Gonarthrosis is a common form of osteoarthritis that affects the knee joints, causing pain, stiffness, and difficulty moving. This article focuses on a specific type known as bilateral gonarthrosis, where both knees are affected simultaneously. Understanding this condition is important because it presents unique challenges compared to when only one knee is involved. Bilateral gonarthrosis can have a significant impact on a person’s day-to-day life and often requires a different approach to diagnosis and treatment. Here, we’ll explore what makes bilateral gonarthrosis distinct, how it develops, its symptoms, diagnostic methods including the relevant ICD-10 medical coding, and the latest treatment options available.

What Makes Bilateral Gonarthrosis Different?

Bilateral gonarthrosis means osteoarthritis is present in both knees at once, rather than just one. While many people develop osteoarthritis in a single knee (unilateral gonarthrosis), having both knees affected can make everyday activities far more difficult. Walking, balancing, and moving around become more challenging because the strain and pain are shared across both joints. This distinction is crucial, as it affects how healthcare professionals plan treatment and manage the condition over time.

In terms of causes and progression, bilateral gonarthrosis often differs from unilateral cases. It can be driven by systemic issues such as genetic factors or metabolic problems, as well as mechanical stresses that affect both knees evenly. This can result in a more rapid or severe worsening of symptoms, with greater impact on mobility and quality of life. Recognising the bilateral nature helps doctors better understand the condition compared with gonarthrosis affecting only one knee, ensuring patients receive the most appropriate care.

Causes and Symptoms of Bilateral Gonarthrosis

Bilateral gonarthrosis typically develops due to a combination of factors. Age-related wear and tear is one of the most common causes, but genetics, obesity, and past knee injuries also play significant roles. Additionally, underlying conditions like rheumatoid arthritis or certain metabolic diseases may increase the risk of both knees being affected. Many of these causes overlap with those responsible for osteoarthritis in other joints, reinforcing the systemic nature of the disease.

The symptoms tend to include persistent knee pain, stiffness (particularly after rest), and swelling in both knees. Patients often find it hard to walk, climb stairs, or stand for extended periods because both knees are compromised. Unlike unilateral gonarthrosis, symptoms in bilateral cases are usually more balanced across the body, sometimes making the pain feel more intense since both knees share the load. These effects greatly impact daily activities, so recognising symptoms early on is key to effective management.

It’s also important to note the differences between bilateral and unilateral symptoms. Mild discomfort in both knees can easily be dismissed as tiredness or minor strain but may indicate early gonarthrosis. Early recognition allows patients to seek treatment sooner, which might slow the progression and improve quality of life in the long term.

Diagnosing Bilateral Gonarthrosis and the Role of ICD-10 Coding

To diagnose bilateral gonarthrosis, doctors start with a detailed medical history to understand risk factors and the timeline of symptoms. They perform a physical examination looking for tenderness, reduced knee movement, and a grinding sensation known as crepitus in both joints. Imaging tests such as X-rays are crucial to assess the degree of cartilage loss, bone growths, and narrowing of the joint space in both knees. Sometimes, an MRI is used to examine soft tissues around the joint in greater detail.

An important part of documenting and managing the condition lies with the gonarthrosis ICD 10 code, a standardised system used internationally to classify medical diagnoses. This coding ensures that cases are recorded consistently, helps with accurate treatment planning, and supports research. Specific codes exist to differentiate between unilateral and bilateral gonarthrosis, highlighting the significance of recognising bilateral involvement in healthcare settings.

Treatment Options for Bilateral Gonarthrosis

Managing bilateral gonarthrosis typically begins with non-surgical approaches. Weight loss, for example, eases pressure on the knee joints, while low-impact exercises help strengthen the muscles around the knees and improve stability. Physiotherapy is often recommended to maintain joint movement and reduce pain. Pain relief medications and anti-inflammatories can also help manage symptoms, though they don’t stop the underlying wear and tear.

In addition to these, physical therapies have gained recognition. For instance, laser therapy has been shown to improve joint swelling, movement, muscle strength, and reduce pain. As Minić (2005) points out, “laser is a very important modern expedient on clinical results for gonarthrosis,” offering another option to complement traditional treatments.

When conservative treatments are no longer effective, surgery may be considered. Surgery on both knees simultaneously can be more complex; timing and rehabilitation need careful planning to support recovery. Osteotomy—an operation where bones are cut and realigned—is one such surgical option, suitable for younger, more active patients with certain types of knee deformity.

Sherman and Cabanela (2009) highlight recent improvements: “new developments in osteotomy techniques and methods of fixation have caused a renewed interest in closing wedge osteotomies of the tibia and femur in the treatment of gonarthrosis.” In more severe cases, the boomerang proximal tibial osteotomy has been developed to correct knee alignment effectively. Sangkaew and Piyapittayanun (2013) found that “the boomerang osteotomy can create adequate valgus alignment in severe varus gonarthrosis,” with the best outcomes seen when the knee is realigned to approximately 11° valgus. Such precise corrections can delay the need for total knee replacement and improve function.

Looking forward, newer treatments like biological therapies, cartilage regeneration, and minimally invasive surgeries continue to be explored, promising better tailored solutions and improved patient outcomes.

Living Well with Bilateral Gonarthrosis

Adapting to life with bilateral gonarthrosis involves more than just medical treatment. Patients benefit from adjusting daily activities to reduce joint strain, using aids such as walking sticks or knee braces when needed, and participating in community or rehabilitation programmes that support both physical and emotional wellbeing. Staying proactive with healthcare providers helps manage symptoms and maintain mobility.

Ongoing research and advances give hope to those with bilateral gonarthrosis. With early diagnosis, effective treatment, and lifestyle changes, many can look forward to a better quality of life, despite the challenges the condition presents. Comprehensive care remains essential in managing this complex condition effectively.

This article aims to provide a clear understanding of bilateral gonarthrosis, guiding patients and healthcare professionals alike through its challenges and treatment possibilities, empowering informed decisions and improved care.

References

Sherman, C. E., & Cabanela, M. E. (2009). Closing wedge osteotomy of the tibia and the femur in the treatment of gonarthrosis. International Orthopaedics, 34(2), 173–184. https://doi.org/10.1007/s00264-009-0883-1
Minić, S. (2005). LASEROTHERAPY IN THERAPY OF GONARTHROSIS. Praxis Medica, 33(1), 29-31. https://doi.org/10.70949/pramed200501108m
Sangkaew, C., & Piyapittayanun, P. (2013). Boomerang proximal tibial osteotomy for the treatment of severe varus gonarthrosis. International Orthopaedics, 37(6), 1055–1061. https://doi.org/10.1007/s00264-013-1802-z