Knee Osteoarthritis

Question 1

Knee OSA:

Treatment options?

Answer 1

1) Exercise
2) Weight loss if overweight
3) Medicine
4) Surgical

Question 2

Knee OSA:

Benefits of exercise for knee OSA and what is recommended?

Answer 2

• strengthen muscles around joints
• improve pain control
• walking, weights, cycling, Tai Chi, swimming, stretching/balancing
• 30minutes at least 3 times per week in 10 minute blocks at the shortest interval
• engage with exercise physiologist/PT/podiatry for advice
• medication may be needed to allow exercise
• education is important to ensure that any pain is correctly understood

Question 3

Knee OSA:

Other helpful aids for exercise?

Answer 3

• restricting high impact exercise
• strapping/braces/compression
• walking aids
• appropriate footwear

Question 4

Knee OSA:

Benefits of weight loss and recommendations?

Answer 4

• for every 1kg lost = 4 times less pressure on knees per step
• improves movement
• lose ≥5% body mass over 20 weeks

Question 5

Knee OSA:

Which medicines and when?

Answer 5

1) Topical
- capsaicin 0.025% cream applied directly to the painful area, 3 to 4 times daily
- NSAIDs
- Rapigel
2) Oral
- Paracetamol
- NSAIDs (most efficacious but have adverse effects [CVS, renal and GIT])
- Duloxetine
3) Intra articular Injections
- Corticosteroids (may provide moderate improvement lasting 4 - 12 weeks - can be given 3 months apart)
- Hyaluronan (not currently recommended)
* Opioids are not recommended for OSA - temporary and limited benefit

Question 6

Knee OSA:

When is surgery indicated and what are the options?

Answer 6

• if non surgical treatments are no longer effective
• Arthroscopic procedures are not effective unless a locked joint is occurring due to a mechanical cause
• correct surgical candidates are not young, overweight, too active as this can loosen or wear the artificial joint out quicker

Question 7

Knee OSA:

Surgical risks?

Answer 7

• local injury to nerves and blood vessels
• infection
• VTE/PE
• failure to heal
• anaesthetic risk
• urinary problems
• allergies
• loosening/wear of artificial joint

Question 8

Knee OSA:

Frequency of complications?

Answer 8

the frequency of complications is 32 in 100

Question 9

Knee OSA:

Recovery time from a knee replacement?

Answer 9

6 - 12 months

Question 10

Knee OSA:

Average public wait list time to see a surgeon for assessment?

Answer 10

190 days