Staged treatment of knee OA

Background: Osteoarthritis is one of the most common systemic diseases leading to physical disability reducing the quality of life. Osteoarthritis affects all the structures of the joint and the surrounding tissues. In the state of Kuwait, osteoarthritis of the knee joint is prevalent, especialy among women. The purpose of this article is to view our experience in the staged treatment of knee osteoarthritis in one of the leading privet hospitals in Kuwait. Methods: A deferent approach of treatment is applied depending on the severity of osteoarthritis, co-morbidities, and age of the patient. Conservative and joint preserving surgical treatment used in mild to moderate cases. The main steps for the conservative treatment consist of patient education and changing of the style of life, medications, physical medicine and rehabilitation, intra and periarticular injections, weight loss, hydrotherapy, orthosis, and braces. The last step is knee arthroplasty. Results: There is no evidence-based medical treatment to stop or reverse the progression of knee osteoarthritis (OA), and thus the available treatments aim is to reduce pain and improve knee function which is also beneficial for other co-morbidities. Almost all the patients eventually reached the final stage of treatment, which is a total knee replacement, regardless, the conservative active treatment and joint preserving surgical treatment. Conclusion: Non-operative treatment in early stages of OA can dramatically help in the prevention of progression of the disease and improve the quality of life.