OA Knee Facts and Solutions
Osteoarthritis is a chronic condition of the joint, which involves some changes to the cartilage, ligaments, underlying bone and muscles. It can lead to people experiencing pain. Osteoarthritis was once thought to be an inevitable part of ageing. However it’s now understood that this is not the case, and activity is good for the joint.
Osteoarthritis does not always progress or worsen, so most people can manage on their own with only periodic visits to their healthcare professional. Participating in activities such as walking and exercise will not cause more damage and is generally safe and encouraged. It is possible for symptoms to improve using simple self-management strategies.
It is normal for a person with osteoarthritis to go through cycles where pain intensity goes up and down. This does not necessarily mean that the arthritis is getting worse, or that the self-management strategies are not working.
The following pages provide you with General Information to assist you manage your knee osteoarthritis.
Assessment for people identified as high risk
History + Diagnostic Criteria
Physiotherapists your overall medical history, history specific to knee osteoarthritis and any additional musculoskeletal impairments or injuries.
Clinical diagnostic criteria for knee osteoarthritis are reviewed and any possible red flags or differential diagnoses are considered.
Royal Australian College of General Practitioners Guidelines
Physical measures:
Physiotherapists routinely assess people with knee osteoarthritis. We test:
- Muscle strength and range of motion
- Patellofemoral involvement in symptoms
- Instability
- Proximal and distal joint impairments
We also use:
Quality of movement during tasks (gait, squats, mobility)
Use of assistive aids
Performance on standardized tests:
I use the Knee injury and Osteoarthritis Outcome Score (KOOS) Questionnaire
Imaging - Its role in management of knee osteoarthritis
Xray
Current guidelines suggest that knee osteoarthritis can be diagnosed based on clinical assessment only. Xray should only be considered for patients presenting with an atypical presentation, trauma, or other red flags. For patients for whom surgery is appropriate, an Xray will be required at that point in time.
Patients may often present to primary care with preconceived ideas about the necessity for an Xray. Healthcare professionals should be well-versed in current guidelines and ready to deliver education to patients pointing out that Xray is not required and not recommended in most cases.
It is important to remind patients that what is seen on imaging often does not correlate with their symptoms, and that having X-Rays taken generally does not change the plan of care.
MRI
When discussing and answering questions about MRI with patients, primary care clinicians should consult current guidelines. Australian Clinical Care Guidelines outline that an MRI should only be considered in cases where a serious pathology is suspected that can not be detected by XRay. It should be noted that degenerative meniscal tears are common in osteoarthritic knees of people with and without symptoms. Their detection on MRI provides limited additional useful information.
