Rehabilitation of orthopedic and rheumatologic disorders. 2. Osteoarthritis assessment, treatment, and rehabilitation.

UNLABELLED This self-directed learning module discusses a patient with knee osteoarthritis and addresses the clinical presentation, assessment, medical management, rehabilitation approaches, and surgical options. It is part of the chapter on osteoarthritis in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This chapter emphasizes the differential diagnosis, clinical diagnostic considerations, current pharmacology, orthotics, exercise interventions, and surgical procedure options for a patient with knee osteoarthritis. OVERALL ARTICLE OBJECTIVE To summarize diagnostic considerations and management of knee osteoarthritis.

[1]  Mellar P. Davis,et al.  Demographics, Assessment and Management of Pain in the Elderly , 2003, Drugs & aging.

[2]  S. Kritchevsky,et al.  Association Between Bone Mineral Density and the Use of Nonsteroidal Anti‐Inflammatory Drugs and Aspirin: Impact of Cyclooxygenase Selectivity , 2003, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[3]  A. Amendola,et al.  The effect of bracing on varus gonarthrosis. , 1999, The Journal of bone and joint surgery. American volume.

[4]  P Tugwell,et al.  Continuous passive motion following total knee arthroplasty. , 2003, The Cochrane database of systematic reviews.

[5]  M. Hochberg,et al.  Treatment With Once‐Weekly Alendronate 70 mg Compared With Once‐Weekly Risedronate 35 mg in Women With Postmenopausal Osteoporosis: A Randomized Double‐Blind Study , 2004, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[6]  Susan R. Johnson,et al.  Osteoporosis prevention, diagnosis, and therapy. , 2001, JAMA.

[7]  P. Tugwell,et al.  Cochrane Review on exercise for preventing and treating osteoporosis in postmenopausal women. , 2004, Europa medicophysica.

[8]  L. Woodhouse,et al.  Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. , 1998, Physical therapy.

[9]  J. Kellgren,et al.  Radiological Assessment of Osteo-Arthrosis , 1957, Annals of the rheumatic diseases.

[10]  S. Crenshaw,et al.  Effects of Lateral-Wedged Insoles on Kinetics at the Knee , 2000, Clinical orthopaedics and related research.

[11]  K. Seibert,et al.  Differential inhibition of fracture healing by non‐selective and cyclooxygenase‐2 selective non‐steroidal anti‐inflammatory drugs , 2003, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[12]  C. Becker.  Clinical evaluation for osteoporosis. , 2003, Clinics in geriatric medicine.

[13]  M. Kuster.  Exercise Recommendations After Total Joint Replacement , 2002, Sports medicine.

[14]  Thomas J. Schnitzer,et al.  Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update , 2000 .

[15]  P. Tugwell,et al.  Exercise for preventing and treating osteoporosis in postmenopausal women. , 2011, The Cochrane database of systematic reviews.

[16]  S. Cummings,et al.  Osteoporosis : an evidence-based guide to prevention and management , 2002 .

[17]  R. Makuch,et al.  Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. , 2000, JAMA.

[18]  M. Hamel,et al.  Diagnosis and Treatment of Osteoporosis in Patients with Vertebral Compression Fractures , 2003, Journal of the American Geriatrics Society.

[19]  J. Lonner,et al.  Prodromes of failure in total knee arthroplasty. , 1999, The Journal of arthroplasty.

[20]  Richard Iorio,et al.  Unicompartmental Arthritis of the Knee , 2003, The Journal of bone and joint surgery. American volume.

[21]  J. Layne,et al.  The effects of progressive resistance training on bone density: a review. , 1999, Medicine and science in sports and exercise.

[22]  Wright Ke,et al.  Viscosupplementation for osteoarthritis. , 2000, American journal of orthopedics.

[23]  M. Liang,et al.  Preoperative education for total hip and knee replacement patients. , 1998, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[24]  C. Milgrom,et al.  Effect of cane use on tibial strain and strain rates. , 1998, American journal of physical medicine & rehabilitation.

[25]  M. Wallace.  Assessment and management of pain in the elderly. , 1994, Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses.

[26]  D. Felson,et al.  Weight Loss Reduces the Risk for Symptomatic Knee Osteoarthritis in Women , 1992, Annals of Internal Medicine.

[27]  P. Miller.  Bone mass measurements. , 2003, Clinics in geriatric medicine.

[28]  K. Garvin,et al.  Preoperative physical therapy in primary total knee arthroplasty. , 1998, The Journal of arthroplasty.

[29]  W T Yuh,et al.  Vertebral compression fractures: distinction between benign and malignant causes with MR imaging. , 1989, Radiology.

