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Musculoskeletal1697 papers

Arthritis of knee

Last edited: 4/16/2026

Overview

Arthritis of the knee encompasses various degenerative conditions affecting the knee joint, leading to pain, stiffness, and reduced function. Common types include osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis, often necessitating a multifaceted management approach.

Diagnosis

  • Clinical Presentation: Pain, stiffness, swelling, and decreased range of motion 65.
  • Imaging Studies: X-rays to assess joint space narrowing, osteophytes, and bone erosions; MRI for detailed soft tissue evaluation 3363.
  • Laboratory Tests: Not typically required unless inflammatory arthritis is suspected (e.g., rheumatoid factor, ESR, CRP) 65.
  • Management

  • Non-Pharmacological: Physical therapy focusing on strengthening and flexibility exercises 6573.
  • Pharmacological:
  • - NSAIDs: For pain and inflammation (e.g., ibuprofen, naproxen) 65. - COX-2 Inhibitors: Alternative to NSAIDs for reduced gastrointestinal risk (e.g., celecoxib) 65. - Glucosamine and Chondroitin: Considered for symptomatic relief, though evidence varies 65.
  • Injections: Corticosteroids for short-term pain relief; hyaluronic acid for osteoarthritis 6573.
  • Surgical: Total knee arthroplasty for severe, end-stage arthritis 6573.
  • Special Populations

  • Pediatrics: Focus on conservative management; avoid early surgical intervention unless absolutely necessary 888.
  • Elderly: Consider comorbidities and functional status before surgery; physical therapy and assistive devices are crucial 6573.
  • Comorbidities: Tailor treatment plans considering coexisting conditions like cardiovascular disease or diabetes 65.
  • Key Recommendations

  • Initiate Physical Therapy Early: Focus on strengthening quadriceps and improving joint flexibility to enhance function and reduce pain (Evidence: Moderate 6573).
  • Consider Corticosteroid Injections: For patients with refractory pain, corticosteroid injections can provide significant short-term relief (Evidence: Moderate 65).
  • Evaluate Surgical Options: For severe, symptomatic osteoarthritis unresponsive to conservative measures, total knee arthroplasty should be considered (Evidence: Strong 65).
  • Monitor Comorbid Conditions: Tailor treatment plans to address coexisting medical conditions that may impact knee arthritis management (Evidence: Expert opinion 65).
  • References

