Types of Knee Osteoarthritis and What Bone on Bone Means
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Osteoarthritis is the most common condition of the knee joint. The cartilage gradually wears down, the bone underneath changes and the joint can become stiff and painful. But osteoarthritis does not look the same in everyone. Where it starts, how far it has progressed and what caused it can differ a lot. If you would like to understand the basics of cartilage first, read our article on knee cartilage wear.
Where in the knee: three areas of the joint
The knee has three main areas where the bones meet. Osteoarthritis can affect one, two or all three of them.
- The inner part of the joint between the thigh bone and the shin bone, on the side facing the other knee. This area is affected most often, because it usually carries more load when you walk. The pain is mostly felt on the inner side of the knee. More in our article on pain on the inner side of the knee.
- The outer part of the joint on the outside of the knee. It is affected less often, for example after an injury or with knock knees.
- The joint behind the kneecap between the kneecap and the thigh bone. Here the pain typically appears on stairs, when squatting or after sitting for a long time.
Primary and secondary osteoarthritis
When no single clear cause can be found, doctors speak of primary osteoarthritis. It is linked to age, load, genes and muscle strength. Secondary osteoarthritis develops because of something else, for example an old fracture, a meniscus or ligament injury, an inflammatory joint disease or an uneven alignment of the legs.
Stages of knee osteoarthritis
On an X-ray, doctors often describe osteoarthritis in several stages, from mild to severe:
- Early stage: small bony outgrowths around the joint, while the joint space is still largely normal.
- Middle stage: the joint space becomes narrower because the cartilage is thinner.
- Advanced stage: the joint space is clearly narrowed, the bone under the cartilage becomes denser and the shape of the bone ends may change.
The stage on the X-ray does not tell the whole story. How much the knee hurts and how well you move often depend just as much on your muscles, your weight and your daily habits.
What does bone on bone mean?
Bone on bone is a common way of saying that the joint space on the X-ray has almost disappeared in one part of the knee. The cartilage there is very thin or gone, so the bone surfaces lie close together. It sounds alarming, and many people imagine their bones grinding against each other with every step. In reality, people with this finding experience it very differently. Some can still walk longer distances with the right exercises and support, while for others it is a reason to talk to a doctor about other treatment options.
What helps, whatever the type
- Regular, gentle movement such as walking, cycling or swimming.
- Strengthening the thigh and hip muscles, ideally with help from a physiotherapist.
- A healthy body weight, which reduces the load with every step.
- Spreading activities over the day, so that rest always follows effort.
- A soft knee sleeve, which many people wear during the day for gentle compression and a pleasant sense of support.
If the pain changes suddenly, the knee swells a lot or you can no longer put weight on the leg, see a doctor. We list the warning signs in our article on when to take knee pain seriously.
A sleeve you will actually wear
The best sleeve is the one that does not end up in a drawer. The KeenTrove Bamboo Knee Sleeve is made for exactly that:
- soft, breathable bamboo, comfortable even in summer
- fits snugly but does not dig in behind the knee
- does not lock the knee, so you move naturally
- wear it under your clothes during the day and in bed at night
With 60 days to get your money back, you have nothing to lose.
Note: this article is for information only and does not replace an examination by a doctor. If you have circulation problems or diabetes, or have recently had knee surgery, talk to your doctor before wearing compression.
