Living with Osteoarthritis of the Knee

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Learn the causes, symptoms and treatment for osteoarthritis of the knee in this presentation by Jeffrey Rosenberg MD, Summit Medical Group. http://www.summitmedicalgroup.com/doctor/jrosenberg/ Dr. Rosenberg is a member of the American Medical Society for Sports Medicine, American Academy of Family Practice, and Society of Teachers in Family Medicine. He is the author of book chapters that are published in the most recent edition of 5-minute Sports Medicine Consult.

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Living with Osteoarthritis of the Knee

  1. 1. Living with Osteoarthritis of the KneeJeffrey Rosenberg MDSummit Medical Group
  2. 2. Plan• What is arthritis?• How do I know if I have arthritis?• How can I treat arthritis?• How can I improve my function and pain?
  3. 3. Arthritis• Inflammation of the Joints  Septic Arthritis: Infection  Rheumatoid Arthritis: Autoimmune  Osteoarthritis: Degeneration of cartilage• Joint pain and limited range of motion
  4. 4. Degenerative Osteoarthritis • Degeneration of Cartilage overlying bone (Articular Cartilage) • Degeneration of Meniscus cushion • Changes to underlying bone • Joint becomes malformed
  5. 5. Osteoarthritis
  6. 6. Causes• Prior Injury• Overuse• Obesity• Joint Imbalances• Genetics
  7. 7. Symptoms• Joint pain-Chronic Deep Ache, Boring• Acute pain-Sharp, Stabbing• Swelling• Limited Range of Motion• Pain worse with walking, standing, getting out of chair, stair• Instability: Giving out/Locking
  8. 8. Symptoms• Joint sore after overuse/prolonged activity• Stiffness after rest and AM <30 min• Pain/Surrounding muscle weakness• Grating/Popping/Catching• Deterioration of posture, walking, and coordination from pain and
  9. 9. Diagnosis• Take a history• Physical Exam: • Fluid in Joint • Limited Range of Motion • Joint Deformity • Pain over joint line• Xrays-Don’t Always Correlate with symptoms
  10. 10. Normal Arthritis
  11. 11. Treatment• Weight Control• Pain Medication• Modified Activity/Physical Therapy• Shoe Wear• Bracing• Injections• Replacement
  12. 12. Pain Medication• Tylenol (acetaminophen)• NSAIDs: Anti Inflammatory (Aleve, Advil, are OTC, others prescribed)-More risks/drug interactions• Topical: Salicylates, Counter irritants Capsaicin, NSAIDS• Heat• Acupuncture
  13. 13. Supplements• Will Not look like this• Glucosamine Chondroitin (2000 mg/day)• Vitamins/Antioxida nts-Vitamin C, D, E• SAMe, Olive Oil, MSM
  14. 14. Physical Activity• Flexibility, Strengthening, Endurance• Best to Continue Exercise/Movement  Non Weight Bearing Exercises • Pool, Bike, Elliptical Trainer  Strengthen Muscles around Joint
  15. 15. Physical Therapy• Physical Therapy, Occupational Therapy• Walking Program, Yoga/Pilates, Water Aerobics
  16. 16. Shoe Wear• Shoes with good support/cushion• Sneakers usually best for standing/walking• Inserts to support Arch• Shoe Wedge-unload the worse part of the joint
  17. 17. Bracing• Knee Sleeve for activity• Unloader Brace for Joint Deformity  Useful for unilateral disease
  18. 18. Injections • Steroids-Swollen, acutely painful joint after trauma. OK to take out the fluid • Viscosupplementation- Replaces the substance missing in joint fluid to improve nutrition to cartilage  Synvisc, Euflexxa, etc  Weekly injections for 1 or 3 weeks depending on med
  19. 19. Surgery• Arthroscopy-Flush out the abnormal joint fluid  ?long term improvement• Menisectomy• Hemiarthroplasty-half knee replacement• Total Knee Arthroplasty-knee replacement

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