Presentation 1:

Osteoarthritis Knee

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

Arthritis Research UK

Anatomy of the knee

Source: WebMD

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

Quadriceps:

knee extend

Hamstrings:

knee flexion

Comparison of healthy knee and OA knee

OrthoInfo

Heredity

Overweight

Repetitive stress injuries

Improperly repaired meniscal tear

Fracture

Bowlegs or knock knees

Causes of OA knee

Sources: HealthyPages

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

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

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

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

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

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

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

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_management_of_arthritis_Position_Statement.pdf/$File/Physiotherapy_in_the_management_of_arthritis_Position_Statement.pdf