Current interventions in the management of knee osteoarthritis

Dinesh Bhatia, Tatiana Bejarano, Mario Novo, Dinesh Bhatia, Tatiana Bejarano, Mario Novo

Abstract

Osteoarthritis (OA) is progressive joint disease characterized by joint inflammation and a reparative bone response and is one of the top five most disabling conditions that affects more than one-third of persons > 65 years of age, with an average estimation of about 30 million Americans currently affected by this disease. Global estimates reveal more than 100 million people are affected by OA. The financial expenditures for the care of persons with OA are estimated at a total annual national cost estimate of $15.5-$28.6 billion per year. As the number of people >65 years increases, so does the prevalence of OA and the need for cost-effective treatment and care. Developing a treatment strategy which encompasses the underlying physiology of degenerative joint disease is crucial, but it should be considerate to the different age ranges and different population needs. This paper focuses on different exercise and treatment protocols (pharmacological and non-pharmacological), the outcomes of a rehabilitation center, clinician-directed program versus an at home directed individual program to view what parameters are best at reducing pain, increasing functional independence, and reducing cost for persons diagnosed with knee OA.

Keywords: Arthrocentesis; Western Ontario and McMaster Universities Osteoarthritis Index scale; hydrotherapy; musculoskeletal disorders; neuromuscular efficiency; osteoarthritis; pharmacological; quadriceps.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Tai Chi exercise program (Reprinted with permission from[3233])
Figure 2
Figure 2
Hydrotherapy/balneotherapy (Reprinted with permission from[33])
Figure 3
Figure 3
Aquatic exercises (Reprinted with permission from[33])
Figure 4
Figure 4
Aerobic exercises (Reprinted with permission from[33])

