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Kneleddsartrose

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Patologiske forandringer i kneleddet som rammer brusken og de andre strukturene i og rundt leddet. Det finnes en klinisk og en radiologisk definisjon. 
Forekomst:
Omtrent hver tredje voksen person over 60 år har radiologiske tegn på tilstanden, prevalens av klinisk artrose ca. 10%. Økende forekomst med økende alder. Kvinner rammes noe hyppigere enn menn. 
Symptomer:
Milde, belastningsavhengige knesmerter i tidlig stadium. Stivhet etter hvile på dagtid, som bedres av noe aktivitet. Ingen eller kun kortvarig morgenstivhet. Etter hvert økende knesmerter, ev. om natten, ev. hvilesmerter. Symptomer fluktuerer over tid. Kun svak korrelasjon av radiologiske funn med symptomer. 
Funn:
Kan være hovent kne, krepitasjon, muskelatrofi, nedsatt passiv bevegelighet, ømme leddspalter og ev. palpable osteofytter.
Diagnostikk:
Tilleggsundersøkelser er ikke nødvendig dersom de kliniske kriteriene er oppfylt. Hos yngre pasienter (< 45 år), ved atypiske symptomer og ved vurdering av operative tiltak tas røntgen. Kun sjelden behov for MR.
Behandling:
Opplæring om sykdommen og individuelt tilpasset treningsprogram. Fysioterapeut kan tilpasse trening til den enkelte. Både utholdenhet, styrke og mental fysisk trening (yoga, tai chi) er anbefalt. Diettbasert vektreduksjon ved overvekt og fedme. Medikamentell behandling, inkludert leddinjeksjoner, kan være aktuelt. Ganghjelpemidler er aktuelt ved store gangproblemer. Kognitiv terapi ved utbredte smerter og behov for bedre smertemestring. Proteseoperasjon kan vurderes dersom konservativ terapi ikke fører frem.
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  • Tuva Moseng, fysioterapeut og forsker, enhet for forskning og innovasjon, klinikk for revmatologi, poliklinikk og forskning, Diakonhjemmet sykehus
  • Nina Østerås, fysioterapeut og seniorforsker, enhet for forskning og innovasjon, klinikk for revmatologi, poliklinikk og forskning, Diakonhjemmet sykehus
  • Peter D. Jost, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Arild Aamodt, overlege/professor, Ortopedisk avdeling, Lovisenberg Sykehus, Oslo
  • Stig Fossum, fysioterapeut, spesialkompetanse på muskel- og skjelettsykdommer, Moholt Fysioterapi, Trondheim
  • Bendik Johannessen, fysioterapeut, Trondheim