Knee Arthritis (Gonarthrosis)

Knee arthritis, medically known as gonarthrosis, is a common joint condition that can significantly impair quality of life.

Gonarthrosis — by definition — refers to the progressive wearing away of the cartilage within the knee joint. The term is derived from the Greek “gonu” (knee) and “arthrosis” (joint disease), and is used interchangeably with knee osteoarthritis.

As the cartilage deteriorates, it loses its shock-absorbing capacity. The space between the bones narrows progressively, leading to abnormal bone-on-bone friction. The result is pain, inflammatory episodes and increasing joint stiffness. Arthritis in the knee typically evolves slowly, sometimes starting in one compartment before gradually spreading to the entire joint.

Without appropriate management, osteoarthritis of the knee can lead to a significant — or even complete — loss of functional capacity. Treatment should be started as soon as the first signs of arthritis in knee appear.

Gonarthrosis Diagnosis: How Knee Osteoarthritis Is Identified

For gonarthrosis, the diagnosis follows three steps: analysis of knee arthritis symptoms, clinical examination and targeted imaging. This process confirms the condition, evaluates its severity and defines the most appropriate treatment strategy.

Symptom Analysis and Clinical Examination

The specialist in knee conditions [link to Knee conditions] begins with a detailed interview to understand the nature of the pain (mechanical — i.e. related to activity), its progression, and any stiffness or functional limitations. Recognising the early signs of arthritis in the knee at this stage is essential for timely intervention.

The physical examination of the knee assesses joint mobility, stability, limb alignment, tenderness on palpation and any inflammatory signs. This step is critical to understanding the real impact of the condition on the patient’s daily life.

Knee X-Rays (Gonarthrosis Radiology)

X-rays are the reference investigation for osteoarthritis diagnosis in the knee. Gonarthrosis radiology allows the specialist to visualise:

• narrowing of the joint space, indicating cartilage loss,
• the presence of osteophytes (bony spurs),
• any changes to the underlying bone.

Weight-bearing X-rays are particularly important in the diagnosis of osteoarthritis, as they reveal the true extent of joint-space loss under load — information that non-weight-bearing films may miss.

Magnetic Resonance Imaging (MRI)

MRI provides a detailed analysis of structures not visible on X-ray, such as the menisci and ligaments. It can be useful when there is diagnostic uncertainty — for example, when it is difficult to determine whether the problem is arthritis or another knee condition.

However, MRI is not routinely required and is generally unnecessary when knee osteoarthritis is clearly identifiable on standard X-rays.

Knee Arthritis Symptoms: What to Look For

Knee arthritis symptoms can vary in intensity depending on the patient’s situation. Below are the characteristic clinical signs. Understanding the symptoms of arthritis in the knees early on is key to accessing timely care.

Knee Pain

Knee pain is usually the first of the osteoarthritis knee symptoms to be felt. It occurs mainly during movements and activities that load the joint, such as walking, climbing or descending stairs, or rising from a chair. The pain may be diffuse or precisely localised within the knee, and tends to worsen with exertion.

Joint Stiffness (Unlocking)

Stiffness typically appears on waking or after prolonged inactivity. It often eases after a few minutes of movement but may return and persist as the day goes on, producing a sensation of a “locked” or less supple knee. Morning stiffness is one of the hallmark signs of arthritis in the knee.

Knee Swelling

Swelling may occur as a result of joint inflammation. It can be intermittent, fluctuating with the level of physical activity and external factors such as weather conditions.

Reduced Range of Motion

As osteoarthritis in the knee progresses, the range of motion diminishes. Full flexion or extension becomes difficult, affecting everyday activities, limiting independence and degrading quality of life.

Functional Impairment and Walking Capacity

Beyond pain, knee osteoarthritis causes progressive functional limitation. Patients may experience:

• difficulty walking long distances,
• a reduced walking perimeter,
• rapid fatigue when on their feet,
• sometimes the need for a walking aid (stick).

In advanced forms of gonarthrosis, independence can be significantly reduced, with a major impact on quality of life.

When properly identified and assessed, gonarthrosis symptoms can be relieved on a lasting basis through personalised management.

The partner surgeons of International Elite Care offer solutions tailored to each clinical situation, with the goal of reducing pain and improving the patient’s mobility

Knee Arthritis: Causes and Contributing Factors

In cases of knee arthritis, the cause is often difficult to pinpoint. When no specific underlying condition can be identified, the diagnosis is primary gonarthrosis — the most common form, driven by a combination of contributing factors that increase the stresses on the joint or promote gradual cartilage breakdown.

Excess Weight and Obesity

Excess body weight significantly increases the load borne by weight-bearing joints, particularly the knees. This mechanical overload accelerates cartilage wear. In addition, adipose tissue has a pro-inflammatory effect: it can amplify joint inflammation and intensify pain.

Previous Injuries or Trauma

A history of knee trauma — fractures, ligament injuries or meniscal tears — can permanently alter the balance of the joint. These injuries weaken the cartilage and may precipitate the onset of arthritis in the knee, sometimes years after the original injury.

Knee Osteoarthritis: Treatment Options and Surgical Interventions

Management of knee osteoarthritis aims to relieve pain, preserve mobility and slow the progression of the disease. Treatments are adapted to the stage of arthritis, its functional impact, the patient’s age, activity level and expectations. They draw on both non-surgical and, where necessary, surgical approaches.

Non-surgical treatments are generally offered as the first line of management, particularly at the early and intermediate stages of arthritis.

Non-Invasive Treatments (First-Line)

These treatments form the foundation of care, especially during the early and intermediate stages

Weight Loss

Reducing excess body weight significantly decreases the mechanical stresses on the knee. Even a moderate weight loss can improve pain levels.

Rehabilitation and Physiotherapy

Physiotherapy plays a central role. It is based on:

• strengthening of the quadriceps, hamstrings and gluteal muscles,
• prioritising full knee extension (a fundamental element),
• flexibility and range-of-motion exercises,
• low-impact endurance work (cycling, swimming).

Manual therapy techniques may complement rehabilitation to improve mobility and reduce pain.

Adapted Physical Activity

Regular exercise improves:

• joint stability,
• proprioception,
• motor control,
• functional confidence.

Extension work is particularly important to maintain normal knee biomechanics.

Biomechanical Optimisation

In certain cases, the following may be proposed:

• orthotic insoles,
• an appropriate knee brace,
• a temporary walking aid.

The aim is to improve load distribution and to limit excessive stress on the arthritic compartment.

Minimally Invasive Treatments

When pain persists despite well-managed first-line care, targeted treatments may be considered.