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Feature Article

Knee osteoarthritis: management as a chronic disease

Shirley P Yu, David J Hunter

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Abstract

The mainstay of treatment of osteoarthritis should be an integrated chronic disease management plan rather than episodic/reactive care. Long-term disease prevention is receiving greater focus, particularly weight control and injury prevention.

Key Points

  • Comprehensive and multidisciplinary osteoarthritis (OA) management involves a combined treatment approach of nonpharmacological and pharmacological treatment to improve pain and function.
  • Regardless of symptom severity or radiographic change, all patients with OA should engage in exercise and neuromuscular training.
  • Weight reduction in overweight or obese patients can improve physical function and pain by up to 50% in weight-bearing joints.
  • Regular education/advice and monitoring are key to patients’ long-term maintenance of physical activity and weight reduction.
  • Choice of analgesia requires careful consideration of risk versus benefit and proven efficacy.
  • Platelet-rich plasma treatment and stem cell injections are not advocated for the management of knee OA.
  • Arthroscopic surgery is not indicated for treating pain associated with knee OA.
  • Referral to an orthopaedic surgeon should be considered in patients with knee OA who have severe symptoms and functional decline and have failed conservative management.

    Picture credit: © Alexandr Mitiuc/Dollar Photo Club.

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