Outpatient Management of Knee osteoarthritis

Osteoarthritis {OA} is a leading cause of disability worldwide. As a major weight-bearing joint, the knee is one of the most common sites affected.

Knee osteoarthritis is a degenerative disease of the knee joint that causes progressive loss of articular cartilage. Osteoarthritis of the knee happens when cartilage of the knee joint breaks down.

When this happens, the bones in your knee joint rub together, causing friction that makes your knees hurt, becoming stiff or swollen.

Osteoarthritis in the Knee can’t be cured but there are treatments that can relieve symptoms and slow down the progress.

Pair is the most common Symptoms of osteoarthritis in the Knee, Knee joint might be painful at rest or during night which may lead to decreased walking distance.

Other symptoms are that the knee feels stiff, particularly when you first get up or when you have been sitting for a long time. Your knee looks swollen or feels puffy. You hear a cracking noise when you move your knee.

There may be mechanical symptoms of locking, catching sensation or instability.

// Key characteristics and symptoms of knee osteoarthritis include:

• Pain: Persistent knee pain, which may be exacerbated by activities like walking, climbing stairs, or kneeling.
• Stiffness: Reduced flexibility and increased stiffness in the knee joint, particularly after periods of inactivity.
• Swelling: Inflammation and swelling around the knee joint.
• Joint Crepitus: A grating or grinding sensation during joint movement.
• Decreased Range of Motion: Difficulty fully extending or bending the knee.
• Weakness: Weakening of the muscles surrounding the knee joint.

// Diagnosis

• History and Physical Examination.
• Investigation : X-ray, blood test, joint aspiration ( arthrocentesis )

// Management and treatment options for knee osteoarthritis may include:

• Lifestyle Modifications: Weight management, regular exercise, and avoiding activities that exacerbate knee pain can help manage symptoms.
• Physical Therapy: Targeted exercises and physical therapy can improve joint function and strengthen surrounding muscles.
• Medications: Pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections may be prescribed to manage pain and inflammation.
• Assistive Devices: Braces, orthotic shoe inserts, or canes may be recommended to provide support and reduce stress on the knee joint.
• Injections: Hyaluronic acid injections or platelet-rich plasma (PRP) injections may be considered to provide relief and improve joint lubrication.
• Surgical Options: In severe cases, when conservative measures are insufficient, surgical interventions such as arthroscopy, osteotomy, or joint replacement (total knee replacement) may be recommended.

// Treatment

The treatment of knee osteoarthritis typically involves a combination of lifestyle modifications, non-pharmacological interventions, medications, and, in some cases, surgical options.

The specific approach may vary based on the severity of symptoms, the individual’s overall health, and the preferences of both the patient and healthcare provider.

// Conclusion

Osteoarthritis of the Knee is a common disease that causes significant disability. Most patients can be managed conservatively in the outpatient setting.

A small minority of cases require surgery. The Cornerstones of treatment are weight loss, physical therapy and Analgesia. Walking aids or orthoses are useful management and early consultation with an Orthopedic Surgeon should be made.