Knee Osteoarthritis
Original Editors - Hamelryck Sascha
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Search Strategy[edit | edit source]
Databases used: Pubmed, Web of knowledge, American college of rheumatology.
Keywords used: osteoarthritis, knee, treatment, definition, exercises, surgery, condition (or a combination of these words).
Definition/Description[edit | edit source]
Simply put, arthritis means inflammation of a joint (artho meaning joint and itis meaning inflammation). Thus, osteoarthritis means inflammation of the bone (osteo means bone) and joint.
Knee osteoarthritis is the occurrence of osteoarthritis (OA) in the knee joint. The OA can be diagnosed in 3 areas within the knee:
- Medial tibiofemoral compartment
- Lateral tibiofemoral compartment
- Patellofemoral compartment
[1] |
[2]
Clinically Relevant Anatomy
|
- Exercise |
Has proved to be effective as pain management and improving of physical functioning on short term. However these exercises have to take place under supervision of a health care professional such as a physiotherapist. When properly instructed these exercises can be performed at home. However research has shown that group exercise combined with home exercise is more effective than home exercise alone.[3] ,[5] |
- Hydrotherapy |
Is recommended in international guidelines. Despite contradictory evidence hydrotherapy can be useful in cases where pain is too grave to exercise on dry land. It can be a good preparation of exercise on dry land.[3] Osteoarthritis usually affects the weight-bearing joints. Some of the above symptoms like muscle weakness will be present in most patients. The strength of muscles around the affected joints can be built up by graduated exercises making use of buoyancy and floats (in the later stage of the treatment).[6][7] Range of motion can also be maintained and increased[7] using the freedom of movement offered by the water with the support given by the buoyancy. Functional difficulties of osteoarthritis patients are generally concerned with walking and climbing stairs and much can be done to re-educate such patients in the pool.[7] Many patients are more mobile in water than on land and this gives them greater confidence and a sense of achievement. Other studies show that aquatic exercise (Aquatherapy) has some short-term beneficial effects.[8] They established that there is a positive effect on both mixed knee and hip Osteoarthritis and on knee Osteoarthritis alone at the end of an aquatic training program. Also no long-term effects have been found. Aquatic exercise may therefore be considered as the first part of an exercise therapy program tot get particularly disabled patients introduced to training.[8] |
- Manual actions: Achieving a passive motion in the joint |
Has proven effective to locate and eliminate factors like pain and joint immobility. However, it is only effective when combined with active exercise. This progress can enable further or advanced exercises. [3] |
- Massage |
Is not effective in the case of osteoarthritis.[3] |
- Thermotherapy |
Can be used to warm up of tissue (for example very stiff joints) before exercise. |
- Electrotherapy |
For example electro stimulation in improving quadriceps muscle strength is not proven effective. [9] |
- Ultrasound |
Is not advised in the treatment of knee osteoarthritis.[3] |
- External support devices |
Braces: Taping: |
- Post-operative exercise |
Is very much recommended. Exercises to improve the function of the new joint and muscle strengthening are most effective.[3][5] |
Key Research[edit | edit source]
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Clinical Bottom Line[edit | edit source]
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References[edit | edit source]
- ↑ Sagacious Studios. Osteoarthritis of the Knee. Available from: http://www.youtube.com/watch?v=IKC52uYdGQ4 [last accessed 22/09/14]
- ↑ doctorsecrets. Osteoarthritis Explained Simply. Available from: http://www.youtube.com/watch?v=TczAeuc3J4E [last accessed 22/09/14]
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Cite error: Invalid
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- ↑ EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis, W Zhang, M Doherty, G Peat, et al., Ann Rheum Dis 2010;69:483–489. doi:10.1136/ard.2009.113100 ( Quality level C : literature study)
- ↑ 5.0 5.1 Supplementing a home exercise program with a class-based exercise program is more effective than home exercise alone in the treatment of knee osteoarthritis ,C. J. McCarthy, P. M. Mills1, R. Pullen, C. Roberts, A. Silman and,J. A. Oldham, Rheumatology 2004;43:880–886 (RCT quality level B)
- ↑ Hinman, R.S., Heywood, S.E. (2007). Aquatic physical therapy for hip and knee osteoarthritis: results of a single-blind randomized controlled trial. Journal of Physical Therapy 87 (1), 32-43 (Level of evidence : 1B)
- ↑ 7.0 7.1 7.2 Wang, T., Belza, B., Elaine Thompson, F., Whitney, J.D., Bennett, K. (2007) Effects of aquatic exercise of flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. Journal of Advanced Nursing, 57 (2), 141-152
- ↑ 8.0 8.1 Bartels et al., Aquatic exercise for the treatment of knee and hip osteoarthritis (Review),The Cochrane Library 2007, Issue 4 (Level of evidence : 1A)
- ↑ A Clinical Trial of Neuromuscular Electrical Stimulation in Improving Quadriceps Muscle Strength and Activation Among Women With Mild and Moderate Osteoarthritis, Riann M. Palmieri-Smith, Abbey C. Thomas, Carrie Karvonen-Gutierrez, MaryFran Sowers, Physical Therapy - Volume 90 Number 10 October 2010 ( RCT quality level C)