Osteoarthritis pp 155-169 | Cite as

Osteoarthritis: Joint Conservation Strategies

Chapter

Key Points

  • Patients with symptomatic osteoarthritis (OA) of the knee should participate in self-management programs, strengthening, low-impact aerobic exercises, and neuromuscular education.

  • Patients with body mass index of equal to or greater than 25 should be encouraged by their physician to lose weight.

  • Aerobic activity of at least 150 min per week of moderate intensity or 75 min per week of vigorous intensity performed in episodes of at least 10 min spread over 7 days and muscle-strengthening activities of moderate or high intensity should be included on 2 or more days per week.

  • The evidence is inconclusive regarding the value of braces and orthotics for OA; cane or walking stick use was appropriate for knee-only OA.

  • Therapeutic ultrasound, acupuncture, and electrotherapeutic therapies are subject to disagreement regarding their use, but there are no clear recommendations for benefit.

  • From the evidence available, the AAOS clinical practice guideline cannot recommend performing knee arthroscopy and lavage or debridement procedures in patients with a primary diagnosis of symptomatic OA of the knee.

  • Patients with evidence of unstable meniscal tears had significantly improved pain and restored knee function when compared to treatment by physical therapy alone, but AAOS clinical practice guidelines published in 2013 were unable to recommend for or against arthroscopic partial meniscectomy in patients with OA.

  • The AAOS clinical practice guidelines provide a limited recommendation for the use of a valgus-producing proximal tibial osteotomy in patients with symptomatic medial compartment OA of the knee.

Keywords

Joint conservation Exercise Strength training Knee bracing Foot orthoses Ultrasound Acupuncture Electrotherapeutics Thermotherapy Arthroscopy Partial meniscectomy High tibial osteotomy 
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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Division of Orthopedic SurgeryUniversity of Toronto (University of Toronto Orthopaedic Sports Medicine)TorontoCanada
  2. 2.Division of Orthopedic SurgeryUniversity Health Network, UHN and Womens College Hospital, University of Toronto Orthopedic Sports Medicine ProgramTorontoCanada

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