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Researcher come clinician at demands bangalore my terminal degree is forced to doctoral fellowship in physical therapy completed in 2018 so my end title of the topic is treatment of oed so this lecture going to cover overview of the oab clinical approach to the knee pain differential diagnosis diagnosis of knee osteoarthritis then what are all the treatment that is
Called management mainly for lifestyle modification medical surgical and physical therapy management that is going to discuss the second slide which described about some of the questions which we have to consider before discussing this lecture consider what type of physical therapy exercise and advice are appropriate how might you facilitate behavior changes how
Can you encourage non-going exercise and activities what advice can you give to a patient exercising in the presence of pain or comorbidity what information can you provide can you refer to any other medical services especially in medical management dietary services followed by rehabilitation care then some surgical intervention which is required or not decided
By whoever they are approaching including physician they have to refer to for further management the next overview the knee osteoarthritis most common new osteoarthritis is the most common cause of disability in adult especially if you cumber with male and female gender female is more prone to get affected this inflammatory disorder decreased work productivity
Frequency days highest medical expenses of all three disc condition symptomatic knee osteoarthritis more than 10 million indians who they are suffering this kind of osteoarthritis day to day life more than 11 percentage of person especially the age above 54 years they used to get osteoarthritis is more common arthrosis there is a gradual loss of articular
Cartilage in the knee joint there are three articulations one is lateral candle of the femur and tibia the second one is medial candle of the femur in tibia the third one is petalofemoral joint this slide which describe about difference between arthritis and orthosis damage caused by a complex interplay of joint integrity biomech chemical process genetics and
Mechanical forces anatomy of the knee joint the knee joint it is a knee complex which is mainly consists of there is a thigh bone and a tibia and petaluma the lower part of the thigh bone upper part of the tibia and petal are going to create a knee complex that is the anatomy of the knee joint the next slide which is describe a boat clinical approach to the knee
Pain my knees been hurting the patient used to trim so we have to take assessment subjective objective assessment and treatment plan there is a socket scale which help to assess the pain intensity followed by there was a clinical symptom mainly inflammatory changes fever heart joint history of trauma or surgery instability instability functional loss and the
Period treatment clinical approach to the knee pain clinical approaches this slide it helped to assess the physical exam the second one vitals the third one palpation the fourth one range of motion fifth one stability alignment and function function mainly gate and vadal tuck walk and waddle gate clinical the next slide which describe about clinical approach to
The knee pain so here there is a test we called as valgus test and the virus test valgus test to identify the medial collateral ligament various test which will help to identify the lateral colloidal ligament patient is supine lying we ask the patient to 90 degree stability then we cue the stretch to the muscles ligament then it leads to pop click sound came
The test is positive fifth one is pack burden it will help to assess the stability of the knee joint the clinical approach to the knee pain especially these are all the tests which will help to identify the diagnostic tool along with some of the blood investigation that is esr and the rheumatoid factor we need to assess arthro synthesis x-rays there are three
Views we need to check on this weight-bearing view that is andropostale review second one is lateral view third one is tan genital patellar view then mri mri it will help to identify and changes in the knee pain then differentiate diagnosis we need to consider four component that is medial frame it is due to medial pain it is due to lateral pain or diffuse pain or
Anteriorate pain the pain in the medial side if it is persisting we need to check what is the why it is happening that is called it is due to middle pain maybe osteoarthritis media collateral ligament meniscus and bursitis natural pain we need to check again osteoarthritis lateral collateral ligament meniscus elio tbl band syndrome third one is anterior pain that
Is osteoarthritis petalofemoral syndrome free petal or bursitis quadicious mechanism the last one is diffuse pain we need to differentiate that’s why this four component we need to check and we need to assess that is called diffuse pain last one is osteoarthritis infective arthritis gout pseudo gout promoted arthritis diagnosis of knee joint especially classic
Clinical criteria established by acr 1981 knee pain plus at least three of six characteristics one is above 50 years people used to suffer both gender morning stiffness it will be persist more than 30 minutes there is a reputation when you move the knee joint flexion extension there is a crypto sound which will be exhibited from the knee joint when it alternates
