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Knee Osteoarthritis

It is Chronic progressive, degenerative, painful disease of knee joint present with chronic pain, loss of joint ROM, bony crepitus, joint deformities in later stage like “genu valgum”.

EPIDEMIOLOGY AND CAUSES

Most common form of joint arthritis.

15% population is affected.

Strongly age related OA knee occurs with 70% population in age group 60 and above.

Leading cause of long term movement disability

11.6 millions cases expected to be in US till 2020.

CAUSES

Age
Overuse injury
Repetitive Stress Fracture
Obesity
Joint Imbalance or mal-alignment
Genetics like FRZB, LRP5 gene etc

CLINICAL FEATURES AND PATHOPHYSIOLOGY

knee pain

swelling in the joint area

pain worsen up in the morning

pain increases after activity

buckling of the knee

inability to straighten up your knee

grinding or snapping noises when perform movements ( bony crepitus )

weakness in the knee joint

PATHOPHYSIOLOGY

Damage at more weight bearing joint like knee joint

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PHYSICAL EXAMINATION AND DIAGNOSIS

Physical examination includes

Check joint alignment

Access quadriceps strength

Evaluation of tenderness point and pain

Access Joint ROM

Palpation for bony swelling

Access Bony Crepitus

Gait Evaluation

Radiographically we find

X-rays show up cartilage loss is revealed by a narrowing of the joint space. An X-ray may also show bone spurs around a joint. Presence of subchondral cyst, bony erosion, inflammed synovium.

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PHYSIOTHERAPY MANAGEMENT

A study found that a combination of manual physical therapy and supervised exercise has functional benefits for patients with knee osteoarthritis.

Physical therapy can help to reduce the pain, swelling, and stiffness of knee osteoarthritis, and it can help improve knee joint motion. It can also make it easier for you to walk, bend, kneel, squat, and sit. The two main types of physical therapy — passive and active treatments. It can help make your knee OA more manageable.

Common Passive Treatments for Knee Osteoarthritis

Cold therapy: It reduces circulation and can help decrease swelling.

Heat therapy: Heat therapy increases blood flow to decrease stiffness in the knee joints and muscles surrounding the knee.

Hydrotherapy: This treatment uses water to decrease your symptoms. There are several advantages of hydrotherapy, you can do gentle exercises in the water and warm water help facilitate motion as well as help you provide pain relief.

Common Active Treatments for Knee Osteoarthritis

Strengthening exercises: Your physical therapist will show you certain exercises that you can do at home to strengthen your muscles. Working out muscles in the leg can help make your knee joints stronger. Strengthening these muscles alone can help decrease the pain of knee OA.

Flexibility exercises: Flexibility exercises are very important. Regular sessions can help increase range of motion, make your knees more flexible, and restore normal knee joint function.

Both strengthening and flexibility exercises are important because they assist in taking strain off the knee.

Rehabilitation Exercise includes

Knee flexion

Hamstring Stretch

Leg Flexion

Hip Extension

Squats

Stair up and down

Heel slide knee extension

Side lying leg lifts

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