Awareness presentation on osteoarthritis of knee joint.

1. Osteoarthritis
or
O = Old age - A = Arthritis
As you Age

2. • The name osteoarthritis comes from
three Greek words meaning bone,
joint, and inflammation.

3. • Affected 44% - 70% of
population of age
55years
• Weight bearing joints
are more affected.
• There is no known cure
of the disease.
Progress can be controlled or delayed

5. CARTILAGE:
• Lining of the joint
• Shock absorber
MENISCUS:
Cushion in the joint
BONES:
Femur, Tibia, Patella
SYNOVIAL FLUID:
Lubricates the joint

6. 6
• As the opposing
cartilage surfaces
wear away, the
knee collapses
causing
deformities such as
–
Bowleggedness
(Genu Varus)
Knock Knees
(Genu Valgus)

7. More
common in
women.
Obese people
(more body
weight).
When the
muscles of
the knee joint
are weak.

8.  Age
 Obesity
 Physical Inactivity
 Injury or Overuse (Athletes, Patients having Surgery, Fracture, or Soft
tissue injury surrounding the joint)
 Genetics or Heredity
 Muscle Weakness
 Other Types of Arthritis (RA, Septic Arthritis)
 Other Diseases or Conditions (Hemochromotosis, Acromegaly)

9. • Pain
• Stiffness
• Muscle spasm
• Restricted movement
• Deformity
• Muscle weakness or wasting
• Joint enlargement and instability
• Crepitus
• Joint Effusion

10. Complaints
Complaints
Get
stuck
at
times
Can’t go
up the
steps
Can’t
walk for a
small
distance
Joint
giving
way- Fear
of falling
Bow legs
Knock
knees
Can’t
sleep at
night
Joint
pain &
Stiffness

11. PAIN
Reduced Mobility and
Activity and thus
WEIGHT GAIN
Increased Joint
Stress
Cartilage
Deterioration
Synovitis

12. Wearing of
cartilage
lining
Exposure of
underlying
bone
Swelling of
joint lining
Bone at edges of joint
grows outwards
forming osteophytes
Arthritic
knee

13. Diagnosis
Clinical
X-rays

14. Life style
modifications
Physiotherapy
Nsaids
Braces
Supports

15. • Sitting on ground
• Squatting
• Sit-ups
• Climbing
• Commode
• High heels
• Shoe modification (lateral
wedges)
• Cane/walker
• Braces

16. Exercises – 4 Ds
• Golden rules:
– Do it
– Do it regularly
– Do it correctly
– Do not over do it
Free cycling for 5 – 10
minutes at zero
resistance. Can be
repeated twice a day

17. Quadriceps Sets
Tighten your thigh muscle and straighten your
knee. Then Hold for 5 to 10 seconds.
Repeat 10 times, rest a minute and again repeat.
Repeat several times till the thigh muscles get
fatigued.

18. Straight Leg Raises
Tighten the thigh muscles with knee fully
straightened. Lift leg at an angle of 45
degrees and hold for 5 to 10 seconds and
then slowly lower.

19. Ankle Pumps
Rhythmically move foot up and down by
contracting calf muscles. Repeat this exercise
for two to three minutes, thrice an hour a
day. Continue doing the exercise until
swelling subsides.

20. Sitting Unsupported Knee Bends
Exercise Position – Sitting at bed side or in a chair
with feet resting on floor.
Slowly straighten your knee and hold the position for
5 – 10 seconds. Then lower the knee and repeat the
exercise several times.

21. • Brisk Walking
• Walking with Aids

22. Swimming

23. Braces
• Instability / lack of
confidence,
• Insecurity /
apprehension
• Meniscus tear
• Ligamentous laxity
• Unicompartmental
disease

24. 24
Hot or Cold Packs
TENS
Massage

25. 25
Weight Loss can reduce
stress on weight-bearing
joints, limit further injury,
and increase mobility.
A Healthy Diet
and
Regular Exercise

26.  Ease the symptoms of the disease.
• Simple analgesics:
paracetamol, low dose
ibuprofen
• NSAID’s/Coxibs PRN regular
• Topical treatment eg NSAID
creams, capsaicin
• ‘Chondroprotective agents’

27. Injections (Hydrocortisone – Hyaluronic acid)
Arthroscopy (debridement)
Alignment corrective surgery (HTO)
Total / partial joint replacement

28. Hyaluronic acid injection
It is a viscosupplementation injection
that lubricates and cushions your joint.
Can provide
pain relief
upto 9
months
Efficacy: Low.
Price: High.
3 injections cost
Rs.15000

29. Arthroscopic debridement
• Joint debridement
• Removal of
mechanical
obstructions,
• Joint lavage
• Drilling of sclerotic
lesions

30. HTO for Varus Malalignment

31. High Tibial Osteotomy

32. Unicompartmental
knee replacement
• Indications
• Unicompartmental arthritis
• Low-demand patients who
are older than 60
• Weight less than 82 kg
• Minimum 90° flexion arc
• Minimal deformity
• Intact anterior cruciate
ligament (ACL)

33. Replacing the damaged cartilage in the knee joint
with metal (Cobalt chrome) and highly specialised
plastic. These components are stuck to the bone
with cement
METAL
Cobalt-chrome
Stainless steel
PLASTIC
Specialized
polyethylene
CEMENT What’s new?
Oxynium knee
Fixed

34. • For advanced tricompartmental arthritis

39. “Those who think they have no time for
bodily exercise will sooner or later have to
find time for illness”
—Edward Stanley,
British Prime Minister (1799-1869)