Hip and Knee Osteoarthritis in Younger People (yeah, that means YOU!)

Hip and Knee Osteoarthritis Affects Younger People, Too
Ackerman, I., Kemp, J. Crossley, K., Culvenor, A., Hinman, R.
Journal of Orthopaedic and Sports Physical Therapy, February 2017, p 67-79.

This Clinical Commentary focused on evidence-based assessment and management approaches for “younger individuals” defined as those less than 40-45 years old.
Why is this important? Hip and knee osteoarthritis (OA) at younger ages has a significant impact on psychosocial well-being and work capacity. People who are affected by OA in their 40’s have decreased exercise tolerance to maintain a healthy weight and active lifestyle. It may further decrease work tolerance for jobs involving high labor which has the potential to decrease available work force for these jobs as well as limiting future job potential for those affected.
Why is this happening? Key risk factors for accelerated development of knee OA are obesity and a history of traumatic knee injury. Traumatic knee injury included anterior cruciate ligament (ACL) rupture and/or meniscal tears. Even more troubling was that having ACL reconstruction surgery “does not appear to prevent future onset of knee OA”. The bright spot in this research was that long distance running in youth did NOT seem to increase the risk of hip and knee OA later in life!
Should I ask my MD for imaging on my painful knee and hips? This commentary stated that imaging should be reserved for those with atypical signs and symptoms that “may indicate diagnoses other than OA”.
What can I do for my youth with knee and/or hip pain? The top recommendations were therapist-prescribed exercise programs to address impairments, specific activity modification, disease-related education, and weight control or weight loss (if applicable). There are specific exercises which have been proven to decrease stress to the hips and knees that can help young athletes. Also, strengthening exercises can help to “protect” the joint for athletes to decrease the risk for ACL rupture or meniscal tears.
What if I am a “younger person” showing signs of hip and/or knee OA? Physical therapy should focus on a specific patient-centered history, comprehensive evaluation including joint mobility, muscle strength, and performance-based measures, and outcome measures to assess symptoms and function over time.
The key “take away” from this article was the importance of early intervention to decrease progression of OA and allow people to maintain their desired level of activity through their lifetime. If you have any questions regarding OA, hip and/or knee pain, please feel free to contact us here at Physical Therapy for everyBODY at amykonvalinpt@gmail.com or (425)658-4944.