1. and
present
What to advise patientsWhat to advise patients
with osteoarthritis?with osteoarthritis?

2. An aerobic activity every day
 Maintains joint flexibility and good muscle tone
 Made easier by wearing shoes with thick, flexible
soles to cushion the impact on the joints or, for
patients with genu varum, with corrective insoles
 During "inflammatory"* flares: avoid undue stress
on the joint, standing for prolonged periods of time
and carrying heavy loads
2
*The joint is more painful than usual and is hot and swollen.
Chevalier X. Arthrose du genou et de la hanche. Rev Prat Med Gen 2012;21:987-91.

3. Fight the flab!
 A risk factor for the onset and
progression of osteoarthritis
 Obesity is known to promote the
onset of knee osteoarthritis and also,
to a lesser extent, hip and hand
osteoarthritis
3
 Even minimal weight loss of about 5% reduces osteoarthritis-induced
pain, functional impairment and disability
 There is no specific diet for osteoarthritis patients.
A balanced, low-calorie diet is recommended for overweight patients
Chevalier X. Arthrose du genou et de la hanche. Rev Prat Med Gen 2012;21:987-91.
Société française de rhumatologie. Osteoarthritis file.

4. 4
Advanced femorotibial knee
osteoarthritis.
Primary osteoarthritis,
CT-arthrography.
MRI of both hands: axial images in 3-D gradient echo sequences with suppression
of the fat signal, with and without injection of gadolinium focussing on the
metacarpophalingeal joints.

5. Aerobic activity and strengthening
exercice required
This will not intensify the knee or hip osteoarthritis-related pain
On the contrary, taking regular exercise can provide relief, improve
range of motion and delay the need for replacement surgery
The recommended regimen is to gradually work up to
30 to 60 minutes, three times a week
5
Bonan I. Rôle de la rééducation dans le traitement de la gonarthrose. Rev Prat 2012;59:1246-47.

6. Do the right exercises
 There are specific exercises recommended for each form of
osteoarthritis: they are designed to maintain tendon flexibility
and joint range of motion, prevent bad posture and reinforce
the muscles
 A few sessions of physiotherapy are required to:
 gradually start exercising again
 learn the right exercises to do regularly at home
6
Bonan I. Rôle de la rééducation dans le traitement de la gonarthrose. Rev Prat 2012;59:1246-47.
 Regular training is required

7. Don't forget home exercises for hand
osteoarthritis
7 Beauvais C. Education thérapeutique en rhumatologie. Rev Prat Med Gen 2012;26:155-60.

8. For overweight patients, combine diet
and exercise
 A diet alone may not be sufficient to provide effective relief
 The combination of diet and aerobic exercise
in overweight patients with knee osteoarthritis:
 significantly improves pain, function and muscle strength
 is more beneficial than each measure applied individually
8
Ghroubi S, et al. Apport de l’exercice physique et du régime dans la prise en charge de la gonarthrose chez l’obèse. Annales de réadaptation et de médecine physique vol. 51, 2008. p.
663-670.

9. 9

10. Choose the right sports
(for the more athletic!)
Gentle, low impact sports are recommended: swimming,
cycling (on flat ground or on an exercise bike),
stretching exercises, etc.
High impact sports (skipping, tennis, etc) are
not recommended for patients with established
knee or hip osteoarthritis: they may aggravate the disorder
10
Patients may continue to run as long as they wear
appropriate footwear (thick, flexible rubber or air/gel
type soles to cushion the impact) and run, wherever
possible, on soft ground. Power walking is a good
alternative
Chevalier X. Arthrose du genou et de la hanche. Rev Prat Med Gen 2012;21:987-91.
Société française de rhumatologie. Osteoarthritis file.

11. Don't forget thermotherapy
 Application of cold or heat can provide effective
short-lasting relief from the symptoms of hip or knee
osteoarthritis (ice for inflammatory flares and heat
for joint stiffness)
 Thermotherapy could be effective against the pain
caused by hand osteoarthritis
11
Zhang W, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI
evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 2008;16(2):137-62.
Chevalier X. Arthrose des doigts. Rev Prat Med Gen 2010;24:162-163.

12. Protect your joints
There are many gadgets (long-handled shoe horn, door openers, etc.)
available to help osteoarthritis sufferers in their daily lives which
can be purchased either directly from retailers or from specialist mail
order catalogues
12
Société française de rhumatologie. Osteoarthritis file.
Beauvais C. Education thérapeutique en rhumatologie. Rev Prat Med Gen 2012;26:155-60.
These will help reduce pain and maintain range of movement

13. Use walking aids
This may help reduce the pain of hip or knee osteoarthritis
During inflammatory flares, it is essential to rest the joint:
use crutches if necessary
Between inflammatory flares: a walking stick will take the pressure
off the joint in daily life and will provide comfort and reassurance
 Sticks or crutches should be carried on the side opposite to the damaged joint
 Some patients find using a cane difficult to accept; it should be noted that,
in most cases, a cane or stick will no longer be required after the hip or knee
replacement procedure
13
Zhang W, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-
based, expert consensus guidelines. Osteoarthritis Cartilage 2008;16(2):137-62.
Société française de rhumatologie. Osteoarthritis file

14. Envisage hydrotherapy (crenotherapy)
 Proven to provide pain relief
 The combination of physical treatments, physiotherapy
and advice from ergotherapists and dieticians contribute
to their beneficial effects
14
Société française de rhumatologie. Osteoarthritis file