Bilateral knee osteoarthritis is a degenerative joint disease that affects both knees. Osteoarthritis (OA) is a type of arthritis that occurs when the cartilage on the ends of bones wears down, causing the bones to rub against one another.

According to the Centers for Disease Control and Prevention (CDC), over 32.5 million adults in the United States had OA in 2020. A 2017 article also suggests that knee OA, specifically, has doubled in prevalence since the mid-20th century.

Bilateral knee OA can be a serious condition, especially if a person does not receive treatment. As the disease progresses, it can cause increasing pain, decreased mobility, and difficulty performing daily activities. In severe cases, it can even lead to disability.

This article discusses what to know about bilateral knee OA, including symptoms, causes, diagnosis, treatment, and outlook.

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The symptoms of bilateral knee OA can vary from person to person. However, according to the American Academy of Orthopaedic Surgeons (AAOS), symptoms generally include:

  • pain in both knees that may worsen after inactivity, such as sitting or sleeping
  • stiffness, particularly after rest periods
  • swelling, particularly after activity or extended periods of standing or walking
  • a decrease in the range of motion of the knee joint
  • clicking or cracking sounds when bending or straightening the knee joints
  • weakness in the knee joint, particularly when going up or down stairs

Bilateral OA is present when these symptoms occur in both knees.

Bilateral OA occurs when the cartilage in both knees wears away, causing a person’s bones to rub together.

According to a 2022 article, primary knee OA may have an unknown cause or be the result of general, age-related wear and tear. Secondary knee OA has a known cause, though this can be one of many things, such as:

  • Injury: Previous injuries or trauma to the knee joint can increase the risk of developing OA later in life.
  • Repetitive stress: Jobs or activities that require repetitive stress on the knee joint, such as squatting or kneeling, can increase the risk of developing OA.
  • Other medical conditions: Certain medical conditions, such as rheumatoid arthritis or metabolic disorders, can increase the risk of developing OA.

As highlighted by the CDC, some of the risk factors for bilateral knee OA include:

  • Age: As people age, the cartilage in the joints can wear down, making them more susceptible to OA.
  • Genetics: A family history of OA can increase your risk of developing the condition.
  • Obesity: Having overweight or obesity can put additional stress on the knee joint, increasing the risk of developing OA.
  • Joint overuse or injury: Repetitive stress or damage to the knee joints can increase a person’s risk of bilateral knee OA.

People may want to speak with a doctor if they are experiencing knee pain or stiffness, especially if it is interfering with their ability to perform daily activities.

To diagnose bilateral knee OA, a doctor may start by taking a medical history and performing a physical examination of the knee joints. During the physical examination, the doctor will look for signs of swelling, stiffness, and limited range of motion.

Doctors who suspect bilateral knee OA may order imaging tests, such as an X-ray, MRI, or CT scan, to confirm the diagnosis. These tests can show the extent of the damage to the joint and help the doctor determine the best course of treatment.

Sometimes, a doctor may refer a patient to a specialist, such as a rheumatologist or orthopedic surgeon, for further evaluation and treatment.

There is no cure for OA, but many treatment options can relieve symptoms and help prevent it from progressing.

Treatment for bilateral knee OA depends on the severity of the condition and the individual’s symptoms. According to the AAOS, treatment options may include:

  • Over-the-counter (OTC) medications: OTC pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
  • Injected medications: A doctor may inject medications, such as corticosteroids, into the knee joint to reduce inflammation and pain. Viscosupplementation injections that contain hyaluronic acid can lubricate the joint and reduce pain. Researchers are studying platelet-rich plasma (PRP) injections as a potential treatment for knee OA.
  • Physical therapy: Physical therapy can help improve mobility, flexibility, and strength in the knee joint, which can reduce pain and improve quality of life.
  • Assistive devices: Assistive devices, such as knee braces, shoe inserts, or a cane, can help support the knee joint and reduce pain during physical activity.
  • Surgery: In severe cases, surgery may be necessary to replace or repair the damaged joint. Doctors may consider total knee replacement surgery for severe OA.

Living with bilateral knee OA can be challenging, but many strategies can help manage symptoms. Some strategies the AAOS approves include:

Simple modifications to daily activities, such as using a cane or taking frequent breaks during physical activity, can also help reduce pain and improve quality of life.

While it may not be possible to prevent bilateral knee OA completely, the Arthritis Foundation recommends several strategies to reduce the risk of developing the condition. This includes:

  • Exercising regularly: Doing regular exercise, including low impact activities such as walking or swimming, can help strengthen the muscles that support the knee joint and improve flexibility. This can help reduce the risk of injury and the development of OA.
  • Maintaining a moderate weight: Maintaining a moderate weight can help reduce the additional stress on the joints and decrease the risk of developing OA.
  • Protecting the knee joint: Avoiding activities that put excessive stress on the knee joint, such as repetitive jumping or running on hard surfaces, can help protect the knee joint from injury and reduce the risk of developing OA.
  • Wearing appropriate footwear: Wearing shoes that provide adequate support and cushioning can help reduce the stress on the knee joint during physical activity.

The outlook for those with bilateral knee OA depends on the severity of the condition and the individual’s response to treatment. With proper management, it is possible to relieve symptoms and improve quality of life.

However, some people may still experience further complications. Complications of bilateral knee OA can include:

  • Reduced mobility: Moving the knee joint can become increasingly difficult as the condition progresses, affecting a person’s ability to perform daily activities.
  • Disability: In severe cases, bilateral knee OA can lead to disability, making it difficult or impossible to perform basic tasks.
  • Joint damage: OA can cause permanent damage to the knee joint, which may require surgical intervention to repair or replace the joint.
  • Depression and anxiety: Chronic pain and disability can significantly affect a person’s mental health, leading to depression and anxiety. A 2022 article suggests that 20% of people with OA also have depression.

Bilateral knee OA is a degenerative joint disease that affects both knees, causing pain, stiffness, swelling, and decreased mobility.

It occurs when cartilage in the knee joint breaks down. Risk factors, such as age, genetics, obesity, injury, and repetitive stress, can exacerbate OA of the knees.

Early diagnosis and treatment are important for managing symptoms and reducing the risk of complications.