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Osteoarthritic knees

Tuesday, 09 July 2002
Answered by: Mathew Varghese
Consultant Orthopaedic Surgeon and Director
St. Stephens Hospital
Delhi
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Q. I have Osteoarthritis in both knee joints with a varus deformity. No evidence of fracture or any other abnormality is seen in the bones of both knee joints. Following treatment was advised by the doctor
Cap contrmal 1 after breakfast, 1 after dinner for 10 days
Tab Rofaday 25mg with breakfast for 10 days
Tab Zinetac(150mg) 1 after breakfast, 1 after dinner for 10 days
Tab Shelcal M 1 in morning, 1 in evening for 3 months
Tab Surbex T with a glass of milk for 3 months
Cap free flex forte 3 times a day for 3 months
Apply Ice and then Dolonex gel twice a day. Use Knee cap
Avoid Indian toilet, jogging, sitting on the floor Physiotherapy Proposed Management: Rt. Knee replacement. I am suffering from much pain in my Right Knee. I am a diabetes paitent. My weight is 74 Kgs. I cannot sit for a long time and cannot stand for a long time. It feels like something is pinching me from inside in the right knee joint. What should I do? Please guide me
Following is the report of X-Ray (2 months back) Radiographs of both knee joints obtained in A.P. [standing] and lateral projections reveal an osteophytic lipping from articular surfaces of knee joints with a decrease in the joint spaces in the medical compartments. There is a varus deformity on either side. The bones of both knee joints show normal bony architecture. No evidence of fracture is seen. There is no evidence of bony erosion, infection or any other intrinsic bony abnormality. No abrormality is seen in surrounding soft tissues. IMPRESSION: Osteoarthritis both knee joints with a varus deformity. No evidence of fracture or any other abnormality is seen in the bones of both knee joints.

A.  As per your symptoms and your X-ray findings you seem to have osteo-arthritis of the knee with varus (bowing of legs) deformity. In addition, you are a diabetic and seem to be on the heavier side. Both are conditions, which can adversely affect your knee. However, you are relatively young and personally (This is difficult to say without seeing you and the X-ray) I would recommend a phase of exercises to build up your front of thigh muscles (quadriceps). With this, with the restricted activities that you have been suggesting take care of your acute pain and symptoms. You will have to be assessed clinically and your X-ray will have to be reviewed to decide on the choice of treatment. If the joint of degeneration involved the inner, outer and the knee cap cartilages then there could be a need for total joint replacement. If on the other hand only varus (bowing) deformity is troubling you, you could benefit from an operation to correct the deformity. This could buy you time before going for a total knee replacement.

A.  As per your symptoms and your X-ray findings you seem to have osteo-arthritis of the knee with varus (bowing of legs) deformity. In addition, you are a diabetic and seem to be on the heavier side. Both are conditions, which can adversely affect your knee. However, you are relatively young and personally (This is difficult to say without seeing you and the X-ray) I would recommend a phase of exercises to build up your front of thigh muscles (quadriceps). With this, with the restricted activities that you have been suggesting take care of your acute pain and symptoms. You will have to be assessed clinically and your X-ray will have to be reviewed to decide on the choice of treatment. If the joint of degeneration involved the inner, outer and the knee cap cartilages then there could be a need for total joint replacement. If on the other hand only varus (bowing) deformity is troubling you, you could benefit from an operation to correct the deformity. This could buy you time before going for a total knee replacement.

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