A Review on the Management of Hip and Knee Osteoarthritis

Abstract

Arthritis is the most common chronic condition affecting patients over the age of 70. The prevalence of osteoarthritis increases with age, and with an aging population, the effect of this disease will represent an ever-increasing burden on health care. The knee is the most common joint affected in osteoarthritis, with up to 41% of limb arthritis being located in the knee, compared to 30% in hands and 19% in hips. We review the current concepts with regard to the disease process and risk factors for developing hip and knee osteoarthritis. We then explore the nonsurgical management of osteoarthritis as well as the operative management of hip and knee arthritis. We discuss the indications for surgical treatment of hip and knee arthritis, looking in particular at the controversies affecting young and obese patients in both hip and knee replacements. Patient and implant related outcomes along with survivorships are addressed as well as the experiences and controversies described in national joint registries.

Osteoarthritis: From complications to cure

“…They must perform light exercise, light as well as water exercise, on daily basis or they can consult a therapist (physical or occupational) to help them perform joint motions, massages. Moreover, patient can also use assistive devices to help them move such as grab rails, knee braces; appropriate foot ware should be used [50,51]. For obese patients, it is recommended to lose weight as it helps in improving physical performance [40].…”

“…They should be motivated by their relatives and friends as it has shown to help to improve OA pain ( Figure 2) [50].…”

Emerging Potential of Cell Based Therapies for Articular Cartilage Repair and Regeneration

“…14,19 In recent years the number and cost of TKR has increased dramatically between 2001 and 2012 from 305,000 to 610,000 procedures and average cost from $25,500 to $52,000 (AHRQ report 2014). Further, revision rates of primary TKR are 2.…”

“…8,12,13 Osteoarthritis affects about 237 million of the population, of which an estimated 9 million people alone in United States suffer from symptomatic knee osteoarthritis and it is predicted that an additional 19 million people will be affected by arthritis by 2020. [14][15][16][17] The incidence of chondral defects is frequent with sporting injuries, and in elderly patients specifically 10% of population over the age of 55 years have troublesome knee pain, and of those, 25% are severely disabled. 18 Depending on disease severity, management ranges from conservative treatment to surgical intervention, including total knee replacement.…”

“…18 Depending on disease severity, management ranges from conservative treatment to surgical intervention, including total knee replacement. 14,19 In recent years the number and cost of TKR has increased dramatically between 2001 and 2012 from 305,000 to 610,000 procedures and average cost from $25,500 to $52,000 (AHRQ report 2014). Further, revision rates of primary TKR are 2.5 times higher in patients under 65 years of age.…”