Knee arthritis

Symptoms

• Pain when walking, on stairs or getting up from a chair
• Stiffness, especially in the morning or after sitting
• Swelling, creaking or grinding
• A knee that gives way or does not fully straighten

Diagnosis

Knee arthritis is usually diagnosed from your symptoms and an examination, with standing X-rays to show which parts of the knee are worn. This matters, because arthritis limited to one part of the knee may be suitable for a partial knee replacement.

Treatment without surgery

• Exercise and physiotherapy to strengthen the thigh muscles
• Weight loss if you are overweight
• Anti-inflammatory gels rubbed onto the knee, and painkillers where needed
• A steroid injection for short-term relief

In line with national guidance, I do not recommend keyhole washouts or hyaluronic acid injections for knee arthritis, because good evidence shows they do not help most people.

When to consider surgery

A knee replacement is worth considering when knee pain has a real effect on your daily life despite these treatments. Depending on the pattern of wear, the options are a partial or a total knee replacement, sometimes with robotic assistance.

Written and reviewed by Mr Krishna Boddu FRCS (Tr & Orth), consultant orthopaedic surgeon, GMC 5206961. Last reviewed: 1 November 2026.

Sources

• NICE guideline NG226: Osteoarthritis in over 16s: diagnosis and management (2022)
• NICE guideline NG157: Joint replacement (primary): hip, knee and shoulder (2020)
• Siemieniuk RAC et al. Arthroscopic surgery for degenerative knee arthritis and meniscal tears: a clinical practice guideline. BMJ 2017;357:j1982.
• NHS: Osteoarthritis