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OA knee guidance
Introduction
The knee joint has three compartments which can be affected – the patello-
femoral joint, between the knee cap and the femur (thigh – bone) and the
medial and lateral tibiofemoral joints, between the tibia and the femur.
Symptoms
• Pain – related to the activity and can persist for many hours.
• Stiffness – causing a reduced range of movement. However,
morning stiffness usually lasts less than 30 minutes.
• Gelling – the joint is resistant to active movement after a period of
inactivity, but the discomfort goes after a few minutes of movement.
• Instability – Severe osteoarthritis of the knee may exist in
conjunction with ligament injury, which would cause an unstable
joint, and damage to the menisci , which can cause instability, and
prevent the knee from fully locking out (straightening.) This can
cause the joint to give way, leading to problems with stairs, and
walking on uneven ground.
Signs –
• Pain,
• Tenderness,
• Swelling,
• Fluid in the joint (effusion),
• Crepitus (“crunching” sound on movement),
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CMG
Investigations
Blood tests are usually normal; X-rays show characteristic changes, such as
joint space narrowing, the presence of bony spurs (osteophytes) and
increased bone density at the margins of the joint.
Treatment
Long term results are good, the overall success rate is more
than 85% after 18 years, according to a study.
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CMG
Not all these factors need to be present to indicate severe disease. The most
important are the first three.
Functional Limitations
MILD CONDITION
The disabling effects, care and mobility requirements vary within this category
according to the stage of the disease.
Early stages
Disabling effects
Care
The person would normally be able to carry out self- care tasks
without help.
Specifically they would normally be able to sit, rise, bend and get in
and out of bed in the usual fashion.
Mobility
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CMG
Later stages
Disabling effects
Care
The person would normally be able to carry out self- care tasks
without help. Specifically they would normally be able to sit, rise,
bend and get in and out of bed, albeit with some discomfort.
Mobility
SEVERE CONDITION
Disabling effects
Continuous pain in the knee on the affected side, and this may wake
them at night:
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CMG
Stiffness would normally be severe; they will limp on walking. The knee
may give way due to instability. There may be swelling of the joint with
associated deformity, muscle wasting and gross restriction of
movement.
Care
Supervision
With knee instability, which occurs with severe disease, falls indoors may
be a factor, and the use of a stick may not be very helpful, in preventing
falls.
Mobility
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CMG
Progress
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