess weight: one of the most common causes, because the added weight puts an extra load on the knees.
• Previous injuries: blows, fractures, or ligament or meniscus injuries suffered earlier.
• Overuse: the repeated strain of heavy physical work or high-impact sports.
• Misaligned legs: bowed legs (an “O” shape) or legs in an “X” shape.
• Heredity and the natural wear of the joint over the years.

The classic symptoms are:

• Clicking or cracking in one or both knees.
• A very tight or stiff feeling in the knee.
• Discomfort that is worse in the morning, because the knee has gone hours without moving.
• Pain or a tight feeling going up or down stairs.

If you recognize these symptoms, they may be due to gonarthrosis; an evaluation helps confirm it.

Gonarthrosis is classified into four stages, from 1 to 4; stage 4 is the most severe. As it progresses, the space between the femur and the tibia gets smaller. In any of the four stages there can be pain, and also loss of movement in the knee.

Cartilage is a soft tissue and, once worn, it has very little ability to recover. That is why the goal is practical: to give the joint between the femur and the tibia more space, help keep it lubricated and improve its movement and flexibility, whatever the state of the cartilage.

To that end, at the practice the same decompression table used for the spine is also used for the knee. It is a non-surgical option worth knowing about before considering surgery. In an evaluation your case is reviewed to decide whether this option is right for you.

Some habits are up to you and support your knees:

• Lose weight if you have some to spare. Many people carry more weight than their knees can handle, and losing weight is good advice for almost any joint problem.
• Exercise regularly. Lack of movement makes the knee feel stiffer; start gradually and, if an exercise increases your knee pain, stop and get advice before continuing.
• Stay well hydrated. Cartilage has no arteries or veins that reach it directly, and drinking enough water is one way to support this tissue.

If you have a heart or kidney condition, or you have been told to limit fluids, ask your doctor how much water you can drink a day.

Gonarthrosis is very common. Recognizing the symptoms early, watching your weight, moving, staying hydrated and knowing what stage your knee is in help you make better decisions and learn about the non-surgical options before considering surgery.