Rehabilitation Of Knee Osteoarthritis With Varus Deformity: A Case Report

Abstract

Introduction: Osteoarthritis (OA) is one of the most common causes of chronic disability in the adult and geriatric population. It is known that 10% of the population aged 65 years and over suffer from knee osteoarthritis. Physical Medicine and Rehabilitation Specialist will often deal with cases of osteoarthritis due to the increasing prevalence of osteoarthritis globally, especially in long-term outpatient services. Case: A 58 years old, female, was referred from the Orthopedic department with a diagnosis of right Osteoarthritis knee grade IV and left Osteoarthritis knee grade II need for Total Knee Replacement (TKR). She felt pain in both knees since 5 months ago with a Visual Analog Scale (VAS) is 6. She is psychologically not ready yet for TKR. She stopped working due to her condition. The joint?s range of motion of the right knee joint range was limited in flexion (0-130?). Physical examination revealed a tender point at the medial area of the knee, crepitation in both knees, a positive patellar grinding test in both knees, a positive varus test of the right knee, atrophy on both vastus medialis muscles, and knee varus deformity. We provide rehabilitation programs for the patient such as giving physical modality (SWD), strengthening exercise, aerobic exercise, knee brace, home education, and home exercise program. Following the rehabilitation program for 3 months, the patient felt more fit, full right knee range of motion was obtained. She walked more easily with her knee brace and experienced improvements in physical function parameters. There was an improvement in ADL (Activity of Daily Living) function represented by the Barthel index, and there was a pain decreased. Conclusion: The combination of a knee brace, physical modality, exercise program, home exercise program, and knee joint protection education is provide improvements in pain, function, and some aspects of OA health-related quality of life.