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Table of Contents
Year : 2019  |  Volume : 16  |  Issue : 2  |  Page : 132-133

Knee Osteoarthritis: Clinical Update

Department of Geriatric Medicine, Indraprastha Apollo Hospitals, New Delhi, India

Date of Submission23-May-2019
Date of Acceptance25-May-2019
Date of Web Publication19-Jun-2019

Correspondence Address:
Om Prakash Sharma
Department of Geriatric Medicine, Indraprastha Apollo Hospitals, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_29_19

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How to cite this article:
Sharma OP. Knee Osteoarthritis: Clinical Update. Apollo Med 2019;16:132-3

How to cite this URL:
Sharma OP. Knee Osteoarthritis: Clinical Update. Apollo Med [serial online] 2019 [cited 2022 Dec 5];16:132-3. Available from: https://apollomedicine.org/text.asp?2019/16/2/132/260685

Editor : Dr. (Prof.) Raju Vaishya

Published by : KONTENTWORX, Paschim Vihar, New Delhi 110087, India

Year of Publication : 2019

ISBN : 978-93-83988-18-1

Knee osteoarthritis-clinical update is a comprehensive book containing scientific literature on various aspects of osteoarthritis (OA) of the knee, along with citations of many illustrative and exciting cases. The book deals with the complete spectrum of knee OA, explaining the basics to managing the most advanced form of the disease. This unique monograph has been compiled and edited extremely well and should provide a good reading to the geriatric physicians, orthopedic surgeons, physiotherapists, and nurses. It would also be a valuable reference book for the postgraduate students in orthopedics and also researchers. I have enjoyed reading it and am summarizing the contents of it below for the readers.

The initial chapters of the book deal with the basic definition, etiology, and clinical and radiological diagnosis of knee OA. It has been highlighted that the OA is no longer a “cartilage centric disease;” instead, these days OA is recognized as more of a panarticular disease. Articular cartilage involvement though important is only one aspect of the pathology of OA. Clinically, OA manifests with pain, stiffness-gelling, and reduced function of the knee. Several causative factors are implicated such as advancing age, obesity, trauma, and joint malalignment. Muscle weakness and genetic and epigenetic factors may also contribute to its development. The features of radiological diagnosis of knee OA have been described well by a diagram and the text. These include joint space narrowing (due to cartilage thinning), subchondral bone sclerosis, and new bone formation at joint margins contributing to osteophyte formation. It has been highlighted that the knee alignment views are also necessary at the time to estimate the damage and check the limb alignment. Ultrasonography, computed tomography, magnetic resonance imaging (MRI), semi-quantitative MRI, quantitative analysis of articular cartilage, and compositional MRI are also infrequently required in complex cases.

This book has covered extensively about various modes of nonoperative treatment of knee OA. The role of physiotherapy in OA is emphasized in relieving the pain. Various modalities used in physiotherapy are also covered, in sufficient details. The role of orthotic devices used to assist or restrict motion has been described with pictures of knee braces/sleeves and foot insoles. The increasing use and role of nutraceuticals (combination of “nutrition” and “pharmaceutical” that provides medical or health benefits) has been covered elaborately for the prevention and treatment of knee OA. These are reported to be useful in early stages of knee OA and include collagen, glucosamine, chondroitin sulfate, curcumin, rosehip, Boswellia serrata, fish oil, ginger, and green tea. The pharmacologic treatment has remained the most commonly used treatment modality for relieving knee pain of knee OA. This part has been discussed at length and to the point. The various pain-relieving drugs include acetaminophen, nonsteroidal anti-inflammatory drugs, opioid analgesics, muscle relaxants, and selective serotonin–norepinephrine reuptake inhibitors. The newer and emerging drugs in this field have also been described and include tanezumab and sprifermin (human fibroblast growth factor). The commonly used intra-articular injection therapies have been covered extensively in separate chapters for steroid, viscosupplements, platelet-rich plasma, and stem cells. These are also effective for the management of OA of knee, in the early and moderate degrees of knee OA.

The commonly performed surgical treatments for knee OA are covered in several chapters separately. These procedures include arthroscopy, periarticular osteotomy, and unicompartment and total knee replacement. The surgical treatment is indicated in moderate-to-severe cases. It has been highlighted that the arthroscopic surgery has a limited and selective role for knee OA. It is indicated for joint debridement, meniscal tears, and removal of loose bodies. Periarticular knee osteotomy for knee OA is used in a patient with angular deformity (especially, varus) by high tibial osteotomy or a proximal fibular osteotomy. Knee arthroplasty is only required in advanced primary tricompartmental OA, end-stage inflammatory arthritis, for example, rheumatoid arthritis, and secondary OA (posttraumatic, dysplasia, and malignancy). The recent developments in implant designs and surgical techniques have been covered in an exclusive chapter. These include custom implants, coated implants, gender-specific implants, high-flexion knees, unicompartmental arthroplasty, computer-assisted navigation system, patient-specific total knee arthroplasty, and robot-assisted navigation. Several illustrative case reports related to various patterns and presentation of knee OA have been lucidly described and not only are interesting to read but also provide several learning points for the readers.

I congratulate the editor and the authors for producing a comprehensive monograph on knee OA, through this book. It should be a good value for money for the readers.


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