This document discusses osteoarthritis of the knee. It defines osteoarthritis as the degeneration of cartilage in the knee joint. Common symptoms include joint pain, swelling, stiffness, and limited range of motion. Risk factors include prior injury, overuse, obesity, and genetics. Treatment focuses on weight control, medications, physical therapy, bracing, injections, and possible joint replacement surgery for severe cases.

1. Living with Osteoarthritis
of the Knee
Jeffrey Rosenberg MD
Summit Medical Group

2. Plan
• What is arthritis?
• How do I know if I have arthritis?
• How can I treat arthritis?
• How can I improve my function and
pain?

3. Arthritis
• Inflammation of the Joints
 Septic Arthritis: Infection
 Rheumatoid Arthritis: Autoimmune
 Osteoarthritis: Degeneration of cartilage
• Joint pain and limited range of motion

4. Degenerative Osteoarthritis
• Degeneration of
Cartilage overlying
bone (Articular
Cartilage)
• Degeneration of
Meniscus cushion
• Changes to
underlying bone
• Joint becomes
malformed

5. Osteoarthritis

6. Causes
• Prior Injury
• Overuse
• Obesity
• Joint Imbalances
• Genetics

7. Symptoms
• Joint pain-Chronic Deep Ache, Boring
• Acute pain-Sharp, Stabbing
• Swelling
• Limited Range of Motion
• Pain worse with
walking, standing, getting out of
chair, stair
• Instability: Giving out/Locking

8. Symptoms
• Joint sore after
overuse/prolonged activity
• Stiffness after rest and AM
<30 min
• Pain/Surrounding muscle
weakness
• Grating/Popping/Catching
• Deterioration of
posture, walking, and
coordination from pain and

9. Diagnosis
• Take a history
• Physical Exam:
• Fluid in Joint
• Limited Range of Motion
• Joint Deformity
• Pain over joint line
• Xrays-Don’t Always
Correlate with symptoms

10. Normal Arthritis

11. Treatment
• Weight Control
• Pain Medication
• Modified
Activity/Physical
Therapy
• Shoe Wear
• Bracing
• Injections
• Replacement

12. Pain Medication
• Tylenol (acetaminophen)
• NSAIDs: Anti Inflammatory
(Aleve, Advil, are OTC, others
prescribed)-More risks/drug interactions
• Topical: Salicylates, Counter irritants
Capsaicin, NSAIDS
• Heat
• Acupuncture

13. Supplements
• Will Not look like
this
• Glucosamine
Chondroitin (2000
mg/day)
• Vitamins/Antioxida
nts-Vitamin C, D, E
• SAMe, Olive
Oil, MSM

14. Physical Activity
• Flexibility, Strengthening, Endurance
• Best to Continue Exercise/Movement
 Non Weight Bearing Exercises
• Pool, Bike, Elliptical Trainer
 Strengthen Muscles around Joint

15. Physical Therapy
• Physical Therapy, Occupational
Therapy
• Walking Program, Yoga/Pilates, Water
Aerobics

16. Shoe Wear
• Shoes with good support/cushion
• Sneakers usually best for
standing/walking
• Inserts to support Arch
• Shoe Wedge-unload the worse part of
the joint

17. Bracing
• Knee Sleeve for activity
• Unloader Brace for Joint Deformity
 Useful for unilateral disease

18. Injections
• Steroids-Swollen, acutely
painful joint after trauma.
OK to take out the fluid
• Viscosupplementation-
Replaces the substance
missing in joint fluid to
improve nutrition to
cartilage
 Synvisc, Euflexxa, etc
 Weekly injections for 1 or 3
weeks depending on med

19. Surgery
• Arthroscopy-Flush out
the abnormal joint fluid
 ?long term improvement
• Menisectomy
• Hemiarthroplasty-half
knee replacement
• Total Knee
Arthroplasty-knee
replacement