Hopp til hovedinnhold

Kneleddsartrose

Knærne er sammen med hofteleddene de leddene i kroppen som belastes mest gjennom livet. Slitasjeforandringer i brusk eller ben i kneleddene er en hyppig tilstand som kalles kneleddsartrose. Behandlingen er opplæring og informasjon om tilstanden, vektreduksjon ved overvekt eller fedme, tilpasset fysisk aktivitet og øvelser livet ut, eventuelt smertestillende medisiner, avlastende tiltak og i noen tilfeller operasjon.

Sist oppdatert: Sist revidert:

QR
Del pasientinformasjon

Den ligger åpent tilgjengelig på NHI.no sammen annen relevant informasjon

https://nhi.no/sykdommer/muskelskjelett/kne/kneleddsartrose/ 

Hva er artrose i kneet?

Årsak

Diagnostikk

Behandling

Hva kan du gjøre selv?

Medisiner

Annen behandling

Prognose

Vil du vite mer?

Kilder

Referanser

Dette dokumentet er basert på det profesjonelle dokumentet Kneleddsartrose. Referanselisten for dette dokumentet vises nedenfor.

  1. Litwic A, Edwards MH, Dennison EM, Cooper C. Epidemiology and burden of osteoarthritis. Br Med Bull. 2013;105:185-99. Epub 2013 Jan 20. PMID: 23337796 PubMed 
  2. Michael JW, Schlüter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Dtsch Arztebl Int. 2010 Mar;107(9):152-62. Erratum in: Dtsch Arztebl Int. 2010 Apr;107(16):294. PMID: 20305774 PubMed 
  3. Wallace IJ, Worthington S, Felson DT3, et al. Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proc Natl Acad Sci U S A. 2017; 114: 9332-6. pmid:28808025 PubMed 
  4. Sharma L. Osteoarthritis of the Knee. N Engl J Med. 2021 Jan 7;384(1):51-59. PMID: 33406330. PubMed 
  5. Furnes O, Hallan G, Kroken G, Fenstad AM. Årsrapport for 2020 med plan for forbedringstiltak. Nasjonalt register for leddproteser. Utgitt 15. juni 2020, Haukeland universitetssykehus. www.kvalitetsregistre.no 
  6. Dieppe PA, Lohmander LS. Pathogenesis and management of pain in osteoarthritis. Lancet 2005; 365: 965-73. PubMed 
  7. Hill CL, Gale DR, Chaisson CE, et al. Periarticular lesions detected on magnetic resonance imaging: prevalence in knees with and without knee symptoms. Arthritis Rheum 2003; 48: 2836-44. PubMed 
  8. National Institute for Health and Care Excellence (NICE). Osteoarthritis: care and management. Clinical guideline [CG177], published: 12 February 2014, last updated: 11 December 2020. www.nice.org.uk 
  9. Wu CW, Morrell MR, Heinze E, et al.. Validation of American College of Rheumatology classification criteria for knee osteoarthritis using arthroscopically defined cartilage damage scores. Semin Arthritis Rheum. 2005 Dec;35(3):197-201. PMID: 16325660 PubMed 
  10. Menkes CJ. Radiographic criteria for classification of osteoarthritis. J Rheumatol Suppl. 1991 Feb;27:13-5. PMID: 2027113. PubMed 
  11. Kan H, Arai Y, Kobayashi M, Nakagawa S, Inoue H, Hino M, Komaki S, Ikoma K, Ueshima K, Fujiwara H, Yokota I, Kubo T. Fixed-flexion view X-ray of the knee superior in detection and follow-up of knee osteoarthritis. Medicine (Baltimore). 2017 Dec;96(49):e9126. PMID: 29245351 PubMed 
  12. Sagsveen M. Lite samsvar mellom knesmerte og MR-funn. Tidsskr Nor Legeforen 2009. 129:1082. doi: 10.4045/tidsskr.09.0539. tidsskriftet.no 
  13. The Royal Australian College of General Practitioners. Guideline for the management of knee and hip osteoarthritis. 2nd edn. East Melbourne, Vic: RACGP, 2018. www.racgp.org.au 
  14. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019 Nov;27(11):1578-1589. Epub 2019 Jul 3. PMID: 31278997 PubMed 
  15. Bjordal JM, Klovning A, Ljunggren AE et al. Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: a meta-analysis of randomised placebo-controlled trials. Eur J Pain 2006, doi: 10.1016/j.ejpain.2006.02.013.
  16. Bannuru RR, Schmid CH, Kent DM, et al. Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: A systematic review and network meta-analysis. Ann Intern Med 2015; 162: 46-54. doi:10.7326/M14-1231 DOI 
  17. Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015 Jan 9;1:CD004376. Cochrane (DOI) 
