{"id":4225,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/osteoarthriticknee\/"},"modified":"2024-07-02T13:39:57","modified_gmt":"2024-07-02T12:39:57","slug":"osteoarthriticknee","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/orthopaedics\/knee\/kneenohistoryoftrauma\/osteoarthriticknee\/","title":{"rendered":"Osteoarthritic Knee"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">History<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Elderly\/older patients<\/li>\n\n\n\n<li>Younger post traumatic\/post operative<\/li>\n\n\n\n<li>Restricted activities of daily living<\/li>\n\n\n\n<li>Reduced walking<\/li>\n\n\n\n<li>Previous diagnosis\/other OA joints<\/li>\n\n\n\n<li>Persistent pain<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-media-text is-stacked-on-mobile is-vertically-aligned-bottom\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"901\" height=\"603\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Orthopaedics-Osteoarthritic-knee.png\" alt=\"Orthopaedics Osteoarthritic knee\" class=\"wp-image-19785 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Orthopaedics-Osteoarthritic-knee.png 901w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Orthopaedics-Osteoarthritic-knee-300x201.png 300w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Orthopaedics-Osteoarthritic-knee-768x514.png 768w\" sizes=\"auto, (max-width: 901px) 100vw, 901px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<h4 class=\"wp-block-heading\"><strong>Signs<\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Limp<\/li>\n\n\n\n<li>Decreased range of movement<\/li>\n\n\n\n<li>Deformity<\/li>\n\n\n\n<li>Medial joint line pain. <em>image copyright NHS Lothian<\/em><\/li>\n\n\n\n<li>Possible effusion<\/li>\n\n\n\n<li>Possible crepitus<\/li>\n\n\n\n<li>Stiffness after sitting\/in the morning<\/li>\n\n\n\n<li>Unable to kneel or squat<\/li>\n\n\n\n<li>Possible old surgery scars<\/li>\n\n\n\n<li>Exclude hip joint as cause (groin pain, hip stiffness)<\/li>\n<\/ul>\n\n\n\n<p>Medial joint line pain. <em>image copyright NHS Lothian<\/em><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Secondary care referral<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If X-Rays show established OA changes, all primary care treatments have been exhausted and patient wishes an opinion on surgical options, refer to Arthroplasty service<\/li>\n\n\n\n<li>If all primary care treatments have been exhausted, consider referral to Non Arthroplasty Knee Service<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>X-Ray &#8211; AP standing&nbsp;&amp;&nbsp;lateral<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Primary care treatment<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Analgesia<\/li>\n\n\n\n<li>Physiotherapy<\/li>\n\n\n\n<li>Cardiovascular exercise<\/li>\n\n\n\n<li>Strengthening exercises<\/li>\n\n\n\n<li>Weight loss<\/li>\n\n\n\n<li>Walking aids<\/li>\n\n\n\n<li>Corticosteroid injection if swollen and no other contraindications to csi**<\/li>\n<\/ul>\n\n\n\n<p><em>** corticosteroid injection not to be given within 6 months of knee replacement surgery due to increased risk of infection at time of surgery<\/em><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.nice.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">National Institute for Health and Care Excellence (NICE)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.sign.ac.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Intercollegiate Guidelines Network (SIGN)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.versusarthritis.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">Arthritisresearchuk.org<\/a><\/li>\n\n\n\n<li>www.<a href=\"https:\/\/www.versusarthritis.org\/\">versusarthritis<\/a>.org<\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>History<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4074,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[405],"class_list":["post-4225","page","type-page","status-publish","hentry","category-osteoarthriticknee"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/orthopaedics\/knee\/kneenohistoryoftrauma\/osteoarthriticknee\/\" rel=\"tag\">Osteoarthritic Knee<\/a>","rttpg_excerpt":"History","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4225","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4225"}],"version-history":[{"count":15,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4225\/revisions"}],"predecessor-version":[{"id":19974,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4225\/revisions\/19974"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4074"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4225"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4225"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}