05:40 AM

What nonoperative approaches for knee OA do you use in recreational vs advanced athletes?

Orthopedics Today discusses nonoperative treatment approaches for knee osteoarthritis in recreational versus advanced athletes according to HSS sports medicine physician David A. Wang, MD, and others.

Dr. Wang noted, “Nonoperative treatment options are similar for all patients, whether they are recreational or advanced athletes. I think about it as a pyramid. The base, which we build off of, consists of PT [physical therapy] to strengthen the surrounding muscles and take load off the joint, activity modification to lessen impact activities using pain/swelling as a guide, and weight loss, if appropriate. The next step up the pyramid is over-the-counter medications, as needed, for pain (for example, acetaminophen or NSAIDs). The following step is injections (cortisone or lubricating gel injections).”

He continued, “In certain situations where the arthritis and pain are in one specific part of the knee, I also consider adding an unloader brace with activity. With recreational athletes, we generally start at the base of the pyramid and work up, if symptoms are not controlled with the previous level of treatment. Advanced athletes may not be able to modify their activities as easily or allow the time for PT to take effect, so we may need to start further up the pyramid with more invasive options.”

Dr. Wang concluded, “Ultimately, every patient works their way through the pyramid differently and we adjust our approach for each individual taking into account their symptoms and activities.”

Read the full article at Healio.com/news/orthopedics. This article also appeared in the April 2021 print issue.