Academy of Orthopaedic Physical Therapy

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22.2 Osteoarthritis: Linking Basic Science to Intervention
Table of Contents

ADVANCES IN PREVENTION AND DIAGNOSIS OF OSTEOARTHRITIS

Abstract:

CONTENT: Osteoarthritis is a challenging condition to treat by both conservative and surgical methods. This monograph provides insight on how they manage patients who desire to improve their function and reduce the effects of this progressive disease. The authors first provide the reader with background information on the epidemiology, pathogenesis, and risk factors of osteoarthritis. The definition of osteoarthritis is discussed in the context of pathology, radiographic, and clinical manifestations. Specific factors highlight the prevalence and the role of obesity, occupation, sport, and physical activity. The diagnostic and examination process are then discussed. The importance of obtaining a detailed history and conducting a complete physical examination is promoted as the first step in diagnosing osteoarthritis. Test and measures and the role of imaging techniques are contrasted and the authors detail considerations for the knee, hip, shoulder, spine, and ankle. The section on differential diagnosis will assist in distinguishing osteoarthritis from other diseases such as rheumatoid arthritis, gout, ankylosing spondylitis, Lyme disease, and psoriatic arthritis. CASE ANALYSES: Two case studies conclude the monograph. The first is a 68-year-old female with right knee pain. The second is a 38-year-old male with the chief complaint of diffuse back pain and stiffness that culminates in a diagnosis of ankylosing spondylitis. The authors document the decision making process for each case.

Keywords:​

arthritis, rehabilitation

References:

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CONSERVATIVE MANAGEMENT OF OSTEOARTHRITIS

Abstract:

CONTENT: The staff from the Hospital for Special Surgery in New York has collaborated on sharing their insight on management of osteoarthritis. The authors first address pharmacological and nonpharmacological management approaches to conservative treatment for the patient with osteoarthritis. They then proceed to describe the importance of patient education in the successful management of the patient with osteoarthritis as well as the role of nutrition and weight management in the conservative treatment of osteoarthritis. A section on assistive devices, bracing, and orthotics for osteoarthritis of the hip, knee, and foot and ankle is also included. The role of complementary medicine follows with discussion regarding massage therapy, yoga mind-body therapies, Tai Chi, and acupuncture, as well as herbal remedies and nutritional supplements. Functional outcome measurement is then reviewed. The reader will gain perspective on the many different approaches and multidisciplinary aspects clinicians should be aware of when caring for patients who must manage osteoarthritis. CASE ANALYSES: Two case studies conclude the monograph. The first case is a 68-year-old female with a diagnosis of right knee osteoarthritis who was referred to physical therapy for range of motion and strengthening. The second case is a 72-year-old male with a diagnosis of left hip osteoarthritis presented for physical therapy for strengthening and gait training.

Keywords:​

arthritis, knee, hip

References:

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SURGICAL MANAGEMENT OF OSTEOARTHRITIS

Abstract:

CONTENT: Surgical intervention for osteoarthritis represents a viable option for patients when adequate pain relief and restoration of function are not achieved by pharmacological and other nonsurgical procedures. Therapists will become familiar with not only the surgical procedures but also factors affecting outcomes and rehabilitation success. In the monograph, the authors first describe the role of total joint arthroplasty in osteoarthritis of the hip, knee, ankle, and shoulder joints. The role of arthroscopy techniques for each of these joint regions is then also discussed. Basic principles governing acute, early, and long-term rehabilitation for arthroplasty and arthroscopy procedures are also detailed. The authors then provide an overview of the degenerative disease process of the spine and the indications for surgical intervention. Common complications when developing rehabilitation treatment plans following surgical intervention for osteoarthritis of the hip, knee, ankle, shoulder, and spine are described. Surgical realignment procedures for knee osteoarthritis are specifically highlighted. CASE ANALYSES: Two case studies conclude the monograph. The first describes a 68-year-old female with a diagnosis of right knee osteoarthritis who has undergone a right total knee arthroplasty and enters rehabilitation. The second case describes a 75-year-old male with a history of left shoulder osteoarthritis referred for physical therapy following a total shoulder arthroplasty.

Keywords:​

arthritis, rehabilitation, arthroplasty

References:

Click here.

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