Tricompartmental Knee Osteoarthritis

Question 1

What is tricompartmental knee osteoarthritis?

Answer 1

Degeneration of articular cartilage, joint space narrowing, possibly osteophyte development in the medial, lateral and patellofemoral compartments.

Question 2

What is the MOI for tricompartmental knee osteoarthritis?

Answer 2

Insidious onset. Often correlated with a history of repeated loading or trauma.

Question 3

What are the precautions for someone with suspected tricompartmental knee OA?

Answer 3

i) pain on prolonged weight bearing

ii) fatigue

Question 4

What subjective reports might you find for someone with tricompartmental knee OA?

Answer 4

i) pain and stiffness in the mornings > 30min, eased throughout the day with activity
ii) snapping, clicking, grinding
iii) pain with repeat and prolonged weightbearing

Question 5

What outcome measure would you use for tricompartmental knee OA?

Answer 5

Knee Injury and Osteoarthritis Outcome Score (KOOS).

Question 6

What are 5 key objective tests to determine the presence of knee OA and what are the expected findings?

Answer 6

i) ROM: capsular pattern of restriction, spring block -> capsular end feel.
ii) MMTs: quads and hams weak and painful, hip weak and painfree
iii) Palpation: swelling, all joint line tenderness, pain on patellar compression
iv) Brush/Stroke/Bulge: +ve
v) Clark’s sign: pain reproduction.

Question 7

What are two differential diagnoses for tricompartmental knee OA and how would you rule them out?

Answer 7

i) Degenerative meniscal tear: -ve Clarke’s sign, +ve meniscal tests, focused joint line tenderness
ii) Pes anserine syndrome (bursitis/tendonitis): -ve Clarke’s sign, pain and/or altered strength of SGT, TOP, +ve Valgus test