Osteoarthritis of the knee: review of risk factors and treatment programs with special reference to evidence-based research

ABSTRACT

Osteoarthritis is a widespread disease leading to physical disability affecting quality of life. It is primarily regarded as a cartilage disease but affect all tissues of a joint. Osteoarthritis can be regarded as an organ failure. Knee osteoarthritis is common in Kuwait, especially in women. The main symptoms are pain, stiffness and weakness affecting knee function. The diagnosis is made by history and clinical examination. A weight-bearing radiograph will fully establish the diagnosis. Many of the patients are also obese, diabetic, hypertensive or affected by other organ failures. The aim is to reduce knee pain and improve knee function which is also beneficial for the other diseases. Initially, we recommend self-management by information about knee osteoarthritis, daily exercise of any type which is pleasant for the individual like walking 10-30 minutes once or twice daily in order to induce light to moderate cartilage load. Further, regular muscle training to increase especially pelvis and lower leg strength and realistic programs to reduce weight is advised. Regular support by a primary care doctor, a physiotherapist or a coach is beneficial.The programisde manding, as it means a change of life-style. Different modalities of non-operative treatment are physiotherapy, pharmacological treatment by analgesics / NS AIDs / glucosamine and injection of steroids or hyaluronic acid. The effect of the pharmacological treatment programs vary. Often the outcome, by evidence based research, is low or at best moderate. If self-management and non-operative treatment fails and the symptoms are pronounced, surgery is an option. Knee prosthesis is the main alternative