References

    1. Hinman RS, Hunt MA, Creaby MW, Wrigley T, McManus FJ, Bennell KL. Hip muscle weakness in individuals with medial knee osteoarthritis. Arthritis Care Res. 2010;62:1190–3.
    1. Heiden T, Lloyd D, Ackland T. Knee extension and flexion weakness in people with knee osteoarthritis: Is antagonist contraction a factor? J Orthop Sports Phys Ther. 2009;39:807–15.
    1. Childs JD, Sparto PJ, Fitzgerald GK, Bizzini M, Irrgang JJ. Alterations in lower extremity movement and muscle activation patterns in individuals with knee osteoarthritis. Clin Biomech (Bristol, Avon) 2004;19:44–9.
    1. Likivainio T, Arokoski J. Physical function and properties of quadriceps femoris muscle in men with knee osteoarthritis. Arch Phys Med Rehabil. 2008;89:2185–93.
    1. Likivainio T, Bragge T, Hakkarainen M, Karjalainen PA, Arokoski J. Gait and muscle activation changes in men with knee osteoarthritis. Knee. 2010;17:69–76.
    1. Hinman RS, Bennel K, Metcalf B, Crossley K. Delayed onset of quadriceps activity and altered knee joint kinematics during stair stepping in individuals with knee osteoarthritis. Arch Phys Med Rehabil. 2002;83:1080–6.
    1. Jain S. Arthritis: Freedom from pain. [Last accessed on Dec 2011]. Available from: .
    1. Ringdahl E, Pandit S. Treatment of knee osteoarthritis. Am Fam Physician. 2011;83:1287–92.
    1. Magrans-Courtney T, Wilborn C, Rasmussen C, Ferreira M, Greenwood L, Campbell B, et al. Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program. J Int Soc Sports Nutr. 2011;8:8.
    1. Esser S, Bailey A. Effects of exercise and physical activity on knee OA. Curr Pain Headache Rep. 2011;15:423–30.
    1. Salve H, Gupta V, Palanivel C, Yadav K, Singh B. Prevalence of knee osteoarthritis amongst perimenopausal women in an urban resettlement colony in south Delhi. Indian J Public Health. 2010;54:155–7.
    1. Kon E, Filardo G, Drobnic M, Madry H, Jelic M, Dijk N, et al. Non-surgical management of early knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2012;20:436–9.
    1. Carvalho NA, Bittar ST, Pinto FR, Ferreira M, Sitta RR. Manual for guided home exercises for osteoarthritis of the knee. Clinics (Sao Paulo) 2010;65:775–80.
    1. Voelker R. Few adults with knee osteoarthritis meet national guidelines for physical activity. JAMA. 2011;306:1428–30.
    1. Smink AJ, van den Ende CH, Vliet Vlieland TP. Beating osteoarthritis: Development of a stepped care strategy to optimize utilization and timing of non-surgical treatment modalities for patients with hip or knee osteoarthritis. Clin Rheumatol. 2011;30:1623–9.
    1. Pai Y, Chang H, Sinacore J, Lewis J. Alteration in multijoint dynamics in patients with bilateral knee osteoarthritis. Arthritis Rheum. 1994;37:1297–304.
    1. Hubley-Kozey C, Deluzio K, Dunbar M. Muscle co-activation patterns during walking in those with severe knee osteoarthritis. Clin Biomech (Bristol, Avon) 2008;23:71–80.
    1. Wilson JL, Deluzio KJ, Dunbar MJ, Caldwell GE, Hubley-Kozey CL. The association between knee joint biomechanics and neuromuscular control and moderate knee osteoarthritis radiographic and pain severity. Osteoarthritis Cartilage. 2011;19:186–93.
    1. Lessi GC, Silva PR, Gimenez A, Say K, Oliveira A, Mattiello S. Male subjects with early stage knee osteoarthritis do not present biomechanical alterations in the saggital plane during stair descent. Knee. 2012;19:387–91.
    1. Rogind H, Bibow-Nielsen B, Jensen B, Moller HC, Frimodt-Moller H, Bliddal H. The effects of a physical training program on patients with osteoarthritis of the knees. Arch Phys Med Rehabil. 1998;79:1421–7.
    1. Escalante Y, Saavedra JM, Garcia-Hermoso A, Silva AJ, Barbosa TM. Physical exercise and reduction of pain in adults with lower limb osteoarthritis: A systematic review. J Back Musculoskelet Rehabil. 1998;23:175–86.
    1. Huang MH, Chen CH, Chen TW, Weng MC, Wang WT, Wang YL. The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity. Arthritis Care Res. 2000;13:398–405.
    1. Deyle GD, Henderson NE, Matekel R, Ryder M, Garber M, Allison S. Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee. Ann Intern Med. 2000;132:173–81.
    1. Ross W. Adey biological effects of electromagnetic fields. J Cell Biochem. 1993;51:410–6.
    1. Ciombor DM, Aaron RK, Wang S, Simon B. Modification of osteoarthritis by pulsed electromagnetic field: A morphological study. Osteoarthritis Cartilage. 2003;11:455–62.
    1. Fini M, Giavaresi G, Carpi A, Nicolini A, Setti S, Giardino R. Effects of pulsed electromagnetic fields on articular hyaline cartilage: Review of experimental and clinical studies. Biomed Pharmacother. 2005;59:388–94.
