treat pain is recommended to reduce other associated risks to taking medications. Knee OA will continue to be prevalent in our society. So it is impor- tant for the physical therapist to understand the etiology, diagnostic procedure, and treatment to manage these patients effectively. The two main goals in the treatment of patients with knee OA and post- operative TKA will always be to reduce pain and improve function in these individuals. Michael, J. W. P., Schluter-Brust, K. U., & Eysel, P. (2010) The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Ärzteblatt International, 107(9), 152–162. Moffet, H., Collet, J-P., Shapiro, S. H., Paradis, G., Marquis, F., & Roy, L. (2004). Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: A single-blind randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 85(4), 546–556. [PubMed: 15083429] Nielsen et al. (2017). Risk factors for joint replacement in knee osteoarthritis: A 15-year follow-up study. BMC Musculoskeletal Disorders, 18, 510. doi: 10.1186/s12891-017-1871-z Orozoco, L., et al. (2013). Treatment of knee osteoarthritis with autologous mesenchymal stem cells: A pilot study. Transplantation, 95, 1535–1541. Petterson, S. C., Mizner, R. L., Stevens, J. E., et al. (2009). Improved function from progressive strengthening interventions after total knee arthroplasty: A randomized clinical trial with an imbedded prospective cohort. Arthritis & Rheumatology, 61(2), 174–183. [PubMed: 19177542] Pozzi, F., Snyder-Mackler, L., & Zeni, J. (2013) Physical exercise after knee arthroplasty: A systematic review of controlled trials. The European Journal of Physical and Rehabilitation Medicine, 49(6), 877–892. Rand, S. E., Goerlich, C., Marchand, K., et al. (2007) The physical therapy prescription. American Family Physician, 76, 1661–1666. Silverwood, V., et al. (2015). Current evidence on risk factors for knee osteoarthritis in older adults: A systematic review and meta-analysis. Osteoarthritis and Cartilage, 23, 507–515. Skou, S., et al. (2015). A randomized, controlled trial of total knee replacement. New England Journal of Medicine, 373(17), 1597–1606.
important for them to undergo physical therapy interventions to restore strength and balance. Patients may participate in aquatic therapy to improve impairments and symptoms associated with knee OA or following a total knee arthroplasty, but the benefits of aquatic therapy do not seem to outweigh the importance of land-based functional intervention training. Restoring strength in these individuals can help to improve function in both nonopera- tive and postoperative patients. Pharmacological management of patients with knee OA and following surgery is important for a physical therapist to understand. But using other modalities to Artz, N., Elvers, K. T., Lowe, C. M., Sackley, C., Jepson, P., & Beswick, A. D. (2015). Effectiveness of physiotherapy exercise following total knee replacement: Systematic review and meta-analysis. BMC Musculoskeletal Disorders, 16(15), 1–21. Bhatia, D., Bejarano, T., & Novo, M. (2013). Current interventions in the management of knee osteoarthritis. Journal of Pharmacy and Bioallied Sciences, 5(1), 30–38. Cakir, S., Hepguler, S., Ozturk, C., Korkmaz, M., Isleten, B., & Atamaz, F. C. (2014). Efficacy of therapeutic ultrasound for the management of knee osteoarthritis: A randomized, controlled and double-blind study. American Journal of Physical Medicine & Rehabilitation, 93, 405–412. Cherry, D. K., Hing, E., Woodwell, D. A., & Rechtsteiner, E. A. (2008). National Ambulatory Medical Care Survey: 2006 summary. National Health Statistics Reports, 1–39. Department of Research and Scientific Affairs, American Academy of Orthopaedic (AAOS). (April 2014). Based on data from the National Health Interview Survey, 2012; U.S. Department of Health and Human Services; Centers for Disease Control and Prevention; National Center for Health Statistics. Fransen, M., McConnell, S., Harmer, A. R., et al. (2015) Exercise for osteoarthritis of the knee: A Cochrane systematic review. British Journal of Sports Medicine, 49, 1554–1557. Huang, M. H., Chen, C. H., Chen, T. W., Weng, M. C., Wang, W. T., & Wang, Y. L. (2000). The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity. Arthritis Care & Research, 13, 398–405. [Pub Med: 14635316] Hussain, S. M., Neilly, D. W., Baliga, S., Patil, S., & Meek, R. M. D. (2016) Knee osteoarthritis: A review of management options. Scottish Medical Journal, 61(1), 7–16. References
