eMedicine Specialties > Physical Medicine and Rehabilitation > Arthritis & Connective Tissue Disorders

Osteoarthritis: Follow-up

Author: Todd P Stitik, MD, Professor, Department of Physical Medicine and Rehabilitation; Director, Outpatient Occupational/Musculoskeletal Medicine, UMDNJ-New Jersey School of Medicine
Coauthor(s): Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School; Irim Ciolino, MD, Co-chief Resident, Department of Internal Medicine, New York Medical College/St Vincent's Catholic Medical Center
Contributor Information and Disclosures

Updated: Jul 16, 2009

Follow-up

Further Inpatient Care

  • Further inpatient care pertains to patients who have undergone a surgical procedure, such as joint replacement. Surgery generally takes place in the acute care setting. After surgery, transfer is arranged to a subacute unit or freestanding rehabilitation hospital, or the patient is discharged directly to home.

Further Outpatient Care

  • Provide outpatient care in support of a patient with osteoarthritis who has undergone a surgical procedure. Provide outpatient physical therapy as well.

Inpatient & Outpatient Medications

  • Analgesics may be prescribed for a patient with osteoarthritis who has undergone surgery. Prescribe anticoagulants/antiplatelet agents as indicated.

Deterrence

  • The prevention of osteoarthritis (OA) is a controversial topic; however, it is believed that maintaining ideal body weight lessens the probability of developing OA. This appears to be particularly true for weight-bearing joints (ie, hips, knees) in females.
  • Some also believe that an adequate intake of vitamins C and D can help to lessen the probability of developing OA.
  • A small study from England suggested that a course of NSAIDs taken after a traumatic event seems to reduce the incidence of posttraumatic OA.

Related Medscape topic:
CME Vigorous Physical Activity May Improve Knee Joint Structures

Prognosis

  • The prognosis is good for patients with osteoarthritis who have undergone joint replacement. The prosthesis may need revision 10-15 years after its installation, depending on the patient's activity level.

Patient Education

  • Patient education is one of the primary therapeutic approaches to osteoarthritis (OA).29 Several Arthritis Foundation studies have demonstrated that education in OA benefits the patient. Through education, patients can institute ways to reduce pain and increase joint function. Emphasize the need for physician follow-up visits.
  • For excellent patient education resources, visit eMedicine's Arthritis Center. Also, see eMedicine's patient education article Osteoarthritis.

Miscellaneous

Medicolegal Pitfalls

  • One potential source of medicolegal action against the physiatrist is the misdiagnosis of an underlying medical problem that causes joint pain as OA. The administration of NSAIDs can lead to GI bleeding, especially if risk factors for GI bleeding are present. Allergic reactions to medications are also possible. The prescription of open-chain kinetic exercises, particularly with respect to quadriceps strengthening, carries the potential for worsened pain and, thus, the potential for medicolegal action on the part of the patient against the physiatrist.
 
Acknowledgments

Evish Kamrava, 4th year medical student, St. George's University School of Medicine, Class of 2009, assisted with the revision of this manuscript.



More on Osteoarthritis

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References
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Further Reading

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Keywords

osteoarthritis, arthritis, joint pain, arthritis pain, knee pain, knee arthritis, hip arthritis, arthritic, degenerative joint disease, synovial, synovial joint, osteoarthritis knee, osteoarthritis treatment, treatment of osteoarthritis, arthroplasty, joint replacement, osteoarthrosis, synovial joints, osteophytes, synoviocytes, hyaluronic acid, hyaluronate, HA, repetitive joint use, crystal deposition, acromegaly, rheumatoid arthritis, obesity, alkaptonuria, hemochromatosis, Wilson disease, Wilson's disease, hemoglobinopathies, sickle cell disease, thalassemia, Charcot joint, Charcot'sjoint, syringomyelia, tabes dorsalis, diabetes, congenital hip dislocation, slipped capital femoral epiphysis, Paget disease, Paget's disease, avascular necrosis

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Contributor Information and Disclosures

Author

Todd P Stitik, MD, Professor, Department of Physical Medicine and Rehabilitation; Director, Outpatient Occupational/Musculoskeletal Medicine, UMDNJ-New Jersey School of Medicine
Todd P Stitik, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Phi Beta Kappa, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Coauthor(s)

Patrick M Foye, MD, FAAPMR, FAAEM, Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Patrick M Foye, MD, FAAPMR, FAAEM is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society
Disclosure: Nothing to disclose.

Irim Ciolino, MD, Co-chief Resident, Department of Internal Medicine, New York Medical College/St Vincent's Catholic Medical Center
Irim Ciolino, MD is a member of the following medical societies: American College of Physicians
Disclosure: Nothing to disclose.

Medical Editor

Curtis W Slipman, MD, Director, University of Pennsylvania Spine Center; Associate Professor, Department of Physical Medicine and Rehabilitation, University of Pennsylvania Medical Center
Curtis W Slipman, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, International Association for the Study of Pain, and North American Spine Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Richard Salcido, MD, Chairman, Erdman Professor of Rehabilitation, Department of Physical Medicine and Rehabilitation, University of Pennsylvania School of Medicine
Richard Salcido, MD is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Physician Executives, American Medical Association, and American Paraplegia Society
Disclosure: Nothing to disclose.

CME Editor

Kelly L Allen, MD, Regional Medical Director, IMX-Medical Management Services
Disclosure: Nothing to disclose.

Chief Editor

Denise I Campagnolo, MD, MS, Director of Multiple Sclerosis Clinical Research and Staff Physiatrist, Barrow Neurology Clinics, St Joseph's Hospital and Medical Center; Investigator for Barrow Neurology Clinics; Director, NARCOMS Project for Consortium of MS Centers
Denise I Campagnolo, MD, MS is a member of the following medical societies: Alpha Omega Alpha, American Association of Neuromuscular and Electrodiagnostic Medicine, American Paraplegia Society, Association of Academic Physiatrists, and Consortium of Multiple Sclerosis Centers
Disclosure: Teva Neuroscience Honoraria Speaking and teaching; Serono-Pfizer Honoraria Speaking and teaching; Genzyme Corporation Grant/research funds investigator; Biogen Idec Grant/research funds investigator; Genentech, Inc Grant/research funds investigator; Eli Lilly & Company Grant/research funds Novaritis; Novaritis  Novaritis; MSDx LLC Grant/research funds investigator; BioMS Technology Corp Grant/research funds investigator; Avanir Pharmaceuticals Grant/research funds investigator

 
 
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