Living with Osteoarthritis of the Knee
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This document discusses osteoarthritis of the knee. It defines osteoarthritis as the degeneration of cartilage in the knee joint. Common symptoms include joint pain, swelling, stiffness, and limited range of motion. Risk factors include prior injury, overuse, obesity, and genetics. Treatment focuses on weight control, medications, physical therapy, bracing, injections, and possible joint replacement surgery for severe cases.
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Living with Osteoarthritis of the Knee
- 1. Living with Osteoarthritis of the Knee Jeffrey Rosenberg MD Summit Medical Group
- 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. Arthritis • Inflammation of the Joints Septic Arthritis: Infection Rheumatoid Arthritis: Autoimmune Osteoarthritis: Degeneration of cartilage • Joint pain and limited range of motion
- 4. Degenerative Osteoarthritis • Degeneration of Cartilage overlying bone (Articular Cartilage) • Degeneration of Meniscus cushion • Changes to underlying bone • Joint becomes malformed
- 6. Causes • Prior Injury • Overuse • Obesity • Joint Imbalances • Genetics
- 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. 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. 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. Normal Arthritis
- 11. Treatment • Weight Control • Pain Medication • Modified Activity/Physical Therapy • Shoe Wear • Bracing • Injections • Replacement
- 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. Supplements • Will Not look like this • Glucosamine Chondroitin (2000 mg/day) • Vitamins/Antioxida nts-Vitamin C, D, E • SAMe, Olive Oil, MSM
- 14. Physical Activity • Flexibility, Strengthening, Endurance • Best to Continue Exercise/Movement Non Weight Bearing Exercises • Pool, Bike, Elliptical Trainer Strengthen Muscles around Joint
- 15. Physical Therapy • Physical Therapy, Occupational Therapy • Walking Program, Yoga/Pilates, Water Aerobics
- 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. Bracing • Knee Sleeve for activity • Unloader Brace for Joint Deformity Useful for unilateral disease
- 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. Surgery • Arthroscopy-Flush out the abnormal joint fluid ?long term improvement • Menisectomy • Hemiarthroplasty-half knee replacement • Total Knee Arthroplasty-knee replacement