A 57-Year-Old Man With Osteoarthritis of the Knee

In a Clinical Crossroads article published in February 2003,¹ Jess H. Lonner, MD, discussed the epidemiology, treatment options, and potential complications of osteoarthritis of the knee. The discussion focused on Mr V, a 57-year-old athlete with a history of persistent knee pain spanning 30 years. Mr V was an avid long-distance cyclist, estimating his annual cycling distance to be approximately 7000 miles. His pain had escalated gradually until it became difficult for him to stand for long periods or bend down to garden. His pain was controlled with 500 mg/d of naproxen. Radiographs of the left knee in 1999 revealed marked tricompartmental osteoarthritis with prominent osteophyte formation and severe joint space narrowing. Mr V received disparate therapeutic recommendations ranging from ongoing physical therapy to total knee replacement. At the conference, Mr V wondered if he should continue long-distance cycling and also questioned whether and when he should have total knee replacement surgery.