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Osteoarthritis: Treatment

by Stephen Holt, MD, MS

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    00:00 Alright, so let's talk about how we're gonna treat patients with osteoarthritis.

    00:05 Weight loss is important.

    00:06 Folks who have terrible knee and hip arthritis, losing weight will help and prevent future progression of disease.

    00:13 Likewise, while our patients are oftentimes resistant, physical therapy is paramount, especially aqua therapy which can be a little bit easier for patients to move around with.

    00:22 Activity modification can be helpful if there's particular things that are exacerbating their arthritis.

    00:27 Sometimes, splinting can be helpful and immobilization under extreme circumstances.

    00:32 Ice and heat can provide some analgesic benefit.

    00:37 NSAIDs of course, ideally especially in elderly patients who wanna try topical NSAIDs like diclofenac and then under some circumstances, especially if there's some evidence of acute synovitis, you can do a steroid injection as well though don't get carried away with doing those too often.

    00:53 Sometimes, chondroitin sulfate is used.

    00:55 However, I will say the evidence and support of that is scant at best.

    01:00 And lastly, if a person has become debilitated by their osteoarthritis especially if it involves the hip or the knees, joint replacement surgery is absolutely an option.

    01:11 Alright, so taking a look at our first case, who have the acute-on-chronic osteoarthritic knee pain, this person, we probably best treat them with NSAIDs.

    01:21 Maybe some ice, activity modification and physical therapy to strengthen the muscles and ligaments around that knee.

    01:28 With an active synovitis, again, you can consider intra-articular steroids but I wouldn't do it too often.

    01:35 And then for our 2nd case, who have the acute-on-chronic carpometacarpal joint, also called basal joint arthritis.

    01:42 I'd also go with the topical NSAID, maybe some ice, perhaps a wrist splint temporarily or at least while working at her job and again, you could consider a low dose intra-articular steroid injection.


    About the Lecture

    The lecture Osteoarthritis: Treatment by Stephen Holt, MD, MS is from the course Non-Autoimmune Arthritis.


    Included Quiz Questions

    1. Topical NSAIDs and a thumb spica splint
    2. Arthroscopic debridement
    3. CMC arthrodesis
    4. Hyaluronic acid injection
    5. Steroid injection
    1. Physical therapy and activity modification
    2. Chondroitin sulfate
    3. Weekly intra-articular steroid injections
    4. A series of three intra-articular hyaluronic acid injections
    5. Oral steroid taper

    Author of lecture Osteoarthritis: Treatment

     Stephen Holt, MD, MS

    Stephen Holt, MD, MS


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