Knee osteoarthritis

Presented By: Rida Fatima

Introduction
 Osteoarthritis, commonly known as wear-and-tear arthritis, is a
condition in which the natural cushioning between joints wears away.
When this happens, the bones of the joints rub more closely against
one another with less of the shock-absorbing benefits of cartilage.
The rubbing results in pain, swelling, stiffness, decreased ability to
move and, sometimes, the formation of bone spurs.
 Who Gets Osteoarthritis of the Knee?
 Osteoarthritis is the most common type of arthritis. it can occur even
in young people, the chance of developing osteoarthritis rises after
age 45. Women are more likely to have osteoarthritis than men.
 Causes
 Age. The ability of cartilage to heal decreases as a person gets older.
 Weight
 Heredity
 Gender. Women ages 55 and older are more likely than men to develop osteoarthritis of
the knee.
 Repetitive stress injuries such as kneeling, squatting, or lifting heavy weights (55 pounds
or more), are more likely to develop osteoarthritis of the knee.
 Obesity
 Joint hypermobility or instability
 Peripheral neuropathy
 Injury to the joint
Symptoms
 pain that increases when you are active, but gets a little better with rest
 swelling
 feeling of warmth in the joint
 stiffness in the knee, especially in the morning
 decrease in mobility of the knee, making it difficult to get in and out of chairs or cars, use the stairs, or walk
 creaking, crackly sound that is heard when the knee moves
Treatment
 The primary goals of treating osteoarthritis of the knee are to relieve the pain and return
mobility.

 Weight loss. Losing even a small amount of weight, if needed, can significantly decrease knee
pain from osteoarthritis.
 Exercise. Strengthening the muscles around the knee makes the joint more stable and decreases
pain. Stretching exercises help keep the knee joint mobile and flexible.
 Pain relievers and anti-inflammatory drugs. acetaminophen , ibuprofen , or naproxen sodium.
 Injections of corticosteroids or hyaluronic acid into the knee. Steroids are powerful anti-
inflammatory drugs.
 Physical and occupational therapy
 Surgery
Hydrotherapy
Exercises
Trigger finger
Introduction
 Trigger finger is thought to be caused by inflammation and subsequent
narrowing of the pulley of the affected digit, typically the third or fourth. A
difference in size between the flexor tendon sheath and the flexor tendons
may lead to abnormalities of the gliding mechanism by causing actual
abrasion between the two surfaces, resulting in the development of
progressive inflammation between the tendons and the sheath.
 Commonly, trigger finger is referred to as “Stenosing tenosynovitis.
Epidemiology/Etiology
 Trigger finger can occur in anyone, but, statistically women in their fifth to
sixth decade of life are more likely to develop the condition than men .The
chance of developing trigger finger is 2-3%, but in the diabetic population, it
rises to 10%. The reason is not of glycemic nature, but rather is the actual
cause of the duration and progression of the disease. Trigger finger can
concomitantly occur in patients with:
 Carpal tunnel syndrome
 DeQuervain's disease
 Hypothyroidism
 Rheumatoid arthritis
 Renal disease
 Amyloidosis
Symptoms
 Initially, patients may present with
painless clicking with movement of the digit
that can progress to painful catching or
popping, typically at the MCP or PIP joints.
 stiffness and swelling (especially in the
morning),
 loss of full flexion/extension,
 palpable painful nodule,
 and/or finger locked into a flexed position
 slight thickening at the base of the digit
and pain that may radiate to the palm or to
the distal aspect of the digit.
Examination
 History:
1. Recent trauma
2. Job related repetitive movements
3. Locking or snapping while flexing or extending the affected digit
4. Radiating pain to the palm or digits
 PMH:
1. Diabetic individuals are 4x more likely to develop trigger finger
2. Disorders causing connective tissue changes such as RA and Gout
Observation:
3. A digit locked in flexion
4. Bony proliferative changes in the PIP joint
 ROM:
1. Loss of motion, particularly in extension
Treatment
 Patient Education
1. Education should be given on:
2. Rest
3. Modifications of activities
4. Splinting
5. Modalities
6. Posture
 Splinting
 Two major types of splinting used are:
1. Splinting at the DIP joint.
2. Splinting at the MCP joint with 15 degrees of flexion.
 Modalities
1. heat/ice,
2. ultrasound
3. electric stimulation
4. stretching and joint motion (active and passive)
5. heat can help by providing increased blood flow and
extensibility to the tendon. Following heat with
stretching can provide more extensibility with plastic
deformation. Joint movement and mobilisations
increase joint and soft tissue mobility via a slow,
passive therapeutic traction and translational gliding
 Finger extensor stretch
 Finger abduction
 Finger spread
 Palm presses
 Object pickups
 Paper or towel grasp
 ‘O’ exercise
 Finger stretches