Knee Osteoarthritis

 
 

Mr Kosuge’s Patient Information Booklet on Knee Osteoarthritis. Please click on image to access the leaflet.

What is Knee Osteoarthritis?

The knee is the joint most commonly affected by osteoarthritis. The condition involves the gradual breakdown of the articular cartilage that covers the bone surfaces within the knee joint, leading to pain, swelling, stiffness, and reduced function. As the cartilage wears away, the bones may begin to rub against each other, causing further pain and inflammation. Bony spurs (osteophytes) may also develop around the joint margins.

Mr Dennis Kosuge is a Consultant Orthopaedic Surgeon specialising in knee conditions, including osteoarthritis of the knee. He consults and operates at The Rivers Hospital, Sawbridgeworth (private) and The Princess Alexandra Hospital, Harlow (NHS), seeing patients from across West Essex and East Hertfordshire.

What are the symptoms of knee osteoarthritis?

Symptoms typically develop gradually and may fluctuate over time. They include:

  • Pain in and around the knee, which may worsen with activity and improve with rest in the earlier stages

  • Swelling and warmth around the joint

  • Morning stiffness or stiffness after sitting for a prolonged period

  • A creaking, clicking, or grinding sensation (crepitus) within the knee

  • Deformity of the knee — the leg may bow inward (valgus) or outward (varus)

  • In more advanced cases, pain at rest or at night, and difficulty with everyday activities such as walking, climbing stairs, or rising from a chair

 

Mr Kosuge’s Patient Information Booklet on Partial Knee Replacement surgery. Please click on image to access the booklet.

Mr Kosuge’s Patient Information Booklet on Total Knee Replacement surgery. Please click on image to access the booklet.

How do you diagnose knee osteoarthritis?

Mr Kosuge will take a detailed history of your symptoms and perform a thorough clinical examination of your knee. Weight-bearing X-rays are the primary imaging investigation and typically show characteristic features of osteoarthritis including joint space narrowing, osteophyte formation, and changes to the underlying bone. An MRI scan may be arranged in selected cases.

What is the best treatment for knee osteoarthritis?

Mr Kosuge adopts a stepwise approach to managing knee osteoarthritis, beginning with non-surgical options:

  • Physiotherapy and a structured exercise programme to strengthen the muscles supporting the knee

  • Weight management advice

  • Oral pain relief and anti-inflammatory medication

  • Knee injections — including steroid, hyaluronic acid, platelet-rich plasma (PRP), or Arthrosamid — to reduce pain and inflammation

When non-surgical management is insufficient and the condition is significantly affecting your daily life, surgical options including partial or total knee replacement may be considered. Mr Kosuge will discuss all options with you fully, ensuring the decision is made together based on your individual circumstances.

What injections are available for knee osteoarthritis?

Corticosteroid injections reduce inflammation and typically last weeks to months. Arthrosamid is a newer hydrogel injection that provides longer-lasting mechanical cushioning from a single injection. Mr Kosuge offers both privately at The Rivers Hospital and will be happy to advise which may be most appropriate for your knee.

How do I know if I need a knee replacement for my osteoarthritis?

A knee replacement is considered when knee osteoarthritis is causing significant pain and functional limitation that has not responded adequately to non-surgical treatment. There is no single threshold — the decision is made jointly between you and Mr Kosuge, taking into account the severity of your symptoms, the degree of joint damage on X-ray, your age, activity level and personal goals. Mr Kosuge will not recommend surgery unless it is likely to offer a meaningful improvement in your quality of life.

  • Unfortunately, once cartilage is lost, it does not regenerate naturally to any significant degree. Treatment is therefore aimed at managing symptoms, slowing progression where possible, and improving function and quality of life. Research into cartilage regeneration is ongoing, but currently no treatment reliably reverses established osteoarthritis. The goal of management is to keep you as active and comfortable as possible for as long as possible.

  • Osteoarthritis is a mechanical "wear and tear" condition caused by cartilage breakdown, usually affecting one or a few joints and more common in older patients. Rheumatoid arthritis is an autoimmune condition in which the immune system attacks the joint lining, typically affecting multiple joints symmetrically and often beginning at a younger age. The two conditions can coexist, and distinguishing between them requires blood tests and specialist assessment. Treatment pathways differ significantly — rheumatoid arthritis is primarily managed with disease-modifying medications, whereas osteoarthritis management focuses on symptom control and function.

Book a Consultation

If you are suffering from knee pain and would like a specialist opinion, Mr Kosuge is available for private consultations at The Rivers Hospital, Sawbridgeworth, and NHS appointments at The Princess Alexandra Hospital, Harlow. He welcomes self-pay and insured patients.

To book an appointment, please call 01279 602675 or use the online booking link below.

NHS patients may be referred by their GP to The Princess Alexandra Hospital, Harlow.

BOOK AN APPOINTMENT