Knee osteoarthritis, a common cause of knee pain

Knee osteoarthritis, a common cause of knee pain

Knee osteoarthritis (OA) or degenerative arthritis is a very common musculoskeletal condition. Primary OA, more common than secondary OA, is a result of biologic changes in cartilage followed by cartilage breakdown due to mechanical forces. Primary OA is a gradual wear-andtear condition that becomes more common with advancing age. Secondary OA can occur at a younger age and is usually a result of significant trauma or injury.

Diagnosis of knee OA is made by a careful history, physical examination and radiographs. Important factors in history include activity level, previous injuries and prior treatment, including any previous surgery. Patients usually report activity-related pain that may be sensitive to changes in barometric pressure. Knee pain at rest can occur as OA becomes severe. Patients may complain of mechanical symptoms such as catching or locking in the knee. Physical examination should include an evaluation of limb alignment, range of motion, swelling, crepitus, tenderness and stability.

Radiographs (x-rays) including weightbearing views with the knee flexed are important in making the diagnosis of knee OA. Magnetic resonance imaging (MRI) is helpful in patients showing minimal radiographic changes with findings suggestive of a meniscus or focal cartilage abnormality.

Treatment of knee OA includes surgical and nonsurgical options. Modification of lifestyle such as avoidance of high impact activities and weight loss can decrease symptoms of knee OA. Physical therapy including muscular strengthening, flexibility and modalities can be helpful. Patients with OA involving primarily one knee compartment may benefit from use of an unloader brace which functions by unloading the arthritic compartment. Use of acetaminophen or nonsteroidal anti-inflammatory medication is useful in reducing symptoms of knee OA. Glucosamine and chondroitan sulfate are protective agents that can decrease cartilage degeneration although recent studies have not shown conclusive evidence of benefit to patients with knee OA. Intra-articular steroid injections are helpful in alleviating inflammation for a few days to several months.

Viscosupplement injections for knee OA have been used successfully for over a decade. Depending on severity of OA, these injections can relieve symptoms of knee OA for up to six to eight months. Arthroscopy can be beneficial in certain patients with knee OA and symptomatic meniscus tears and cartilage flap tears. Osteotomy is a realignment procedure that is used to unload the arthritic knee compartment in younger, more active patients. Unicompartmental or total knee replacement is definitive treatment for severe knee OA. In order to diagnose and learn about treatment options for knee OA, an evaluation by an orthopedic surgeon is recommended.

Author
Luis M. Espinoza MD Dr. Espinoza served as the AAA Team Doctor for the the New Orleans Zephyrs/BabyCakes since joining the Orthopedic Center for Sports Medicine in 2003. He is double board certified in General Orthopedic Surgery and Sports Medicine.

You Might Also Enjoy...

OCSM Healthcare: Cervical Spine Dermatomes. 4921 Airline Drive, Metairie, LA 70001

Neck Pain (Dermatome) Patterns

Dermatomes are specific regions of the skin that are innervated by a single spinal nerve. The cervical dermatomes refer to those areas of the skin that are supplied by the sensory nerves arising from the cervical (neck) region of the spinal cord. Each cerv
OCSM Lifestyle Medicine: 4921 Airline Drive, Metairie, LA 70001. NOLASPORTSMEDICINE.COM

Thanksgiving Gratitude

Thanksgiving can be a time when we all choose to share in the giving and receiving of food that we may not be accustomed to eating every day. Here are a few hints to ensure this time of year is indeed filled with intentions of GRATITUDE as well as LOVE!
OCSM Physical Therapy - Annual Wellness visits. 4921 Airline Drive, Metairie, LA 70001

Benefits of Annual Physical Therapy Assessments

Physical therapists specialize in biomechanical assessments of the body. PTs are training to help people maintain every level of activity, Identifying problems BEFORE injury can make huge differences in long term outcomes.
Chadwick Murphy MD - Neck and Back Pain  Interventional Spine Specialist. OCSM Health Clinic at 4921 Airline Drive, Metairie,

Neck and Low Back Spine Specialist

Chadwick Murphy, MD, is a double board-certified interventional spine specialist at Orthopedic Center for Sports Medicine in Metairie, Louisiana. Specializing in pain medicine, physical medicine, and rehabilitation, Dr. Murphy understands the importance of
Metairie Pulmonary and Lifestyle Medicine Clinic

Ode to a Physician: A Tree, a Car and an Empty Glass Jar

After reading the recent article in the New York Times titled "The Moral Crisis of America's Doctors", I felt the need to encourage those beginning this journey. There is MUCH HOPE in this calling. The HEALING has to begin with self reflection.