Knee Arthritis.

Anatomy & the role of cartilage

The knee is a hinge joint between the femur, tibia, and patella. All three surfaces are lined with smooth articular cartilage. Where cartilage breaks down, bone surfaces grind against each other, creating pain, inflammation, and the formation of bone spurs (osteophytes).

Symptoms

• Localised knee pain — typically worse with activity
• Sleep disturbance from night pain
• Limping
• Stiffness, especially in the morning or after sitting
• Crepitus — grinding or grating sensation
• Knee bowing (varus deformity) or knock-knee (valgus)
• Reduced walking distance and overall mobility

Non-surgical treatment

• Strengthening — quadriceps, hamstring, and gluteal work
• Activity modification — swap high-impact for low-impact
• Weight loss — every kilo lost reduces knee joint load measurably
• NSAIDs — carefully managed
• Walking aids

Alternative therapies

Several alternative options are commonly asked about. Evidence quality varies:

• Glucosamine and chondroitin — modest evidence; safe
• Hyaluronic acid injections — short-term benefit in some patients
• PRP (platelet-rich plasma) — limited high-quality evidence

Stem cell therapy

Stem cell therapy is widely marketed for knee arthritis. The current evidence does not support its use as a reliable treatment — controlled studies have not consistently shown benefit beyond placebo or simple injections. Mr Gormack does not currently offer stem cell therapy outside of a formal trial setting.

Surgical treatment

When non-surgical care no longer provides adequate relief, four surgical options exist:

• Total knee replacement — most common; see full procedure guide
• Partial knee replacement — single-compartment resurfacing for isolated disease
• Patellofemoral replacement — for isolated patellofemoral arthritis
• Osteotomy — realignment surgery for younger patients with single-compartment disease (see High Tibial Osteotomy on the Knee Surgery page)