by Bailey Pepper, SPT

Knee Osteoarthritis PT & Interventions

Background

The degeneration of bone structures in the knee joint is referred to as knee osteoarthritis (OA).  Knee OA can be due to primary degeneration with no known cause, perhaps from general aging or wearing over time. Knee OA could also be a secondary cause of abnormal forces at the joint, traumas, or as a result of cartilage disorders such as rheumatoid arthritis (RA). OA of the knee can occur on both sides of the joint, or be limited to the medial or lateral joint surfaces, with medial knee OA being slightly more common.

This progressive disease may be a result of many factors & may cause a variety of symptoms depending on stage and severity.  There are 4 stages of knee OA which can be identified via imaging.  Non-surgical interventions are often the first line of defense after identification of knee OA.  Surgical interventions may include a debridement, partial meniscectomy, or total joint replacement after further progression or lack of proper management of this disease.

Risk Factors

  • Knee trauma
  • Occupation – prolonged standing or repetitive knee bending
  • Muscle weakness/imbalances
  • Increased BMI
  • More common in females & in older individuals

Symptoms

  • Knee pain worsening with activities (especially repetitive bending or stairs)
    Knee stiffness & swelling
  • Knee pain after prolonged sitting

Recommendations

  • Strong
    • Supervised Exercise
      • High & low intensity strengthening – focus on quadriceps strength
      • Aquatic, balance, & aerobic exercise
      • Yoga & Tai Chi
  • Self-management
  • Patient education
  • Topical/Oral NSAIDs (only if appropriate)
  • Avoid use of lateral wedge supports

Moderate

  • Use of canes/braces
  •  Balance/agility/coordination training
  • Weight loss intervention
  • Hyaluronic acid injections
  • Intra-articular corticosteroids

 Limited

  • Manual therapy, massage
  • Laser, Acupuncture, & TENS
  • Oral/dietary supplements

References

1)      Hsu H, Siwiec RM. Knee Osteoarthritis. [Updated 2022 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507884/

2)      Kohn, Mark D. BA1; Sassoon, Adam A. MD1; Fernando, Navin D. MD1,a Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis, Clinical Orthopaedics and Related Research: August 2016 – Volume 474 – Issue 8 – p 1886-1893

doi: 10.1007/s11999-016-4732-4

3)      American Academy of Orthopaedic Surgeons Management of Osteoarthritis of the Knee (Non- Arthroplasty) Evidence-Based Clinical Practice Guideline. https://www.aaos.org/oak3cpg Published 08/31/2021

For more information or to schedule an appointment, contact one of our PT clinics in the Capital Region in Queensbury, Malta or Saratoga. If you are experiencing any knee pain or discomfort, schedule a consultation or evaluation with one of our skilled Physical Therapy professionals.