DEFINITION: Osteoarthritis (or O/A) of the knee is most commonly referred to the “wear and tear” of the knee. This wear and tear process can occur at any joint, however most often seen at the knee joint. Osteoarthritis is basic degeneration or breaking down of the joint surfaces of the knee. The smooth cartilage lining of the knee begins to wear away over time causing bone on bone contact at the knee joint. This diagnosis is made by physical examination and X-rays by your physician.
CAUSES: The most common cause of knee arthritis is wear and tear associated with activity over a period of time. Arthritis of the knee greatly increases most commonly after the age of 45. Therefore the longer on the planet the more likely we may develop O/A. Many factors may contribute to this loss of joint cartilage or lining. These may include but not limited to obesity, heredity, previous injury, lifestyle, activity level or occupation and least likely underlying disease process. Women are more likely to develop O/A than men in the same age groups.
SYMPTOMS: The most noticeable early sign is pain in the knee usually associated with activity. Later on pain may occur at rest and even disturb sleep. This is often followed by swelling and stiffness of the joint as well. Loss of motion of the knee can occur as this progression continues. Over time these may lead to loss of full functional strength of the quad, hamstring and related hip muscle groups. This in turn may lead to decreases in activity levels, and decline of function and perhaps general fitness. This combination of factors may not only affect one’s ability to recreate but one’s job performance as well.
TREATMENT AND MANAGEMENT: Because we don’t cure O/A in the purest form of the word, are option is to manage this disease. Management of O/A is perhaps the key word in treatment. Ways in which one may manage O/A include the following:
Exercise: The first line of defense of treating O/A of the knee is exercise. The proper type and intensity of exercise designed to improve motion, strength and endurance of the structures around the knee is most basic. These include quad, hamstring and hip muscles strengthening and flexibility to enhance the joint function and lessen symptoms.
Activity: One may need to modify his or her activity to provide relief. Stationary bike, pool, or even elliptical are options over walking and certainly running.
Weight loss: Proper management of knee O/A may involve weight loss. Pressure on the weight bearing joints can certainly be lessened by loss of unwanted and unnecessary weight.
Supports: The use of a supportive device may aid in the management of O/A of the knee. Knee sleeves and modest forms of bracing may allow one to engage in activity with more efficiency.
Ice: Ice post activity may is an easy and productive way to manage the symptoms of O/A. Application of ice after activity for 10-15 minutes can be very helpful to decrease swelling and pain.
Your Doctor: Your treating doctor may suggest other interventions. These may include anti-inflammatory medication or injections that may be viable options at some point in your treatment. The most severe cases may ultimately end up with surgery intervention being the only option. Total knee replacement and partial knee replacements are often indicated in the most advanced O/A cases and where conservative measures are not enough and functional ability continues to decline.
CONCLUSION: The Physical Therapist in very well trained in directing you in the proper management of O/A of the knee. They can direct your exercise program in prescription and proper advancement as needed. They can aid you in modification of activity by suggesting more efficient ways to manage your exercise of job activities if needed. They also can aid you in referral to the Orthopedist for further intervention if needed.
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