Jakobsen, T. L., Kehlet, H., Husted, H., Petersen, J., & Bandholm, T. (2014). Early progressive strength training to enhance recovery after fast-track total knee arthroplasty. A randomized controlled trial. Arthritis Care & Research, 66(12), 1856–1866. Law, P. P., & Cheing, G. L. (2004). Optimal stimulation frequency of transcutaneous electric nerve stimulation on people with knee osteoarthritis. Journal of Rehabilitation Medicine, 36, 220–225. Liao, C. D., Liou, T. H., Huang, Y. Y., & Huang, Y. C. (2013) Effects of balance training on functional outcome after total knee replacement in patients with knee osteoarthritis: A randomized controlled trial. Clinical Rehabilitation, 27(8), 697–709. Lonner, J. H. (2007). Patellofemoral arthroplasty. The Journal of the American Academy of Orthopaedic Surgeons, 15, 495. Mat, S., Tan, M. P., Kamaruzzaman, B., Ng, C. T. (2015). Physical therapies for improving balance and reducing fall risk in osteoarthritis of the knee: A systematic review. Age and Ageing, 44, 16–24. Wang, et al. (2014). Assessing the comparative effectiveness of tai chi versus physical therapy for knee osteoarthritis: Design and rationale for a randomized trial. BMC Complementary and Alternative Medicine, 14, 333. Retrieved from http://www.biomedcentral.com/1472-6882/14/333 Wang, et al. (2012). Role of tai chi in the treatment of rheumatologic diseases. Current Rheumatology Reports, 14, 598–603. Weinstein, et al. (2013). Estimating the burden of total knee replacement in the United States. The Journal of Bone & Joint Surgery AM, 95, 385–392. Westby, M., Brittain, A., & Backman, C. (2014). Expert consensus on best practices for post-acute rehabilitation after total hip and knee arthroplasty. Arthritis Care & Research, 66(3), 411–423. White, D. K., Neogi, T., Nguyen, U. D. T., Niu, J., & Zhang, Y. (2016). Trajectories of functional decline in knee osteoarthritis: The osteoarthritis initiative. Rheumatology, 55, 801–808. KNEE OSTEOARTHRITIS: OVERVIEW, NONSURGICAL/SURGICAL MANAGEMENT AND PHYSICAL THERAPY TREATMENT Final Examination Questions Select the best answer for each question and mark your answers on the Final Examination Answer Sheet found on page 203, or complete your test online at EliteLearning.com/Book 108. Knee OA is strongly associated with:
113. Which type of exercise should be avoided when working with the elderly population because of an increase in heart rate and blood pressure? a. Isometric. b. Isotonic. c. Cardiovascular. d. Concentric. 114. A patient who has unicompartmental arthritis may undergo a unicompartmental knee arthroplasty if he has ______. a. An unstable joint. 115. A single-leg stance duration of less than _____ seconds represents a defect in balance and is associated with a risk of injurious fall. a. 10. b. 30. c. 20. d. 5. 116. The two main goals of treating patients with knee osteoarthritis and following a total knee arthroplasty are: a. Reduce pain and improve function. b. Reduce pain and improve stability. c. Reduce swelling and improve function. d. Reduce swelling and improve strength. 117. The quadriceps muscle acts to ________ at the knee and ________ the thigh at the hip. a. Flex the leg, extend. b. Contract, relax at. c. Extend the leg, flex. d. Bend the leg, straighten. Course Code: PTCA02KN b. Fixed flexion less than 10 degrees. c. Minimal medial compartment disease. d. Uncorrectable valgus deformity.
a. Aging and obesity. b. Injury and aging. c. Obesity and injury. d. Trauma and aging. 109. The pain associated with knee OA is often described as: a. Sharp. b. Intermittent. c. Dull. d. Throbbing. 110. What type of imaging is typically used for primary diagnosis of knee OA? a. MRI. b. X ray. c. CT scan. d. Bone density. 111. What stage of arthritis is described as having moderate joint space narrowing and moderate subchondral sclerosis? a. Stage 1. b. Stage 2. c. Stage 3. d. Stage 4. 112. The force across the knee joint is __________ times a person’s body weight. a. 10.
b. 5 to 6. c. 3 to 6. d. 2.
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