  18. Anwer S, Alghadir A, Brismée JM. Effect of Home Exercise Program in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. J Geriatr Phys Ther. 2016 Jan-Mar;39(1):38-48. pmid: 25695471. PubMed 
  19. Juhl C, Christensen R, Roos EM, et al. Impact of exercise type and dose on pain and disability in knee osteoarthritis: A systematic review and meta-regression analysis of randomized controlled trials. Arthritis Rheumatol 2014; 66: 622–636. doi: 10.1002/art.38290 DOI 
  20. Amin S, Baker K, Niu J, et al. Quadriceps strength and the risk of cartilage loss and symptom progression in knee osteoarthritis. Arthritis Rheum 2009; 60: 189-98. PubMed 
  21. Tanaka R, Ozawa J, Kito N, et al. Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2013;27(12):1059-71. doi: 10.1177/0269215513488898.
  22. American Academy of Orthopaedic Surgeons Management of Osteoarthritis of the Knee (Non-Arthroplasty). Evidence-Based Clinical Practice Guideline. Published 08/30/2021 www.aaos.org 
  23. da Costa BR, Pereira TV, Saadat P, et al. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis. BMJ. 2021 Oct 12;375:n2321. PMID: 34642179 PubMed 
  24. Grotle M, Hagen KB, Natvig B, Dahl FA, Kvien TK. Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord. 2008 Oct 2;9:132. PMID: 18831740 PubMed 
  25. da Costa BR, Reichenbach S, Keller N, et al. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. Lancet 2017. PMID: 28699595 PubMed 
  26. Gunter BR, Butler KA, Wallace RL, et al. Non-steroidal anti-inflammatory drug-induced cardiovascular adverse events: a meta-analysis. J Clin Pharm Ther 2017; 42: 27-38. pmid:28019014 PubMed 
  27. Han SB, Seo IW, Shin YS. Intra-Articular Injections of Hyaluronic Acid or Steroids Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cells, or Placebo in Knee Osteoarthritis: A Network Meta-Analysis. Arthroscopy. 2020 Apr 17:S0749-8063(20)30318-2. Epub ahead of print. PMID: 32305424. PubMed 
  28. McAlindon TE, LaValley MP, Harvey WF, et al . Effect om intra-articular triamcinolone vs saline on knee cartilage volumen and pain in patients with knee osteoarthritis. A randomized clinical trial. JAMA 2017; 317: 1967-75. doi:10.1001/jama.2017.5283 DOI 
  29. Machado GC, Maher CG, Ferreira PH, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ 2015; 350: h1225. doi:10.1136/bmj.h1225 DOI 
  30. Østerås N, Moseng T. Oppsummering av behandlingsanbefalinger for hofte- og kneartrose. Nasjonal kompetansetjeneste for revmatologisk rehabilitering (NKRR). Publisert 30.04.2019 / Sist oppdatert 06.04.2021. diakonhjemmetsykehus.no 
  31. Østerås N, Moseng T. Behandlingsanbefalinger ved kne- og hofteartrose. Enhet for forskning og innovasjon, Klinikk for revmatologi, poliklinikk og forskning, Diakonhjemmet sykehus. Mai 2021.
  32. Xu Z, He Z, Shu L, et al. Intra-Articular Platelet-Rich Plasma Combined With Hyaluronic Acid Injection for Knee Osteoarthritis Is Superior to Platelet-Rich Plasma or Hyaluronic Acid Alone in Inhibiting Inflammation and Improving Pain and Function. Arthroscopy. 2020. PMID: 33091549 PubMed 
  33. Lisi C, Perotti C, Scudeller L, et al. Treatment of knee osteoarthritis: platelet-derived growth factors vs. hyaluronic acid. A randomized controlled trial. Clin Rehabil. 2018; 32: 330-9. PMID: 28783969 PubMed 
  34. Patel S, Dhillon MS, Aggarwal S, et al. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med 2013; 41: 356-64. pmid:23299850 PubMed 
  35. Le ADK, Enweze L, DeBaun MR, Dragoo JL. Current Clinical Recommendations for Use of Platelet-Rich Plasma. Curr Rev Musculoskelet Med. 2018; 11: 624-34. pmid:30353479 PubMed 
  36. Bennell KL, Paterson KL, Metcalf BR, et al. Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis The RESTORE Randomized Clinical Trial. JAMA 2021; 326: 2021-30. pmid:34812863 PubMed 
  37. Sit RWS, Wu RWK, Rabago D, et al. Efficacy of Intra-Articular Hypertonic Dextrose (Prolotherapy) for Knee Osteoarthritis: A Randomized Controlled Trial. Ann Fam Med. 2020 May;18(3):235-242. doi: 10.1370/afm.2520. PMID: 32393559 PubMed 
