Early-Onset Osteoarthritis Of The Knee | Causes, Symptoms, And Best Treatments

Written By on May 16, 2022 — Medically Reviewed By Kris Ceniza (PT)

Early-onset osteoarthritis of the knee is when the joint’s degenerative process starts earlier in life. So, no, this condition doesn’t only affect seniors.

This can happen to young people due to a knee injury, like a meniscus tear. Or, because of a previous medical condition, such as hemophilia. (1, 2)

In this guide, you’ll learn about the injuries and diseases that can make you prone to this type of knee OA. Also, what to do to slow down the progression of this condition.

Here’s what we’ll cover – tap on any of these topics to navigate through this article:

What is the early-onset of knee osteoarthritis?

Osteoarthritis (OA) is the wear and tear of the joint cartilage. It’s a common form of arthritis that often affects weight-bearing joints – like the knees. (1)

Now, knee osteoarthritis is a common condition in the elderly. Here, cartilage damage happens due to the aging process. This is known as “primary knee OA” and it’s common in people over 60 years old. (1)

But under specific circumstances, this cartilage degeneration process can speed up. This is known as early-onset knee OA because, well, it happens earlier than it should.

So, what ages are included in the “early” part?

Researchers haven’t agreed yet on what exactly is “early.”

Some studies cap it at 40 years old, while others at 55 years old. (2) So, for the purposes of this guide, we’ll use the upper limit.

This is because early signs of knee osteoarthritis can be present up to 2 decades before symptoms appear. (2)

So, this means that someone diagnosed with osteoarthritis at 55 years old may have had early symptoms in their mid-thirties. That’s early enough for me.

The 2 causes of early-onset knee osteoarthritis

The 2 main things that can speed up the process of cartilage degeneration are (1, 2):

1) Previous knee injury

The biggest risk factor that predicts developing early knee OA is a previous traumatic knee injury. This is especially true for young and middle-aged people. (2)

The knee injuries that make you prone are also two common sports injuries (2, 3):

These joint injuries are huge risk factors for early-onset arthritis because they cause joint instability. This in turn can further alter the mechanics of the knee joint. (3)

In fact, 50-90% of people with ACL ruptures will have radiographic signs of osteoarthritis. The highest rate tends to be present in people that had ACL with meniscal injuries. (2)

Studies suggest that 1 in 3 people with an ACL injury and meniscus tear will develop symptomatic knee OA.

And their risk of needing a total knee replacement is 22%. (2)

I know the outlook seems grim. But, there are several treatments you can do to slow down the progression of the condition. More on that below.

2) A specific disease

In this second cause, a medical condition speeds up the degenerative process of osteoarthritis. As such, the degeneration may happen in other joints too – not only in the knee.

Here, there are specific metabolic reactions that damage the cartilage. They often are a consequence of an immune system response. (1)

The most common diseases that can cause early-onset of knee osteoarthritis include (1):

  • Gout/Pseudogout.
  • Rheumatoid arthritis.
  • Infectious arthritis.
  • Psoriatic arthritis.
  • Blood disorders – like hemophilia or sickle cell disease.
  • Paget disease.

If you suffer from any of them, please consult with a doctor. She/he will give you medications and treatment strategies to manage the disease, which in turn will slow down the progression of osteoarthritis.

Symptoms of early-onset knee osteoarthritis

This type of knee osteoarthritis often starts asymptomatic. The symptoms often appear after the wear and tear is already advanced. (3)

Now, the main symptom is knee joint pain, with different patterns depending on the stage of the disease. (3)

In the early stages, the pain occurs almost only during activity. But as the condition progresses, the pain is more constant. In the late stages, the pain is present almost all the time and can be unpredictable. (3)

Other symptoms of knee OA include but aren’t limited to (1):

  • A grating sensation when bending or straightening your knee.
  • Joint stiffness, mostly after long periods of rest.
  • Inflammation of varying degrees.

Diagnosis of early-onset knee osteoarthritis

Sadly, diagnosing this condition is difficult. This can be because the early symptoms may be attributed to other injuries, like ACL or meniscus tears. (4)

Apart from your medical history and your symptoms, your doctor needs imaging tests, like magnetic resonance imaging (MRI) or X-ray tests.

If there’s in fact early-onset arthritis, these tests will likely show (3):

  • Reduction of joint space.
  • Some level of joint cartilage loss.
  • Bone spurs.

Learn more: How is a knee OA diagnosis made?