    1. Puett DW, Griffin MR. Published trials of non-medicinal and noninvasive therapies for hip and knee osteoarthritis. Ann Intern Med. 1994;121:133–40.
    1. Sen A, Gocen Z, Unver B, Karatosun V, Gunal I. The frequency of visits by the physiotherapist of patients receiving home-based exercise therapy for knee osteoarthritis. Knee. 2004;11:151–3.
    1. Deyle GD, Allison SC, Matekel RL, Ryder MG, Stang JM, Gohdes DD, et al. Physical therapy treatment effectiveness for osteoarthritis of the knee: A randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther. 2005;85:1301–17.
    1. McQuade KJ, de Oliveira AS. Effects of progressive resistance strength training on knee biomechanics during single leg step-up in persons with mild knee osteoarthritis. Clin Biomech (Bristol, Avon) 2011;26:741–8.
    1. Wang C, Bannuru R, Ramel J, Kupelnick B, Scott T, Schmid CH. Tai chi on psychological well-being: Systematic review and meta-analysis. BMC Complement Altern Med. 2011;10:1–16.
    1. Wong C. Osteoarthritis pain relief remedies. [Last accessed on 2007 Jul]. Available from: .
    1. Hernandez V. Wellness as a whole. [Last accessed on 2011 Dec]. Available from:
    1. Lund H, Weile U, Christensen R, Rostock B, Downey A, Bartels E, et al. A randomized controlled trial of aquatic and land-based exercise in patients with knee osteoarthritis. J Rehabil Med. 2008;40:137–44.
    1. Fransen M, Nairn L, Winstanley J, Lam P, Edmonds J. Physical activity for osteoarthritis management: A randomized controlled clinical trial evaluating hydrotherapy or tai chi classes. Arthritis Rheum. 2010;57:407–14.
    1. Evcik D, Sonel B. Effectiveness of a home-based exercise therapy and walking program on osteoarthritis of the knee. Rheumatol Int. 2002;22:103–6.
    1. Petrella RJ, Bartha C. Home based exercise therapy for older patients with knee osteoarthritis: A randomized clinical trial. J Rheumatol. 2000;27:2215–21.
    1. Sled EA, Khoja L, Deluzio KJ, Olney SJ, Culham EG. Effect of a home program of hip abductor exercises on knee joint loading, strength, function, and pain in people with knee osteoarthritis: A clinical trial. Phys Ther. 2010;90:895–904.
    1. Lo GH, LaValley M, McAlindon T, Felson D. Intra-articular hyaluronic acid in treatment of knee osteoarthritis. JAMA. 2003;290:3115–21.
    1. Bhatia D, Bansal G, Joshi D, Anand S, Tewari RP. Coordination between lower limb muscles in different locomotion activities. Int J Biomed Eng Technol. 2011;6:23–30.
    1. De Luca CJ. The use of surface electromyography in biomechanics. J Appl Biomech. 1997;13:135–63.
    1. Glazier RH, Dalby DM, Badley EM, Hawker GA, Bell MJ, Buchbinder R, et al. Management of common musculoskeletal problems: A survey of ontario primary care physicians. CMAJ. 1998;158:1037–40.
    1. Tesch PA, Dudley GA, Duvoisin MR, Hather BM, Harris RT. Force and EMG signal patterns during the repeated bouts of concentric or eccentric muscle actions. Acta Physiol Scand. 1990;138:263–71.
    1. Law PP, Cheing GL. Optimal stimulation frequency of transcutaneus electrical nerve stimulation on people with knee osteoarthritis. J Rehabil Med. 2004;36:220–5.
    1. Kumar D, Rudolph K, Manal K. EMG driven modeling approach to muscle force and joint load estimations: Case study in knee osteoarthritis. J Orthop Res. 2012;30:377–83.
    1. Chau T. A review of analytical techniques for gait data. Part 1: Fuzzy, statistical and fractal methods. Gait Posture. 2001;13:49–66.
    1. Kozanoglu E, Basaran S, Guzel R, Uysal F. Short term efficacy of ibuprofen phonophoresis versus continuous ultrasound therapy in knee osteoarthritis. Swiss Med Wkly. 2003;133:333–8.
    1. Pinals RS. Pharmacologic treatment of osteoarthritis. Clin Ther. 1992;14:336–46.
    1. Huang MH, Lin YS, Lee CL, Yang RC. Use of ultrasound to increase effectiveness of isokinetic exercise for knee osteoarthritis. Arch Phys Med Rehabil. 2005;86:1545–51.
    1. Kane RL, Saleh KJ, Wilt TJ, Bershadsky B. The functional outcomes of total knee arthroplasty. J Bone Joint Surg Am. 2005;87:1719–24.
    1. Scharf HP, Mansmann U, Streitberger K, Witte S, Kramer J, Maier C, et al. Acupuncture and knee osteoarthritis: A three-armed randomized trial. Ann Intern Med. 2006;145:12–20.
    1. Patsika G, Kellis E, Amirdis IG. Neuromuscular efficiency during sit to stand movement in women with knee osteoarthritis. J Electromyogr Kinesiol. 2011;21:689–94.
    1. Klaiman MD, Shrader JA, Danoff JV, Hicks JE, Pesce WJ, Ferland J. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc. 1998;30:1349–55.
    1. Fitzgerald GK, Childs JD, Ridge TM, Irrgang JJ. Agility and perturbation training for a physically active individual with knee osteoarthritis. Phys Ther. 2002;82:372–82.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner