Knee osteoarthritis is wear of the smooth cartilage that covers the ends of the bones in the knee. It causes pain on walking and stairs, stiffness after rest, and sometimes swelling or a bowed leg. It is the most common cause of long-term knee pain in people over 50, and most people manage it without surgery.
What causes knee osteoarthritis?
Osteoarthritis develops when the cartilage wears faster than the joint can repair it. Age, excess weight, a previous knee injury and a bowed or knock-kneed leg all add to the load on the cartilage.
- Age: cartilage becomes less able to repair itself over time
- Weight: each extra kilogram adds several kilograms of force across the knee when you walk
- Past injury: a meniscus or ligament tear, or a fracture into the joint, can lead to arthritis years later
- Alignment: bow legs load the inner side of the knee, knock knees the outer side
- Family history and sex: it runs in families and is more common in women
What are the symptoms?
The usual symptoms are pain that comes on with activity and eases with rest, stiffness for less than half an hour after getting up, a grinding feeling, and swelling after a busy day. In later stages the pain can be there at rest or at night.
- Pain on stairs, squatting, kneeling or getting up from a chair
- Stiffness in the morning or after sitting
- Swelling or a feeling of fullness in the knee
- Reduced bending or straightening
- A leg that has become more bowed over the years
How is it diagnosed?
Your knee specialist examines the knee and arranges standing X-rays, which show how much joint space is left and which part of the knee is worn. An MRI is only needed if another problem, such as a meniscus tear, is suspected.
What is the treatment for knee osteoarthritis in Singapore?
Treatment goes step by step: exercise and weight loss first, then medication and injections, then surgery only if pain still limits daily life. Surgery options include realigning the leg (osteotomy), a partial knee replacement or a total knee replacement.
| Step | Treatment | Who it suits |
|---|---|---|
| 1 | Strengthening exercise, weight loss, activity changes | Everyone with knee osteoarthritis |
| 2 | Pain relief and anti-inflammatory medicines, bracing | Flare-ups, or when exercise alone is not enough |
| 3 | Knee injections: steroid, PRP or hyaluronic acid gel | Mild to moderate arthritis, or to settle a flare |
| 4 | Osteotomy: realigning the leg to unload the worn side | Younger, active patients with wear on one side and a bowed or knock-kneed leg |
| 5 | Partial or total knee replacement | Advanced arthritis when other treatment no longer helps |
Keyhole surgery to wash out or smooth an arthritic knee is no longer recommended for osteoarthritis on its own; it does not give lasting relief.
Can knee osteoarthritis be reversed?
Worn cartilage does not grow back, but symptoms can improve a great deal. Stronger thigh muscles and a healthy weight reduce pain for many people, and some live with mild arthritis for years without it getting worse.
How can I manage it day to day?
- Low-impact exercise: walking, swimming, cycling, the cross-trainer
- Thigh and hip strengthening exercises, 2 to 3 times a week
- Losing weight if you are overweight; even 5 to 10% helps
- Pacing activities and using a walking stick on bad days
- Heat for stiffness, ice for swelling
Total Orthopaedic can refer you to a physiotherapist to set up an exercise programme.
Your knee surgeon: Dr Hamid Razak
Consultant Orthopaedic Surgeon with over 17 years of experience. MBBS (NUS), MMed (Ortho Surg), FRCSEd (Orth), FRCSGlasg (Tr & Orth), FAMS (Orth Surg). Dr Hamid led the Sports & Joint Preserving Osteotomy Service at Sengkang General Hospital and is an Adjunct Associate Professor at Duke-NUS Medical School. He is a founding member and vice-president of the Singapore Knee Preservation Society, and operates at Mount Elizabeth Novena and Gleneagles Hospitals. Read Dr Hamid’s profile
To book a knee consultation, contact Total Orthopaedic. No referral is needed. The clinic sees patients in Novena, Orchard, Gleneagles and Tampines.
Medically reviewed by Dr Hamid Razak. Last updated October 2026. Sources: international osteoarthritis treatment guidance. This page is general information and does not replace a consultation.
