Femoro-tibia osteoarthritis
Femoro-tibial osteoarthritis refers to the wear and tear of the cartilage between the femur and the tibia. It can affect the medial compartment, the lateral compartment, or both, and cause pain, stiffness, or difficulty walking.
Treatment depends on the affected area, the symptoms, and their impact on daily life. Its primary aim is to relieve discomfort and maintain movement, favoring non-surgical solutions when appropriate.
UNDERSTANDING KNEE OSTEOARTHRITIS
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This is the area located on the inner side of the knee and is the most frequently affected by osteoarthritis. Its wear and tear can cause internal pain and gradually lead to leg deformity.
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Located on the outer side of the knee, this compartment is less frequently affected. Its wear and tear can cause lateral pain and gradually alter the leg's alignment.
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This joint is located between the kneecap and the femur. When it is affected, pain often appears when climbing stairs, squatting, or after sitting for a long time.
RECOGNIZING THE SYMPTOMS
The pain can be located on the inner or outer side of the knee, depending on which femorotibial compartment is affected. It often appears during walking or activities that put stress on the knee, and may then become more frequent.
Pain on the inside or outside of the knee
It can be located on the side corresponding to the affected compartment. It is often more pronounced during loading.Difficulty walking or on stairs
Certain movements, such as going up or down stairs, can become less comfortable. The discomfort varies from person to person and from time to time.Stiffness after a period of immobility
Your knee may feel less flexible after sitting for a long time or upon waking. This sensation may lessen with resuming movement.Swelling or reduced mobility
A feeling of swelling or difficulty fully bending or straightening the knee may occur. These signs can also have other causes.
These symptoms alone are not sufficient to confirm femorotibial osteoarthritis. A clinical examination and, if necessary, imaging studies will determine their origin.
WHY DOES FEMORO-TIBIAL OSTEOARTHRITIS OCCUR?
Femoro-tibial osteoarthritis results from several factors that can act together. Age, mechanical stress, the knee's history, and the condition of its various structures are taken into account to understand the situation.
Cartilage wear
Cartilage can deteriorate gradually. This process may affect the inner compartment more, the outer compartment more, or several areas of the knee.
axis of the lower limb
Leg alignment can influence the distribution of stress between the two compartments. Its role is assessed through examination and appropriate imaging.
History of knee
A previous injury or surgery may be taken into account in the assessment. This does not mean that it is the sole cause of the osteoarthritis.
Daily requests
Repetitive activities and stresses can contribute to the discomfort experienced. They should be considered along with other factors, without attributing osteoarthritis to a single isolated action.
MAKE THE RIGHT DIAGNOSIS
Diagnosis is based on symptoms, examination of the knee, and imaging results when appropriate. An image alone cannot always explain the discomfort experienced.
01 — DISCUSSING SYMPTOMS
The doctor specifies the location of the pain, its progression, and the activities that trigger it. The patient's knee history and any difficulties encountered in daily life are also discussed.
02 — EXAMINE THE KNEE
The clinical examination assesses, in particular, the mobility, pain, stability, and alignment of the lower limb. It helps to relate the symptoms to the structures of the knee.
03 — CHOOSING USEFUL IMAGES
X-rays can help visualize the femorotibial compartments and the condition of the joint. Further examinations are only considered if the clinical situation warrants them.
The diagnosis combines symptoms and clinical examination with the images necessary to inform the decision.
RELIEVING FEMORO-TIBIAL OSTEOARTHRITIS WITHOUT SURGERY
Treatment typically begins with measures tailored to the individual's symptoms and abilities. The choice of treatments takes into account the location of the osteoarthritis and the degree of functional impairment.
The goal is to reduce pain, preserve mobility, and support daily activities. Appropriate therapeutic exercise is an important component of managing knee osteoarthritis.
PHYSIOTHERAPY AND STRENGTHENING
Physiotherapy can help improve mobility, muscle strengthening, and movement control. Exercises are tailored to the level of pain and progress according to individual tolerance.
ADAPTATION OF ACTIVITIES
It can be helpful to temporarily reduce activities that worsen symptoms, then gradually resume them depending on how the knee responds. The goal is to maintain movement without causing a lasting increase in discomfort.
PAIN RELIEF
Pain relievers or anti-inflammatory medications may be discussed depending on the situation and any potential contraindications. The choice of medication or injection requires individualized medical advice.
CONSTRAINT MANAGEMENT
When appropriate, adjusting certain restrictions or supporting weight management can help alleviate symptoms. These measures should be discussed openly and without judgment, taking into account the individual's needs.
Non-surgical management can be adjusted as symptoms and activities evolve.
WHEN TO CONSIDER SURGERY FOR FEMORO-TIBIAL OSTEOARTHRITIS?
Surgery may be considered when pain and activity limitations remain significant despite appropriate non-surgical management. The choice depends in particular on the affected compartment and the condition of the other structures of the knee.
The decision is based on symptoms, clinical examination, imaging, and the individual's goals. Intervention is not always necessary, and the options vary depending on the knee.
Localized osteoarthritis in one compartment
If osteoarthritis primarily affects a single compartment and other conditions are met, a partial joint replacement may sometimes be considered. This option is not suitable for all situations.
Knee axis imbalance
In certain selected situations, an osteotomy may be considered to modify the distribution of stress. It aims to preserve the joint and does not eliminate osteoarthritis.
Extensive osteoarthritis and significant discomfort
When multiple compartments are affected and symptoms remain severely limiting despite conservative treatments, a total knee replacement may be considered. The indication depends on the individual assessment.
→ Learn more about total knee replacement
STAYING ACTIVE WITH FEMORO-TIBIAL OSTEOARTHRITIS
Appropriate physical activity is generally still possible with femorotibial osteoarthritis. The level and type of activity should take into account the symptoms and current abilities.
Walking on level ground, cycling, or strengthening exercises can be considered depending on the situation. A physiotherapy program helps to choose and adapt the movements.
Mild and temporary discomfort may occur during the recovery period. If the pain increases significantly, persists, or is accompanied by unusual swelling, it is best to reduce activity and seek advice.
Activity is gradually resumed, alternating movement and recovery according to the knee's response. Adaptations may change with the symptoms.
Moving at one's own pace helps to preserve mobility, with activities adapted to one's knee.
→ Learn more about knee osteoarthritis and activities
A CARE APPROACH TAILORED TO EACH PATIENT
Femoro-tibial osteoarthritis can affect different compartments and cause varying degrees of discomfort. Therefore, there is no single solution that works for everyone.
Dr. Benoît Coulin considers the location of symptoms, mobility, activities, occupation, goals, and medical history. Clinical examination and relevant imaging help to complete this assessment.
Conservative treatment and surgical options are discussed based on the individual situation and its impact on daily life. When surgery is considered, the choice also depends on the extent of the damage and the condition of any remaining healthy areas.
«"The location of the osteoarthritis is important, but it is also the discomfort experienced on a daily basis that guides treatment."»
FREQUENTLY ASKED QUESTIONS
DO YOU WANT TO BETTER UNDERSTAND YOUR PAIN?
A clinical examination combined with appropriate imaging helps to determine the origin of symptoms and identify the most suitable treatments.
