Knee osteoarthritis Flashcards
What is Knee OA
Knee OA is a degenerative joint condition where the articular cartilage in the patellofemoral and/or tibiofemoral joints breaks down over time. This leads to pain, stiffness, and reduced range of motion, often due to excessive pressure and shearing forces.
What are the main risk factors for knee OA?
Age: More common in those over 40, with severity increasing with age.
Lifestyle/Employment: Repetitive knee movements or heavy load-bearing activities.
Previous Injuries/Surgery: Past knee trauma, like ACL tears, fractures, or meniscectomies, increases risk.
Obesity: Increases pressure on the knee joint.
Genetics: Family history can play a role.
What happens in the knee joint during osteoarthritis?
Articular cartilage degenerates, leading to bone exposure and friction.
Osteophytes (bone spurs) form around the joint.
Subchondral bone thickens, leading to sclerosis.
Synovial membrane becomes inflamed, producing excess fluid, causing swelling and stiffness.
What are the key symptoms of knee osteoarthritis?
Pain: Worsens with activity, improves with rest.
Stiffness: Particularly in the morning or after periods of inactivity.
Swelling: Due to excess synovial fluid.
Loss of Range of Motion (ROM): In both flexion and extension.
Crepitus: A grating sensation during movement.
Instability: Knee “giving way” during weight-bearing activities.
How is knee OA diagnosed?
History: Gradual onset of pain, worse with rest, improving with movement.
Physical Exam: Palpation tenderness, limited ROM, joint line pain.
What are the stages of knee OA according to the Kellgren and Lawrence classification?
Grade 1 (Doubtful): Doubtful joint space narrowing, possible osteophytic lipping.
Grade 2 (Minimal): Definite osteophytes, possible joint space narrowing.
Grade 3 (Moderate): Moderate osteophytes, joint space narrowing, sclerosis, possible deformity.
Grade 4 (Severe): Large osteophytes, marked joint space narrowing, severe sclerosis, bone deformities.
What are the conservative treatment options for knee OA?
Exercise Therapy: Strengthening the quadriceps, improving flexibility, and aerobic exercises.
Manual Therapy: Joint mobilisations and soft tissue techniques.
Pharmacological: NSAIDs for pain relief, topical analgesics.
Bracing/Orthotics: For support and alignment correction.
When is surgery considered for knee OA?
Surgery is considered when conservative treatments fail or in advanced OA:
Arthroscopy: For joint cleaning or removal of loose bodies.
Osteotomy: Bone realignment for younger patients with unicompartmental OA.
Knee Replacement: Partial or total knee replacement in severe cases.
