Recommendations for Active Patients with OA of the Knee

Surgical and non-surgical interventions are allowing young men and women with osteoarthritis of the knee to return to demanding sports and remain active, according to a review published in the Journal of the American Academy of Orthopaedic Surgeons.

"The number of patients between the ages of 40 and 60 who are experiencing knee arthritis is growing, and unlike most older patients, this patient population presents a unique set of treatment challenges," said lead author Brian Feeley, M.D., assistant professor of orthopaedic surgery, University of California, San Francisco, in a press release. "Understanding available options and tailoring treatments to each patient's needs and desires is the key to successful outcomes."

The study was designed to evaluate treatments for young patients and to determine the most appropriate form for patients to continue active sport lifestyles. With younger patients there is a higher desire to participate in more flexible treatment programs that would allow them to remain active.

"There is an increasing trend in the United States of people who want to stay active in sports and recreational activities after the age of 40. These patients are not content with being told to stop what they love doing," said Dr. Feeley, in a press release. "As a result, orthopaedic surgeons and other physicians need to come up with different treatment strategies including non-operative treatments or even cartilage restoration procedures, to address pain and functionality, and to help keep patients as active as possible."

Non-operative management, including bracing, viscosupplementaion, activity modification, or anti-inflammatory medication may be used initially and if improvement does not take place then surgery may be an option.

"In a vast majority of cases, the onset of arthritis is a slow, degenerative process and therefore there is rarely a need to rush to surgery," he said, in a press release. "Depending on the symptoms and activity level, many patients can be managed well with non-operative treatment strategies, whereas others truly benefit from surgical procedures. For each patient, it is important to tailor treatment to their symptoms and activity level, and to look for a healthcare provider who is willing to work with them over time to keep their knee as healthy as possible."

Dr. Feeley recommends this approach:

- Take control of your situation-understand the disease process and learn about different treatment options.

- Work with your physician to come up with both short-term and long-term courses of treatment to help manage your symptoms early while maintaining the health of your knee and body for as long as possible.

- Be flexible with your activities and do not put the exact same stresses on the knee everyday. In some cases, mild activity modification such as switching to more biking or swimming and less running may make a huge difference in the number and severity of symptoms. Trying new activities also can help keep morale high.

- Don't be afraid to ask questions of your physician. Look for a doctor who can help you understand the advantages and disadvantages of each treatment option, and who is willing to work with you to tailor a treatment strategy to your individual needs.