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The Degenerative Knee/Osteoarthritis

Updated: Feb 8, 2020

Osteoarthritis (OA) is often referred to as “wear and tear” arthritis. OA can affect joints due to uneven or excessive loading, resulting in the lining of the joint (cartilage) wearing away and causing more force through the bones (Hence the term “bone on bone”).

  1. Over 3.1 million Australians suffer from Osteoarthritis

  2. 53% of the population over 75 suffer from increased disability due to osteoarthritis

  3. Osteoarthritis is more common in females

Causes of knee Osteoarthritis

  1. Repetitive strain injuries can lead to early onset of Osteoarthritis – E.g. constant stress on the knee could be from excessive kneeling, squatting or heavy lifting

  2. Previous injury such as ACL rupture of meniscus damage

  3. Being overweight – progression of Osteoarthritis is more rapid in people who are overweight

  4. Genetic disposition – abnormal structure of the shape of the bones

  5. Rheumatoid arthritis – you may develop secondary Osteoarthritis

Treatment options of knee Osteoarthritis

While knee Osteoarthritis is often a degenerative and an irreversible process, functional improvement and pain control are reasonable goals. Earlier treatment intervention may improve the odds of preserving joint integrity and function for years and possibly prolong or reduce the need for joint replacement surgery.

Treatment may include some of the following:

  1. Unloading the painful structures by taping or bracing

  2. Stabilising the unstable patella (Knee cap) through specific exercises

  3. Restore dynamic balance of the quadricep muscles to support the knee joint

  4. Improve lower limb mechanics, working on flexibility of the hips and gluteal strength

  5. Decrease swelling

  6. Reconditioning program

  7. Hydrotherapy (strengthening the knee without weight bearing)

  8. Orthotic therapy to correct lower limb alignment

  9. Weight loss – According to a study by S P Messeir “For every kilogram of weight loss there is 4kg less load through the knee for every step”

Other treatments may include:

  1. NSAID’s

  2. Diet and nutrition

  3. Joint injections

When conservative treatment isn’t enough and the joint is too damaged you may need an orthopedic review to consider joint replacement surgery.

What is the aim of physiotherapy treatment?

The aim of physiotherapy treatment is to reduce the pain and stiffness at the knee joint by improving the loading through the joint. Waiting for knee replacement surgery is not the only option. The first principle in management of OA is to slow the progression of the disease and improve functional capacity. This can be done through a combination of physio, exercise, weight loss and the use of anti-inflammatory pain medication.

Written by Ashley Holliday

Physiotherapist

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