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OA Knee

OA Knee (Osteoarthritis of the knee)

Normal Knee Anatomy
 
The normal knee consists of lower femur (thigh bone), upper tibia (shin bone) and the patella (knee cap).  The thigh bone moves and rotates on the shin bone to produce knee movement.  Cartilage covers ends of bone to allow smooth movements at the knee joint.  Synovial membrane, which surrounds the joint, releases fluids to lubricate the joint.
 
Knee ligaments provide stability to the knee and restricting excessive knee movements.  Knee muscles (e.g. the quadriceps) provide strength for active knee movements.
 
What is OA Knee?
 
Osteoarthritis (OA) is the most common form of arthritis.  It is also a degenerative joint disease (DJD).  OA knee is osteoarthritis that happens at the knee joint.  It is characterized by the breakdown of cartilage within the knee joint.
 
Articular cartilage is made up of protein substance such as collagen.  It is used as a cushion or shock absorber within the joint.  As these cartilages break down within the joint (in this case, knee joint), the bones start to grind with each other.  This causes symptoms such as pain, swelling, joint deformation and reduced motion.  Osteoarthritis usually affects weight bearing joints, such as knee, the hip and the back.
 
Who is more likely to have OA knee?
 
-People who are overweight
-Older people
-Someone who had knee injury before
-Someone who has a family history of OA knee
-Someone who frequently involves in repetitive activities like squatting, walking or running
 
Signs/ Symptoms of OA knee
 
Some major signs/ symptoms of OA knee:
 
Pain of involved limbs
Joint changes
Redness
Hotness
Knee stiffness (loss of mobility)
 
Diagnosis of OA knee:
 
Diagnosis of OA knee consists of:
History: e.g. patient reported symptoms
 
Physical examination: examining knee movements, redness, hotness, deformities of the knee
 
Radiological studies: X-ray usually shows changes of the knee (e.g. joint space decrease, osteophytes formation)
 
Treatment options for OA knee
 
Treatment divided into surgical and non- surgical means
 
Non- surgical:
 
-Health and behavior modification- patient education, weight loss, knee brace usage
-Physical therapy and exercise 
-Drug therapy: pain killers or anti-inflammatory drugs
-Intra-articular treatment like injections
-Alternative therapies (e.g. acupuncture)
 
Surgical: only one out of four patients needs this option
 
-Total knee replacement (please see our “total knee replacement” section for more information
 
Physical Therapy for OA knee
 
After a thorough evaluation, the physical therapist designs an individualized program for the patient.  The program varies from patient to patient depends on severity and acuteness.  The program usually involves:
 
-Therapeutic exercises 
-Electrical therapy
-Ultrasound therapy
-Joint mobilization
-Manual therapy
-Stretching exercises
-Advises regarding the condition 
 
Home Exercises for OA knee
 
Home exercises for OA knee should be prescribed by the physical therapist.  A proper evaluation of the condition should precede.
 
Mobilization Exercises
 
Knee flexion
-Start with lying on your tummy
-Bend knee up towards the air towards buttock
-Repeat 10 times
 
Cycling exercise
-Start in sitting with a static bike
-Knee start cycling, the knee bending should not bend more than 90 degrees
 
Strengthening exercises
 
Quadriceps strengthening 
-Start with lying flat, with a rolled towel placed under the knee
-Exert force (press down) onto the towel, so that the upper thigh muscle is tightened
-Hold for 5-10 seconds
 
Straight leg raise
-Start with lying on your back, one knee bent
-Straightly raise up the leg, toes pointing up to the ceiling
-Hold for 5-10 seconds, repeat 5-10 times
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