Clinical Management in Early OA

Adv Exp Med Biol. 2018:1059:111-135. doi: 10.1007/978-3-319-76735-2_5.

Abstract

Knee osteoarthritis affects an important percentage of the population throughout their life. Several factors seem to be related to the development of knee osteoarthritis including genetic predisposition, gender, age, meniscal deficiency, lower limb malalignments, joint instability, cartilage defects, and increasing sports participation. The latter has contributed to a higher prevalence of early onset of knee osteoarthritis at younger ages with this active population demanding more consistent and durable outcomes. The diagnosis is complex and the common signs and symptoms are often cloaked at these early stages. Classification systems have been developed and are based on the presence of knee pain and radiographic findings coupled with magnetic resonance or arthroscopic evidence of early joint degeneration. Nonsurgical treatment is often the first-line option and is mainly based on daily life adaptations, weight loss, and exercise, with pharmacological agents having only a symptomatic role. Surgical treatment shows positive results in relieving the joint symptomatology, increasing the knee function and delaying the development to further degenerative stages. Biologic therapies are an emerging field showing early promising results; however, further high-level research is required.

Keywords: Cartilage; Early osteoarthritis; Knee.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Age of Onset
  • Analgesics / therapeutic use
  • Arthroplasty, Replacement, Knee
  • Arthroscopy / methods
  • Athletic Injuries / complications
  • Combined Modality Therapy
  • Conservative Treatment
  • Disease Management
  • Early Diagnosis
  • Humans
  • Hyaluronic Acid / analogs & derivatives
  • Hyaluronic Acid / therapeutic use
  • Injections, Intra-Articular
  • Mesenchymal Stem Cell Transplantation
  • Osteoarthritis / epidemiology
  • Osteoarthritis / genetics
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / etiology
  • Osteoarthritis, Knee / surgery
  • Osteoarthritis, Knee / therapy*
  • Platelet-Rich Plasma
  • Postoperative Complications / etiology
  • Tibial Meniscus Injuries / surgery

Substances

  • Adrenal Cortex Hormones
  • Analgesics
  • hylan
  • Hyaluronic Acid