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British journal of hospital medicine (London, England : 2005) 2024. link 6 Pace JL, Schlechter JA, Haus B, Huang R. Survey Results Concerning Current Trends in Meniscus Repair Indications and Preferences from Members of the Pediatric Research in Sports Medicine (PRiSM) Society. The journal of knee surgery 2024. link 7 Kunze KN, Haddad A, White AE, Cohn MR, LaPrade RF, Chahla J. The Top 50 Most Cited Publications in Meniscus Research. The journal of knee surgery 2023. link 8 Bolton S, Bailey MEA, Wei R, McConnell JS. Paediatric injuries around the knee: Soft tissue injuries. Injury 2022. link 9 Koëter S, Van Tienen TG, Rijk PC, Vincken PWJ, Segers MJM, Van Essen B et al.. Dutch Guideline on Knee Arthroscopy Part 2: non-meniscus intra-articular knee injury: a multidisciplinary review by the Dutch Orthopaedic Association. Acta orthopaedica 2021. link 10 Van Arkel ERA, Koëter S, Rijk PC, Van Tienen TG, Vincken PWJ, Segers MJM et al.. Dutch Guideline on Knee Arthroscopy Part 1, the meniscus: a multidisciplinary review by the Dutch Orthopaedic Association. Acta orthopaedica 2021. link 11 Stepan JG, Goodbody C, Kumar K, DelPizzo K, Fabricant P, Wendel P. Retrospective study of the effect of opioid prescribing guidelines on prescribing practices in pediatric orthopedic sports medicine patients having knee surgery: A single institution's experience. Journal of opioid management 2021. link 12 Xiao M, Donahue J, Safran MR, Sherman SL, Abrams GD. Administrative Databases Used for Sports Medicine Research Demonstrate Significant Differences in Underlying Patient Demographics and Resulting Surgical Trends. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2021. link 13 Kyhos J, Johnson D, Alvandi B, Terry M, Tjong V. Multi-ligament reconstructions as a risk factor for adverse outcomes in arthroscopic surgery. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2021. link 14 Davenport M, Oczypok MP. Knee and Leg Injuries. Emergency medicine clinics of North America 2020. link 15 Duethman NC, Martin RK, Krych AJ, Stuart MJ, Levy BA. Surgical Treatment of Combined ACL PCL Medial Side Injuries. Sports medicine and arthroscopy review 2020. link 16 Ajdaroski M, Tadakala R, Nichols L, Esquivel A. Validation of a Device to Measure Knee Joint Angles for a Dynamic Movement. Sensors (Basel, Switzerland) 2020. link 17 Beck JJ, West N, Shaw KG, Jackson N, Bowen RE. Delays in Obtaining Knee MRI in Pediatric Sports Medicine: Impact of Insurance Type. Journal of pediatric orthopedics 2020. link 18 Mellor X, Buczek MJ, Adams AJ, Lawrence JTR, Ganley TJ, Shah AS. Collection of Common Knee Patient-reported Outcome Instruments by Automated Mobile Phone Text Messaging in Pediatric Sports Medicine. Journal of pediatric orthopedics 2020. link 19 Lim TW, Choi YH, Kim JY, Choi JB, Lee SK, Youn EJ et al.. Efficacy of the bispectral index and Observer's Assessment of Alertness/Sedation Scale in monitoring sedation during spinal anesthesia: A randomized clinical trial. The Journal of international medical research 2020. link 20 Charles-Lozoya S, Treviño-Báez JD, Brizuela-Ventura JM, Rangel-Flores JM, Tamez-Montes JC, García-Hernández A. Work, sport activities and factors associated with medial meniscal tears in nonathletic subjects. Cirugia y cirujanos 2020. link 21 Beckett R, Le P, Rheinboldt M, Petraszko A. Avulsion fractures of the knee: a review of the pathophysiology, radiographic, and cross-sectional imaging features. Emergency radiology 2019. link 22 Grassbaugh JA, Turner EK. Editorial Commentary: Anatomy of the Anterolateral Ligament of the Knee-The Science of Looking for Bigfoot. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2019. link 23 Parisien RL, Trofa DP, Dashe J, Cronin PK, Curry EJ, Fu FH et al.. Statistical Fragility and the Role of P Values in the Sports Medicine Literature. The Journal of the American Academy of Orthopaedic Surgeons 2019. link 24 Richards JT, Dickens JF. Multiligamentous Knee Injuries in the Military Tactical Athlete. Sports medicine and arthroscopy review 2019. link 25 Aksu N, Akgonul B, Aksu T, Atansay V, Kara AN. Traumatic knee injury patterns in Anatolian folk dancers: a case series and literature review. International journal of occupational medicine and environmental health 2019. link 26 Kim SH, Kim DH, Shin S, Kim SJ, Kim TL, Choi YS. Effects of dexmedetomidine on inflammatory mediators after tourniquet-induced ischemia-reperfusion injury: a randomized, double-blinded, controlled study. Minerva anestesiologica 2019. link 27 Arundale AJH, Bizzini M, Giordano A, Hewett TE, Logerstedt DS, Mandelbaum B et al.. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention. The Journal of orthopaedic and sports physical therapy 2018. link 28 Judy RP, Shin JJ, McCrum C, Ayeni OR, Samuelsson K, Musahl V. Level of evidence and authorship trends of clinical studies in knee surgery, sports traumatology, arthroscopy, 1995-2015. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2018. link 29 Haijie L, Dasen L, Tao J, Yi Y, Xiaodong T, Wei G. Implant Survival and Complication Profiles of Endoprostheses for Treating Tumor Around the Knee in Adults: A Systematic Review of the Literature Over the Past 30 Years. The Journal of arthroplasty 2018. link 30 Fernandes LR, Ouanezar H, Saithna A, Sonnery-Cottet B. Combined ACL reconstruction and Segond fracture fixation fails to abolish anterolateral rotatory instability. BMJ case reports 2018. link 31 Robins RJ, Anderson MB, Zhang Y, Presson AP, Burks RT, Greis PE. Convergent Validity of the Patient-Reported Outcomes Measurement Information System's Physical Function Computerized Adaptive Test for the Knee and Shoulder Injury Sports Medicine Patient Population. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2017. link 32 Tsubosaka M, Matsushita T, Kuroda R, Matsumoto T, Kurosaka M. Pseudoaneurysm of the articular branch of the descending genicular artery following double-bundle anterior cruciate ligament reconstruction. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2017. link 33 . Exercise as effective as surgery for common knee injury. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2016. link 34 Lalam RK, Winn N, Cassar-Pullicino VN. Interventional articular and para-articular knee procedures. The British journal of radiology 2016. link 35 Lubowitz JH. Editorial Commentary: The Medial Side of the Knee Is Amenable to Repair. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association 2015. link 36 Sommerfeldt M, Bouliane M, Otto D, Rowe BH, Beaupre L. The use of early immobilization in the management of acute soft-tissue injuries of the knee: results of a survey of emergency physicians, sports medicine physicians and orthopedic surgeons. Canadian journal of surgery. Journal canadien de chirurgie 2015. link 37 Alaia MJ, Khatib O, Shah M, A Bosco J, M Jazrawi L, Strauss EJ. The utility of plain radiographs in the initial evaluation of knee pain amongst sports medicine patients. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA 2015. link 38 Hegedus EJ, McDonough S, Bleakley C, Cook CE, Baxter GD. Clinician-friendly lower extremity physical performance measures in athletes: a systematic review of measurement properties and correlation with injury, part 1. The tests for knee function including the hop tests. British journal of sports medicine 2015. link 39 Jarraya M, Guermazi A, Niu J, Duryea J, Lynch JA, Roemer FW. Multi-dimensional reliability assessment of fractal signature analysis in an outpatient sports medicine population. Annals of anatomy = Anatomischer Anzeiger : official organ of the Anatomische Gesellschaft 2015. link 40 Scillia AJ, Aune KT, Andrachuk JS, Cain EL, Dugas JR, Fleisig GS et al.. Return to play after chondroplasty of the knee in National Football League athletes. The American journal of sports medicine 2015. link 41 Salzler MJ, Lin A, Miller CD, Herold S, Irrgang JJ, Harner CD. Complications after arthroscopic knee surgery. The American journal of sports medicine 2014. link 42 Chen Z, Chakrabarty S, Levine RS, Aliyu MH, Ding T, Jackson LL. Work-related knee injuries treated in US emergency departments. Journal of occupational and environmental medicine 2013. link 43 Erquicia J, Gelber PE, Cardona-Muñoz JI, Pelfort X, Tey M, Monllau JC. There is no relation between mild malalignment and meniscal extrusion in trauma emergency patients. Injury 2012. link70183-9) 44 Wong OM, Cheung RT, Li RC. Isokinetic knee function in healthy subjects with and without Kinesio taping. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine 2012. link 45 Nagai T, Sell TC, Abt JP, Lephart SM. Reliability, precision, and gender differences in knee internal/external rotation proprioception measurements. 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    Original source

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