Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon
Part 2 of 12 in Spectrum of Orthopaedic Disorder - Evaluation and Management
Understanding the Main Causes of Knee Arthritis
September 6, 2026
Knee arthritis is not a single disease. Dr. Rohit Lamba's Jivo Masterclass session on the spectrum of orthopaedic disorders described four distinct causes, each with its own pattern of damage and its own path to treatment.
Osteoarthritis, the most common cause
The most frequent cause of knee arthritis is simple wear with age, osteoarthritis. The cartilage that cushions the joint wears down over years, in a process unrelated to any injury or underlying disease.
Rheumatoid arthritis can affect young patients
Rheumatoid arthritis is an inflammatory form of arthritis in which the patient's own immune system damages the knee, and it can affect people who are still very young. Dr. Lamba showed a case where the cartilage was already lost and the bone had weakened from long-term steroid use, requiring a knee implant with a long stem running down into the leg bone on both sides for extra support.
Post-traumatic arthritis follows an old injury
A third pattern develops after a fracture or other injury near the joint. One case involved a gunshot injury that left a crooked knee, severe arthritis and total stiffness, with the joint unable to bend at all; another involved a fracture that had not united properly, causing the bone to sit at the wrong angle, with arthritis following from there.
Gout, and how the diagnosis is confirmed
Gout, caused by high uric acid levels in the blood, is a fourth cause of joint inflammation. To work out which of these is responsible, Dr. Lamba starts with routine blood tests and inflammatory markers such as ESR, CRP and anti-CCP, then an X-ray of the knee taken in the standing position, which shows the true condition of the cartilage more reliably than a resting X-ray. Early cases can often be managed with physiotherapy or with cartilage-directed injections such as viscosupplementation or platelet-rich plasma, before surgery is ever considered.
This article is based on a Jivo Masterclass session conducted by Dr. Rohit Lamba, Consultant, Orthopaedics & Joint Replacement, Artemis Hospital, Gurgaon. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass: Dr. Rohit Lamba taught doctors across Africa on April 6, 2025.
FROM THE LIVE Q&A
Doctor on the call (name unclear from transcript)
Is there a definitive treatment for arthritis?
Dr. Rohit Lamba
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
Frequently Asked Questions
Which group of patients is hip replacement surgery indicated for?▼
Dr. Lamba outlined four categories. The first is congenital deformity, such as developmental dysplasia of the hip, where the hip is out of the socket from birth. The second is a childhood infection, Perthes disease, or a slipped epiphysis that reshapes the hip and leads to arthritis later in life. The third is avascular necrosis that has reached an advanced, arthritic stage in early adulthood. The fourth is a hip fracture that has not united properly, healing in a poor position that causes arthritis and pain.
Is there a definitive treatment for arthritis?▼
Dr. Lamba answered on the assumption the question was about rheumatoid arthritis, since a network issue had cut off part of the question. In the early stage, before the cartilage is damaged, it can be managed well with disease-modifying antirheumatic drugs (DMARDs); cases that do not respond well can move to biological disease-modifying drugs, but only after full evaluation by an orthopaedic surgeon or rheumatologist. Once the cartilage is already damaged, the definitive treatment is hip replacement, and with current implants a patient can expect to stay pain-free and active for the next 30 to 35 years.
What are the main causes of knee arthritis?▼
Dr. Rohit Lamba identified four: osteoarthritis from age-related wear, rheumatoid arthritis from the body's own immune system, post-traumatic arthritis following a fracture or injury, and gout caused by high uric acid levels.
How is knee arthritis diagnosed?▼
Diagnosis starts with routine blood tests and inflammatory markers such as ESR, CRP and anti-CCP, followed by an X-ray of the knee taken in the standing position, which shows the true condition of the cartilage.
Can knee arthritis be treated without surgery?▼
Early cases can often be managed with physiotherapy or with cartilage-directed injections such as viscosupplementation or platelet-rich plasma before surgery is considered.
In This Series: Spectrum of Orthopaedic Disorder - Evaluation and Management
- 1.Spectrum of Orthopaedic Disorders
- 2.Understanding the Main Causes of Knee Arthritis
- 3.How Robotic and Computer-Navigated Systems Are Used in Joint Replacement
- 4.Developmental Dysplasia of the Hip: Treating a Childhood Hip Problem
- 5.Perthes Disease: When Childhood Hip Damage Surfaces Years Later
- 6.Avascular Necrosis of the Hip: Causes, Stages and Treatment
- 7.Hip Replacement and Sickle Cell Disease: Why Blood Transfusion Comes First
- 8.When Is Hip Replacement the Right Treatment?
- 9.ACL and Ligament Reconstruction: Grafts and When Surgery Is Needed
- 10.Treating Fracture Non-Union and Bone Infection with External Fixators
- 11.Reconstructing Severe Trauma: Distraction Osteogenesis for Bone and Limb Loss
- 12.Vitamin D Deficiency in Children: When Rickets Requires Corrective Knee Surgery