Osteoarthritis, commonly known as wear-and-tear arthritis, is a condition in which the natural cushioning between joints -- cartilage -- wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, decreased ability to move and, sometimes, the formation of bone spurs.

Osteoarthritis in India?

• In India, about 5-6% of the population has joint or related diseases. Among these, osteoarthritis is the most common.

•Demographic analysis revealed:

* Most affected were females(63.1%).

* Maximum patients were in the age group of 40-60 years(59.5%).

* Most of the patients had osteoarthritis of the back (50%) followed by knee (45.23%) and hips (14.3%).

Osteoarthritis: Risk Factors/Causes

• Age

• Heredity - People born with defective cartilage or abnormalities in their joints which lead to OA

• Obesity - Excess weight has been found to be a risk factor in Knee OA

• Trauma - Injury to a joint (e.g. Fracture)

• Physical inactivity

• Overuse of joints (e.g. Athletes)

• Misalignment

Clinical Approach to Knee Pain


• SOCRATES pain questions

• Inflammatory sx e.g. fever, hot joint

• History of trauma or surgery

• Instability

• Functional loss

• Prior treatment

Physical Exam

• Vitals, BMI

• Palpation: isolate tenderness, effusion, crepitus

• ROM: measure degree of flexion

• Stability: ligaments, menisci

• Alignment: genu varus or valgus

• Function: gait, duck waddle

Diagnosing OA of the Knee: Identification Through Imaging

• Kellgren-Lawrence radiographic criteria for assessment

• Order weight-bearing X-rays to reveal different views

* Reveals compression of the knee

* Reveals joint space narrowing

* Provides a clear frontal view to help rule out patellofemoral syndrome

Treatment Goals in OA of the Knee

Primary Goals

• Relieve Pain

• Improve muscle strength, conditioning

• Preserve independence, mobility, quality of life

• Minimize complications of therapy

Key principles: EULAR guidelines

• Treatment should be tailored to the patient

• The relationship between the healthcare team and the patient should be a two-way process

• Using tools can help to assess the patient’s pain and disability

• Patient education has a significant impact on pain management

• Treatment should be a combination of non-pharmacological and pharmacological measures