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. 

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.

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 world’s 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.

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.

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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