Osteoarthritis - What is arthritis?


Arthritis is a common condition that literally means inflammation of a joint.  There are many types of arthritis affecting the hip and knee the most common of which are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is a degenerative (wear and tear) joint disease which is caused by damage to the cartilage that lines the joint.  It progressively worsens with time leading to chronic ache or pain and reduced function.  People often complain of difficulty walking or standing for too long, ascending or descending stairs and even putting on shoes and socks can become difficult.  In the later stages of arthritis patients complain of pain at rest or at night which can wake them from sleep. 

What causes osteoarthritis

You are more likely to develop osteoarthritis if there is a family history.  The genetics of arthritis are poorly understood.  Other risk factors include age, previous injury that has damaged the cartilage and obesity/being overweight.

The initial treatment of arthritis is non-operative.  It involves a series of measures to reduce the load going through the joint and control the pain.  There is no cure for osteoarthritis and most of our management aims to slow its progression.


Activity and strengthening is the mainstay of non-operative treatment.  Staying active helps keeps your joints strong and mobile.  This may mean modifying your exercise to include ‘low-impact’ activity such as using an exercise bike, elliptical or swimming.  These activities avoid excess loading of the joint.

Weight Loss

Maintaining a healthy weight is crucial to reducing stress on the hip and knee joints.  It will not only help to manage the symptomatic joints but also slow the progression of arthritis in the asymptomatic joints. A 10 % reduction of your body weight can reduce the pain of arthritis considerably and improve your overall function.  


There are a number of medication options to help relieve the pain.  These medications help to control pain and ease the inflammation of arthritis. Corticosteroids and local anesthetic injections may also be helpful in an acute flare of arthritis.  The steroid acts to reduce inflammation in the joint and settle the inflamed and painful joint lining.  Care should be taken in people with a history of infection in the joint or diabetics as this may cause difficulty in controlling blood sugars. 

Other treatments such as off-loader braces, lubricant injections (viscosupplementation) and platelet rich plasma injections have had variable results in the literature.  I do not recommend these routinely as part of my management pathway.


Keyhole surgery, also known as arthroscopic surgery, may be considered in mild arthritis but has a limited role in the management of advanced osteoarthritis and in most instances is not recommended. This has been routinely shown to be ineffective with no difference in pain or function versus non operative management.  

Joint replacement is a last resort in the management of arthritis.  It is reserved for those who can no longer manage their symptoms with non-operative measures.  Joint replacement is major surgery with considerable risks and candidates for surgery are chosen carefully. 

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