NONOPERATIVE TREATMENT FOR OSTEOARTHRITIS

One of the most common problems that we have been seeing in our clinic are patients that have developed a stiff, arthritic knee; many seeing us for a second opinion. Often times, patients have seen another physician; either primary care, orthopedist, or orthopedic physician assistants and the patient may have been given a diagnosis of arthritis but did not fully understand the diagnosis.

NOT ALL PATELLAR DISLOCATIONS ARE THE SAME

A clear understanding of the anatomy and mechanics of the patellofemoral joint is critical when treating a patient that presents with a possible patellar dislocation. The alignment of the patellae should be evaluated to understand where the patellae sit in relation to the trochlea medially and laterally, as well as looking at the height of the patellae, proximal to distal. Physical exam should include assessing for a “J” sign, the patella height and patella tilt and comparing to the opposite knee.

USING A CPM MACHINE: DOES IT MATTER FOLLOWING KNEE SURGERY?

The use of a continuous passive motion (CPM) machine was initiated around 1982 after total knee replacements (TKA) to promote healing to the tissues, but other benefits found from CPM included increased ROM, decrease pain and the need for analgesics, and decreased rate of deep vein thrombosis (DVT). [6, 12, 21, 22] Ritter et al [20] however, found that the use of the CPM lead to a weaker leg, flexion tightness and extension lag along with increased cost with its use.