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195: KNEE OSTEOARTHRITIS

Eric Shamus, PhD, DPT, PT, CSCS; Reuben Escorpizo, DPT, MSc, PT

CONDITION/DISORDER SYNONYMS

  • Knee arthritis

  • Arthrosis

  • Osteoarthrosis

  • Degenerative joint disease

  • Knee degenerative joint disease

ICD-9-CM CODES

  • 715 Osteoarthrosis and allied disorders

  • 715.16 Osteoarthrosis localized primary involving lower leg

  • 715.26 Osteoarthrosis localized secondary involving lower leg

  • 715.36 Osteoarthrosis localized not specified whether primary or secondary involving lower leg

  • 715.9 Osteoarthrosis, unspecified whether generalized or localized

  • 715.95 Osteoarthrosis, unspecified whether generalized or localized involving pelvic region and thigh

ICD-10-CM CODES

  • M17.10 Unilateral primary osteoarthritis, unspecified knee

  • M17.5 Other unilateral secondary osteoarthritis of knee

  • M17.9 Osteoarthritis of knee, unspecified

PREFERRED PRACTICE PATTERNS

  • 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion (ROM) Associated with Connective Tissue Dysfunction1

  • 4F: Impaired Joint Mobility, Motor Function, Muscle Performance, Range of Motion, and Reflex Integrity Associated with Spinal Disorders2

  • 4H: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated With Joint Arthroplasty3

  • 4I: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Bony or Soft Tissue Surgery4

PATIENT PRESENTATION

Patient is a 70-year-old male that presents with bilateral knee pain. Patient states the pain in both of his knees has been progressively getting worse over the last 10 years. About 5 years ago, he had bilateral knee arthroscopies to clean out the joints. Last year, he had a Synvisc injection with some relief. The patient has limited knee ROM with bilateral genu varum. He states that if he is on his feet for any period of time he needs to sit down. The patient has morning stiffness. If he rides his stationary bike for a few minutes, the knee pain subsides for a little. He finds pool exercises are helping. The x-ray shows bilateral decreased joint space.

FIGURE 195-1

Frontal view of a 65-year-old man shows the classic features of osteoarthritis of the knee with medial articular space narrowing, subchondral cyst formation, sclerosis, and osteophyte formation. Osteoarthritis of the knee initially involves the medial compartment but may, over time, progress to involve the lateral and patellofemoral compartments. (From Chen MYM, Pope TL, Ott DJ: Basic Radiology, 2nd ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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KEY FEATURES

Description

  • Most common form of arthritis

  • Degenerative

  • Commonly affects hip and knee joints, weight-bearing joints

  • Can also affect spinal facet joints

  • Associated with increasing age, obesity, female sex

  • Associated with abnormal loading of the joints

  • Characterized by joint pain

FIGURE 195-2

Effect of age on the prevalence of arthritis. *Knee cartilage degeneration at autopsy is the prevalence of significant histological changes of degeneration. **Radiographic evidence of OA (Kellgren and Lawrence Grade 2 or greater) present in at least one joint site (hands, feet, ...

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