Anthony M. DiGioia III, MD

In response to all of the information that has been released about various topics concerning both hip and knee replacements, we have decided to post an informational blog, which will allow patients to obtain both current and accurate information. We know how confusing making the decision to have knee or hip surgery can be, and we want to make this process as easy as possible by providing you with an unbiased account of the latest trends in orthopaedic surgery. Please visit our websites at: www.orthodoctor.com and www.amd3.org

Anthony M. DiGioia III, MD: March 2009 Archives

American Academy of Orthopaedic Surgeons (AAOS) Issues New Practice Guidelines for Treatment of Osteoarthritis of the Knee

By Anthony M. DiGioia III, MD on March 16, 2009 2:23 PM | Permalink | Comments (5)

Osteoarthritis of the Knee

Leading cause of physical disability
33 million Americans affected
Most common in aged 65 or older
Affects activities of daily living like climbing stairs or walking

Symptoms include:

Pain
Joint stiffness
Swelling in knee

Factors that increase a persons risk of developing osteoarthritis:

Heredity
Weight
Age
Gender
Injuries or trauma to the knee
Poor posture or bone alignment
Lack of aerobic exercise and muscle weakness

The AAOS Guidelines and Evidence Report Recommendations:

AAOS recommends:

Patients should be encouraged to begin or increase their participation in low-impact aerobic fitness.
Patients who are overweight should lose a minimum of 5% of their body weight
Overweight is a body mass index (BMI) of greater than 25

you can calculate your own body mass index by multiplying your weight in pounds by 703 divided by your height in inches
Weight loss has the highest potential to slow the progression of osteoarthritis

AAOS recommends for pain control:

Tylenol
NSAIDs (common include ibuprofen and naprosyn)
Steroid injections into the knee like depomedrol or cortisone

AAOS recommends against:

Glucosamine and or chondroitin sulfate or hydrochloride
Drawing fluid from the knee with a needle
Custom made foot orthotics or foot supports
Performing a knee arthroscopy (knee scope) as a clean out procedure for arthritis when no other problems are present like loose bodies or cartilage tears

"The current science shows us that just washing out the joint does not decrease the patient's osteoarthritis symptoms and can expose the patient to additional risk," said John Richmond, MD, chair of the AAOS work group.

AAOS does not recommend for or against:

Bracing
Acupuncture
Hyaluronic acid injections like synvisc or hyalgen

"AAOS Issues New Clinical Practice Guidelines for Osteoarthritis of the

Knee." American Academy of Orthopaedic Surgeons. 11 DEC. 2008 http://www.aaos.org/home.asp.

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