5 Treatment options for early knee OA

Here, the first line of treatment focuses on non-surgical options. This is because surgical interventions are irreversible – it’s best to exhaust conservative options first before going under the knife. (5)

Non-surgical options for early-onset arthritis include:

1) Address the cause of knee osteoarthritis

This is pretty straightforward. If a joint injury makes you prone to developing osteoarthritis, make sure you recover from it first. A physio can help you with this.

The same applies to medical conditions. If you have a blood or metabolic disorder that increases your risk of osteoarthritis, make sure to treat it properly. This will be the most efficient way to treat your wear and tear.

2) Physical therapy

A physical therapist is your best ally when it comes to joint problems. He/she will:

  • Teach you self-management strategies for knee pain relief.
  • Help reduce your symptoms with a customized plan.
  • Promote recovery and get you back on track.

This is regardless of the cause of your knee osteoarthritis. A physio can help you, whether it’s caused by a disease – like rheumatoid arthritis- or a knee injury.

Check this out: What do physios do to rehab your knee OA?

3) Home treatments

These are a staple in any osteoarthritis treatment, regardless of the cause. These often include:

  • Hot/cold therapy to reduce joint swelling and pain.
  • Taking pain relievers, like nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Taking dietary supplements, like glucosamine chondroitin sulfate.
  • Wearing a knee brace to make your daily activities easier.

Usually, your physio and/or physician will give you home treatment recommendations. But here’s our guide with 11 home remedies for knee OA to get you started.

4) Cortisone injections

These injections can help treat pain during a flare-up. They can help reduce joint inflammation in the arthritic knee for up to 3 months. (5)

Yet, they may speed up the cartilage degeneration process. So it’s best to use them with caution and only when strictly needed. (5)

5) Surgical treatment options

When nonsurgical treatments can’t ease symptoms anymore, your doctor may recommend surgery. There are several surgical options available – the choice will depend on your age, lifestyle, symptoms, and budget.

The most common surgeries suggested for early-onset arthritis include:

Joint replacement surgery is left as a last resort – once that’s done, there’s no turning back. A prosthesis can last between 10 to 20 years, so this procedure is best for older patients. (5)

This can help: Do you need knee OA surgery? (Decision-making guide)

FAQs

Is early knee joint osteoarthritis reversible?

Yes, but if it’s detected early enough. People that are most likely to reverse this process are very young patients with low BMI and lack of radiographic knee changes. (4)

Can I get osteoarthritis in my 20s?

It’s unlikely, but you can if you had a severe knee injury. Or if you have a medical condition that makes you prone to wear and tear. (1)

Is early osteoarthritis in the knee curable?

With the right strategies, most people can manage the symptoms and slow down the progression. To cure it, specific conditions must be met and the diagnosis should show it’s in an early stage. (4)

Conclusion: Early-onset arthritis in the knee

Early-onset osteoarthritis can happen due to a knee injury or a medical condition.

Although it’s hardly reversible – unless the patient is young and healthy -, there are several ways to treat and live with this type of osteoarthritis. (4)

Finally, consult with your doctor if you suspect you have it. Early diagnosis is key to preventing complications, like chronic pain.

Resources

  1. Hsu H, Siwiec RM. Knee Osteoarthritis. [Updated 2021 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507884/
  2. Ackerman, Ilana N et al. “Hip and Knee Osteoarthritis Affects Younger People, Too.” The Journal of orthopaedic and sports physical therapy vol. 47,2 (2017): 67-79. DOI: 10.2519/jospt.2017.7286
  3. Favero, Marta et al. “Early knee osteoarthritis.” RMD open vol. 1,Suppl 1 e000062. 15 Aug. 2015, DOI: 10.1136/rmdopen-2015-000062
  4. Grazina, Rita et al. “Clinical Management in Early OA.” Advances in experimental medicine and biology vol. 1059 (2018): 111-135. DOI: 10.1007/978-3-319-76735-2_5
  5. The Royal Australian College of General Practitioners. Guideline for the management of knee and hip osteoarthritis. 2nd edn. East Melbourne, Vic: RACGP, 2018. Retrieved on February 2022 from: https://www.racgp.org.au/download/Documents/Guidelines/Musculoskeletal/guideline-for-the-management-of-knee-and-hip-oa-2nd-edition.pdf

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Author
Mich Torres (PT)
Mitch is a physical therapist, personal trainer, and nutrition coach. Fascinated with the knee joint, Mitch poured that passion into writing about knee pain and how to overcome it with movement. His goal is to teach you how to apply this knowledge into your daily life, so you can keep knee pain away for good.

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