What is the mainstay treatment for knee osteoarthritis?

What is the mainstay treatment for knee osteoarthritis?

• A. Active rehabilitation (stretching and strengthening) and exercise
• B. Total knee replacement as first-line
• C. NSAIDs alone
• D. Steroid injections as initial therapy

Answer: (A)

The main concept here is that nonpharmacologic management, especially active rehabilitation with stretching and strengthening exercises, serves as the foundation for knee osteoarthritis care. Strengthening the quadriceps and surrounding muscles improves knee stability, reduces pain, and enhances function by improving joint mechanics and reducing abnormal loads. A structured program—ideally guided by physical therapy—often includes quadriceps and hip-strengthening exercises, range-of-motion work, and low-impact aerobic activity (like walking or cycling). If the patient is overweight, weight loss amplifies these benefits, further easing joint stress and improving outcomes. Pharmacologic options and procedures can be added to control symptoms once an appropriate exercise program is underway, but they do not replace the benefits of nonpharmacologic therapy. Intra-articular steroid injections may relieve pain temporarily but are not a first-line or long-term solution due to limited duration of effect and potential risks with repeated use. Total knee replacement is reserved for advanced disease after conservative measures have failed or in cases with severe functional impairment, not for initial management.

The main concept here is that nonpharmacologic management, especially active rehabilitation with stretching and strengthening exercises, serves as the foundation for knee osteoarthritis care. Strengthening the quadriceps and surrounding muscles improves knee stability, reduces pain, and enhances function by improving joint mechanics and reducing abnormal loads. A structured program—ideally guided by physical therapy—often includes quadriceps and hip-strengthening exercises, range-of-motion work, and low-impact aerobic activity (like walking or cycling). If the patient is overweight, weight loss amplifies these benefits, further easing joint stress and improving outcomes.

Pharmacologic options and procedures can be added to control symptoms once an appropriate exercise program is underway, but they do not replace the benefits of nonpharmacologic therapy. Intra-articular steroid injections may relieve pain temporarily but are not a first-line or long-term solution due to limited duration of effect and potential risks with repeated use. Total knee replacement is reserved for advanced disease after conservative measures have failed or in cases with severe functional impairment, not for initial management.