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Health & Exercise Forum

Knee Arthritis in Athletes: Part II of II

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Sep 21, 2009

Dr. Paul MackareyLast week I attempted to answer an email from Don Loftus, a teacher a Scranton Prep and former athlete who suffers from arthritis in his knees. An overview of the symptoms and causes of osteoarthritis in athletes was discussed based on a recent long-term study of thousands of Division I college athletes. The study discovered that the athletes had significant differences in lifestyle due to arthritic pain when compared with the general population. This study found that these athletes experienced more pain in daily activities and required modification in lifestyle, often rendering them less active at an earlier age, than their contemporaries who did not participate in Division I college athletics. This week will discuss the treatment options available to former athletes and others for the management of knee arthritis.

Conservative Treatment

In the early stages your treatment will be a conservative, nonsurgical approach, which may include; anti-inflammatory medication, orthopedic physical therapy, exercise, activity modifications, supplements, bracing, etc. You and your family physician, orthopedic surgeon or rheumatologist will decide which choices are best.

Anti-inflammatory Medications: such as aspirin, acetaminophen or ibuprofen to reduce pain and swelling in the joint.
Topical Agents: pain relievers in cream or gel form containing wintergreen oil or camphor can provide temporary relief. Also, a gel form of the NSAID VoltarinR is now available for use with a physician’s prescription. It is applied 3-4 times per day and patients report good temporary relief.
Orthopedic Physical Therapy: such as heat, cold, ultrasound, electrical stimulation, joint mobilization, range of motion exercises, strengthening exercises, partial weight bearing aerobic exercises.
Activity Modifications: such as eat well and lose weight, doubles tennis instead of singles, sitting or lying leg exercises instead of standing, walk instead of run, soft bed treadmill instead of hard surfaces, avoid squatting, kneeling, and bending.
Supportive Devices: such as knee sleeves, light bracing, use good running shoes for exercise and walking, use good quality supportive shoes for work/dress.

Conservative But More Aggressive Treatment

Corticosteroids: stronger anti-inflammatory medications than those above which are injected directly into the knee joint.
Viscosupplementation: a type of synthetic fluid, injected into the knee joint and designed to imitate the joint fluid of the knee to promoted healing and mobility.
Glucosamine and Chondroitin: supplements taken orally to control the pain of osteoarthritis and promote healing.

Surgical Treatment

When conservative measures no longer succeed in controlling pain and deformity, improving strength and function then more aggressive treatment may be necessary.

Arthroscopic Surgery: uses a scope to clean and repair damaged tissues inside the knee joint.
Osteotomy Surgery: cuts one of the knee bones to realign the joint for less wear and tear
Total or Partial Knee Replacement: replaces severely damage joint surfaces with metal or plastic.
Cartilage Grafting: is performed on rare occasions, usually at teaching facilities, when young healthy cartilage with minor damage needs to be repaired.

SOURCES: Rothman Institute, Philadelphia, PA and American Academy of Orthopaedic Surgeons

Visit your doctor regularly and listen to your body. And, if you missed it, read Part I of II on Knee Arthritis in Athletes