Body enlargement no palpable walk the diagnosis of knee joint mainly for synovial fluid we need to check x-ray there is a changes in osteobite formation loss of joint surface subcontal sclerosis subchondral cyst confirmed by arthroscopy diagnosis we can confirm through x-ray ct scan mri there is a changes first normally the gap between the tibian the gap between
The thigh bone lower part of the thigh bone and upper part of the tbr if it is normal it is indicating this slide the second one is there is a narrow joints if you compare with the lateral side and medial side the lateral side is more deviation to the medial side then bone is power also we can check in this x-ray report the third another report the last one is the
Lateral side lateral condyle automatically it’s connected with the medial quantile so there is a less cap it is indicating there is a osteoarthritis now we can discuss about lifestyle modification so the patient already it is a big bearing joint so the patient already more obeys so we have to address for dietary consultation followed by weight loss wellness and
Fitness so proper nutrition they have to advise what are the exercise which will help to reduce the weight reduction because upper body weight is more automatically the pain accumulating joint it will increase the pain so we have to focus there is a stretching strengthening along with the isometric exercise so what is of strengthening range of motion exercise low
Impact activities mainly for swimming and biking ambulatory ssc device mainly we are using can and walker then orthotic advices install modification unloaded knee braces we have to address to the patients then followed by management of there is a valcus and the virus virus means means knock knead so there is a changes it is indicating and the knocked knee that is
Valgus deformity unloader this bridge which will help to adjust the knee joint whatever the the impairment is there or pain level automatically it will help to adjust so that is called knee brace which will help to keep the knee in neutral position and which will help to reduce the pain that is indicating management mainly glucosamine acetaminophen launch their
Anti-inflammatory tracts which we have to perform this is the medical management then we can go for some of the steroids it’s a severe it is more then we can advise the patient to undergo for steroids so steroids will help to reduce the pain and improve the quality of life the next slide which describe about acetominophen indomethazine these are all the drugs
Which will help to reduce the pain then we can go for medical management is over now we can go for so intra-articular injection the patient position is supine let’s try it manipulate patella ankle lead is slightly posturally inject after drop in resistance or fluid aspirated that will help to reduce the pain so what are all the advices we have to give lifestyle
Modification which is performed through wellness expert dietary expert along with some of the steroids the non-steroid non-steroid anti-inflammatory drugs these are all the things physiotherapy which will help to restore the functions so another that is a surgical intervention we called as high tbl osteotomy so this high tb elastiotomy it will help to realign
The uh upper upper and after tibia and lower end of the tibia upper part of the tibia and formula it will correct that so the correction and the repair all those things so another surgical approach is tkr total knee replacement that also will help to restore the function then these are all the exercise the patient position is b squat another exercise leg cross
Which will be help to strengthen the quadriceps as well as other joint muscles so mainly we have to perform one minute rest and the repetition of this exercise v squat at least two times the same this leg cross the same position sitting in the stool or sitting in the chair we ask them to perform ask them to extend the knee hold for five seconds rest one minute
Repeat for two times the third one is muscle stretching exercise the patient position is supine lying the affected side affected side should be knee straight position unaffected side knee should be flexed to position then we keep the position for five seconds rest for one minute repeat three times then step up start climbing activities this asks the patient to
Start climb we keep the position five five seconds hold rest one minute repeat for three times the third one is sit to stand exercise sit to stand which we can perform through chair so we ask the patient to sitting position at the edge of the couch we ask the patient to sit we ask them to get up from the chair so the holding time five seconds rest one minute then
Repeat for three times then last one is take home message overall this medical surgical physiotherapy treatment approach which will help to minimizing symptom and maximizing function of osteoarthritis this intervention which help overall health well-being wisdom gait balance flexibility joint range for osteoarthritis thanks for giving the opportunity to share my
Knowledge experience in these osteoarthritis for the management of management of the physiotherapy approach once again thanking you
Transcribed from video
Physiotherapeutic Evidence Of DMD || Dr. Karthikeyan T. || MMA By MOVEMENT MAESTRO ACADEMY®liveBroadcastDetails{isLiveNowfalsestartTimestamp2022-10-02T140012+0000endTimestamp2022-10-02T141512+0000}
