Osteoarthritis management

A short presentation on osteoarthritis of knee and its management in our clinical practice

1. Dr. A.MOHAN KRISHNA


M.S.ORTHO, MCh ORTH(U.K)
Consultant Orthopaedic surgeon ,
Trauma, Arthroscopy,
Arthroplasty
Surgeon
Apollo hospitals, Hyderabad
Consultant Orthopaedic Surgeon at
%%% A"rwMm&ApwmM r"
%%% wCM•uw#'rmu •:$ r"
%%% $rmCpMm'rmup •m r"
www.drmohankrishna.com
www.healthyjointclub.com
www.bonesandjointsclinic.com

2. OA is a disease of joints that affects all of the weight-bearing
components of the joint:
•Articular cartilage
•Menisci
•bone

4. Wearing of cartilage
lining
Exposure of
underlying bone
Swelling of joint lining
Bone at edges of joint
grows outwards
forming osteophytes

5. Articular cartilage is the main tissue affected OA results in:
•Increased tissue swelling
•Change in color
•Cartilage fibrillation
•Cartilage erosion down to subchondral bone

11. As the degeneration progresses

12. 1.Analgesics:
- Tramadol + paracetomol Combination
- Plain paracetomol
as on need basis
2 . Local antiinflammatory gels 2 to 3 times application.
3. NSAID’s : reserved for acute exacerbations of pain for week to 10
days.
4.Weight reduction if one is heavy
5.Physiotherapy: exercises are taught to patient once or twice
Patient needs to do them regulary
- It strengthens the periarticular muscles around the knee
- Further helps to maintain the tone of the muscles

13. Treatment methods of stage I 1,2,3,4,5 and
1.Nutraceuticals :
a. Glucosamine 1500mg + chondrotin 1200mg in divided doses for a
period of 3 months
b. Dycerin 50mg twice a day ( warn about red urine/irritable bowel)
c. Collagen peptide II : 10gm per day given for a period of 2-3 months
3 to 4 months break and restart for the complaints

15. It is a viscosupplementation injection
that lubricates and cushions your joint.
Can provide
pain relief
upto 9
months

18. -Reserved for relief of pain from acute exacerbations of
arthritic pain.
-If patient with knee pain want to buy some time for surgery.
-In patients not fit for surgery

20. 1.Extraarticular steroid injection: many bursa around the knee joint
can get inflamed in OA knee and may mimic acute exacerbations.
- Local steroid shots will be helpful
2.Arthroscopic lavage:
- When there are mechanical symptoms like locking of knee,
feeling of foreign body sensation which is due
- Loose bodies
- Torn degenerative menisci
Arthroscopic wash out can give relief from these symptoms.

21. Osteoarthritis: articular cartilage thins
out and becomes irregular exposing the
underlying bone. Some times loose
pieces of worn out cartilage and
synovial tissue move inside the knee
joint producing locking and secondary
inflammation.
Joint wash using arthroscope to wash
out this debris can be done . This
procedure can reduce mechanical
symptoms like locking and also aids
pain relief.

22. Dr.A.MOHAN KRISHNA
M.S.Ortho., MCh Ortho(U.K).,
Consultant Orthopaedic Surgeon,
Apollo Hospitals,
Hyderabad.
Appointments: Secretary : 09441184590
08332936085
www.drmohankrishna.com
www.healthyjointclub.com
www.bonesandjointsclinic.com
Email: [email protected]