  38. Vaysbrot EE, Osani MC, Musetti MC , et al. Are bisphosphonates efficacious in knee osteoarthritis? Osteoarthritis Cartilage 2018; 26:154-64. PMID: 29222056 PubMed 
  39. Cai G, Aitken D, Laslett LL, et al. Effect of Intravenous Zoledronic Acid on Tibiofemoral Cartilage Volume Among Patients With Knee Osteoarthritis With Bone Marrow Lesions A Randomized Clinical Trial. JAMA 2020; 323: 1456-66. doi:10.1001/jama.2020.2938 DOI 
  40. Pas HI, Winters M, Haisma HJ et la. Stem cell injections in knee osteoarthritis: a systematic review of the literature. Br J Sports Med 2017; 51: 1125-33. pmid:28258177 PubMed 
  41. van den Driest JJ, Schiphof D, Koffeman AR, et al. No Added Value of Duloxetine in Patients With Chronic Pain due to Hip or Knee Osteoarthritis: A Cluster-Randomized Trial. Arthritis Rheumatol 2022; 74: 818-828. pmid:34989159 PubMed 
  42. Lu Z, Li X, Chen R, Guo C. Kinesio taping improves pain and function in patients with knee osteoarthritis: A meta-analysis of randomized controlled trials. Int J Surg. 2018 Nov;59:27-35. Epub 2018 Sep 28. PMID: 30273684 PubMed 
  43. Hinman RS, McCroy P, Pirotta M, et al. Acupuncture for chronic knee pain. A Randomized clinical trial. JAMA 2014; 312: 1313-22. doi:10.1001/jama.2014.12660 DOI 
  44. Beard DJ, Davies LJ, Cook JA, et al. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Lancet 2019. pmid:31326135 PubMed 
  45. Price AJ, Alvand A, Troelsen A, Katz JN, Hooper G, Gray A, Carr A, Beard D. Knee replacement. Lancet. 2018 Nov 3;392(10158):1672-1682. PMID: 30496082 PubMed 
  46. Shan L, Shan B, Suzuki A, et al. Intermediate and long-term quality of life after total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Am. 2015;97(2):156-68. PMID: 25609443 PubMed 
  47. Kane RL, Saleh KJ, Wilt TJ, Bershadsky B, Cross WW III, MacDonald RM, et al. Total knee replacement. Rockville, MD: Agency for Healthcare Research and Quality, 2003. (Evidence report/technology assessment No 86.)
  48. Kmietowicz Z. Mortality after hip and knee replacement has halved since 2003. BMJ 2014; 349: g5599. pmid:25216656 PubMed 
  49. Lindberg MF, Miaskowski C, Rustøen T, Rosseland LA, Cooper BA, Lerdal A. Factors that can predict pain with walking, 12 months after total knee arthroplasty. Acta Orthop. 2016; 87: 600-6. PMID: 27658970 PubMed 
  50. Robertsson O, Knutson K, Lewold S, Lidgren L. The Swedish Knee Arthroplasty Register 1975-1997. An update with special emphasis on 41,223 knees operated on in 1988-1997. Acta Orthop Scand 2001; 71: 503-13. PubMed 
  51. Minns Lowe CJ, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis: systematic review and meta-analysis of randomised controlled trials. BMJ 2007; 335: 812. British Medical Journal 
  52. Holm B, Hvidovre HK. Genoptræning efter total knæalloplastik. Ugeskr Læger 2009; 171: 691. Ugeskrift for Læger 
  53. Liao CD, Lin LF, Huang YC, et al. Functional outcomes of outpatient balance training following total knee replacement in patients with knee osteoarthritis: A randomized controlled trial. Clin. Rehabil 2014. pmid:25552523 PubMed 
  54. Tria AJ Jr, Coon Tm. Minimal incision total knee arthroplasty: early experience. Clin Orthop 2003; 416: 185-90. PubMed 
  55. Petursson G, Fenstad AM, Gøthesen Ø, Aamodt A, et al. Computer-Assisted Compared with Conventional Total Knee Replacement: A Multicenter Parallel-Group Randomized Controlled Trial. O. J Bone Joint Surg Am. 2018; 100:1265-74. PMID: 30063588 PubMed 
  56. Martin GM. Complications of total knee arthroplasty. UpToDate. Topic last updated Mar 18, 2020. Site visited 28.09.2021. www.uptodate.com 
  57. Flugsrud GB, Nordsletten L, Reinholt FP, et al.. Artrose. Tidsskr Nor Legeforen 2010; 130: 2136. doi:10.4045/tidsskr.09.1054 DOI 
  58. Figueroa D, Calvo R, Villalón IE, Meleán P, Novoa F, Vaisman A. Clinical outcomes after arthroscopic treatment of knee osteoarthritis. Knee. 2013 Dec;20(6):591-4. doi: 10.1016/j.knee.2012.09.014. Epub 2012 Oct 25. PMID: 23103346. PubMed