Osteoarthritis of the Knee

Diagnosis
H&P
Risk factors: genetics, female sex, past trauma, advancing age, and obesity.
X-ray (look for the radiographic signs of OA.)
DDx & Causes:
Treatment
The mainstay of treatment of OA of the knee is active rehabilitation and exercise.
-Exercise-based physical therapy. Start with regular home stretching and strengthening exercises for muscle strength.
-Refer to PT if home exercise do not show improvement
-Weight loss if BMI > 25 kg / m²
-Acetaminophen for pain
-Follow up in 6 weeks
At f/u, get an x-ray of the affected joint (if not already done)

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Exercise-based PT is the foundation for treating knee OA

-Hyaluronic acid injections are controversial. Studies don’t show any evidence of benefit.
-Knee braces produced little or no benefit for reducing pain or improving knee function.

“The mainstay of treatment for osteoarthritis of the knee is active rehabilitation and exercise.Active rehabilitation, such as stretching and strengthening, is more effective than passive rehabilitation,such as taping, heat, electrostimulation, or therapeutic ultrasound ” ABFM

What to expect

Morning joint pain lasting less than 30mins
Asymmetrical joint pain
Locking or joint instability
Affects distal interphalangeal joints

*For Osteoarthritis involving the knees, narrowing of the medial compartment is usually the first radiographic finding.

Osteoarthritis of the Knee

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