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This presentation consists of anatomy, clinical features, pathophysiology, doctor & physiotherapy management (generally)

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  1. 1. Presentation 1: Osteoarthritis Knee
  2. 2. Definition: Osteoarthritis (OA) is a condition in which the cartilage between the joints is wears away leading to pain and stiffness. American Academy of Orthopaedic Surgeon A. INTRODUCTION
  3. 3. Arthritis Research UK
  4. 4. Anatomy of the knee Source: WebMD
  5. 5. The knee joins of femur to the tibia, fibula and also patella. Tendons that stabilize the knee are: (a)Anterior Cruciate Ligament: prevent femur from sliding backward on the tibia (or tibia sliding backward on the femur). (b)Posterior cruciate ligament: prevents the demur from sliding forward on the tibia (or the tibia sliding backward on the femur). (c)Medial and Lateral collateral ligaments: prevent from sliding side to side. Two C-shaped of cartilage that called medial and lateral menisci that act as absorber. Source: WebMD
  6. 6. Quadriceps: knee extend
  7. 7. Hamstrings: knee flexion
  8. 8. Comparison of healthy knee and OA knee OrthoInfo
  9. 9. Heredity Overweight Repetitive stress injuries Improperly repaired meniscal tear Fracture Bowlegs or knock knees Causes of OA knee Sources: HealthyPages
  10. 10. Pathophysiology of knee OA Damage at the more weight bearing articular cartilage Osteophytosis Changes in subchondral bone Synovitis Thickening of the joint capsule Source: J Musculoskeletal Neuronal interact 2006; 6(4):376-378
  11. 11. SIGN Reduced range of joint movement. Pain on movement of the joint or at extremes of joint movement. Joint swelling/ synovitis (warmth, effusion, synovial thickening). Periarticular tenderness. Crepitus. Clinical presentation Source: http://www.patient.co.uk/doctor/osteoarthritis
  12. 12. Joint instability. Muscle weakness/wasting around the affected joint. SYMPTOM Pain with activities, relieve by rest. Usually pain felt in or around the knee. Joint stiffness in the morning or after rest. Reduced function and participation restriction Source: http://www.patient.co.uk/doctor/osteoarthritis
  13. 13. Doctor’s management Non – pharmacological management 1. Education and behavioral intervention 2. Weight loss 3. Exercise 4. Mechanical aids Source: The Medical Journal of Australia
  14. 14. Pharmacological management (i) Systemic drugs Paracetamol NSAIDS and cyclo-ocgenase-2-specific inhibitors Glucosamine and chondroitin Opioids (ii) intra-articular injection Viscosupplementation Glucocorticoids Topical analgesia Source: The Medical Journal of Australia
  15. 15. 1. Exercise therapy 2. Hydrotherapy 3. Self management and education 4. Manual therapy or mobilization techniques 5. Joint protection and provision of walking aids and splint or braces 6. Electrophysical agents (e.g. thermotherapy, ultrasound and laser) Physiotherapy’s management Source: Australian Physiotherapy Association
  16. 16. 1. The American Academy of Orthopaedic Surgeon. (October 2007). Arthritis of the Knee. Retrieved on April 19, 2013 from http://orthoinfo.aaos.org/topic.cfm?topic=a00212 2. Arthritis Research UK. (n.d.). Which joints affected by osteoarthritis? Retrieved on April 19, 2013 from http://www.arthritisresearchuk.org/arthritis- information/conditions/osteoarthritis/which-joints-are-affected.aspx 3. WebMD. (2005). Knee (Human Anatomy) images, functions, ligaments and muscles. Retrieved on April 19, 2013 from http://www.webmd.com/pain-management/knee-pain/picture-of-the- knee 4. Wright Michelle. (2010). Osteoarthritis. Retrieved April 20, 2013 from http://www.patient.co.uk/doctor/osteoarthritis 5. Osteoarthritis in the knee. (n.d.) retrieved April 20, 2013 from http://healthpages.org/health-a-z/osteoarthritis-knee/ References
  17. 17. Online journal 1. Goldring, S.R. & Goldring, M.B..(2006). Clinical aspects, pathology and pathophysiology of osteoarthritis. J Musculoskelet Neuronal Interact 2006; 6(4):376- 378. Retrieved April 19, 2013 from http://ismni.org/jmni/pdf/26/30GOLDRING.pdf 2. Grainger, R. & Ciccuttini, F.M..(2004). Medical management of osteoarthritis of the hip and knee joints. Med J Aust 2004; 180 (5): 232-236. Retrieved April 20, 2013 from https://www.mja.com.au/journal/2004/180/5/medical-management-osteoarthritis- knee-and-hip-joints 3. Australian Physiotherapy Association. (November 2005). Physiotherapy in the management of the arthritis and musculoskeletal conditions. Retrieved on April 26, 2013 from http://www.goforyourlife.vic.gov.au/hav/admin.nsf/Images/Physiotherapy_in_the_manag ement_of_arthritis_Position_Statement.pdf/$File/Physiotherapy_in_the_management_o f_arthritis_Position_Statement.pdf