[30]  E B Hunziker,et al.  Articular cartilage repair: basic science and clinical progress. A review of the current status and prospects. , 2002, Osteoarthritis and cartilage.

[31]  R. Hinman,et al.  Immediate effects of adhesive tape on pain and disability in individuals with knee osteoarthritis. , 2003, Rheumatology.

[32]  Laura B. Hansen,et al.  Current approaches to the prevention and treatment of postmenopausal osteoporosis. , 2003, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[33]  K. Lorig,et al.  Patient education interventions in osteoarthritis and rheumatoid arthritis: a meta-analytic comparison with nonsteroidal antiinflammatory drug treatment. , 1996, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[34]  M. Stallmeyer,et al.  Optimizing patient selection in percutaneous vertebroplasty. , 2003, Journal of vascular and interventional radiology : JVIR.

[35]  W. Applegate,et al.  A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). , 1997, JAMA.

[36]  M. Sinaki.  Critical appraisal of physical rehabilitation measures after osteoporotic vertebral fracture , 2003, Osteoporosis International.

[37]  F. Haddad,et al.  The prevention of periprosthetic fractures in total hip and knee arthroplasty. , 1999, The Orthopedic clinics of North America.

[38]  E Itoi,et al.  Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. , 2002, Bone.

[39]  K. Lorig,et al.  Arthritis self-management. A five-year history of a patient education program. , 1984, The Nursing clinics of North America.

[40]  P. Peloso.  Opioid therapy for osteoarthritis of the hip and knee: use it or lose it? , 2001, The Journal of rheumatology.

[41]  Frank M Phillips,et al.  Minimally Invasive Treatments of Osteoporotic Vertebral Compression Fractures , 2003, Spine.

[42]  F. Bonner,et al.  Evaluating bone mineral density in osteoporosis. , 2000, American journal of physical medicine & rehabilitation.

[43]  R. Moskowitz,et al.  Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group. , 1998, The Journal of rheumatology.

[44]  R. Greenwald,et al.  A biomechanical analysis of a medial unloading brace for osteoarthritis in the knee. , 2000, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[45]  Jh. Kellgren.  Radiological assessment of osteoarthrosis , 1957 .

[46]  John A. Anderson,et al.  Seven to 10 Years Followup of an Anatomic Hip Prosthesis: An International Study , 2004, Clinical orthopaedics and related research.

[47]  Nicole Ferko,et al.  Diagnosis and management of vertebral fractures in elderly adults. , 2002, The American journal of medicine.

[48]  C. A. Hartman,et al.  Effects of T'ai Chi Training on Function and Quality of Life Indicators in Older Adults with Osteoarthritis , 2000, Journal of the American Geriatrics Society.

[49]  L. Fitzpatrick.  Secondary causes of osteoporosis. , 2002, Mayo Clinic proceedings.

[50]  Jeffery L. Pierson,et al.  Brake response time after total knee arthroplasty: when is it safe for patients to drive? , 2003, The Journal of arthroplasty.

[51]  R. Moskowitz,et al.  Erratum: Intraarticular sodium hyaluronate (Hyalgan®) in the treatment of patients with osteoarthritis of the knee: A randomized clinical trial (Journal of Rheumatology (1998) 25 (2203-2212)) , 1999 .

[52]  R. Iorio,et al.  Athletic activity after total knee arthroplasty. , 2000, Clinical orthopaedics and related research.

[53]  L. Talbot,et al.  A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee. , 2003, The Journal of rheumatology.

[54]  M. Rubin,et al.  The anabolic effects of parathyroid hormone therapy. , 2003, Clinics in geriatric medicine.

[55]  K. O'malley,et al.  A controlled trial of arthroscopic surgery for osteoarthritis of the knee. , 2002, The New England journal of medicine.

[56]  V. Podichetty,et al.  Vertebral compression fractures: manage aggressively to prevent sequelae. , 2003, Cleveland Clinic journal of medicine.

[57]  R. Emerson,et al.  Comparison of a Mobile With a Fixed-Bearing Unicompartmental Knee Implant , 2002, Clinical orthopaedics and related research.

[58]  J. Lane,et al.  Nonmedical management of osteoporosis , 2002, Current opinion in rheumatology.

[59]  A. LaCroix,et al.  Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial. , 2003, JAMA.

[60]  M. Grabois,et al.  Health Professional's Guide to Rehabilitation of the Patient with Osteoporosis , 2003, Osteoporosis International.

[61]  R. Marks,et al.  Are foot orthotics efficacious for treating painful medial compartment knee osteoarthritis? A review of the literature , 2004, International journal of clinical practice.

[62]  Jike Lu,et al.  Thoracic Spine Fractures in Patients Older Than 50 Years , 1996, Clinical orthopaedics and related research.