KNEE OSTEO ATRHRITIS

Knee pain -
Osteoarthrosis
Degenerasi

Over weight Over used Injury

Fragmentasi & Nyeri & kaku lutut

erosi rawan sendi
Antalgic gait
Hipertrofi
subchodr. & Rom: Flx < Ext
osteofit Firm end feel
Corpus libera
JPM: Nyeri akhir
Kontraktur ROM / Firm end feel

Joint blockade Joint blockade Sugijanto, 2015

 OA Lutut

Functioning, and disability Contextual

factor
Anatomic impairment
Internal External
Capsul factor factor
Rawan Otot/ Vascular
Sendi Ligamen Tendon
Micro
Laxity Spasme Sirculation
Erosi
Kontraktur
Inflamasi tl Penumpukan
Subchondral Deformitas zat iritan

Immobilisasi Functional
Osteofit Nyeri impairment
Capsular pagi
Iritasi Pattern Activity
Participation
Jaringan limitation
Tightness/ Lemah restriction
Kontraktur
Inflamasi
Nyeri Antalgic gait Work
Kronis
Regang

Hypomobility Stair Sport

Nyeri Nyeri
kompresi climbing
Regang Recreation
Sugijanto, 2015
PEMERIKSAAN FISIOTERAPI YG
DIBUTUHKAN
Diutamakan pemilihan evidence untuk:
 Pemeriksaan alignment lutut:
◦ Deformitas valgus/varus/recurvatum
 Pemeriksaan rawan sendi:
◦ Passive  crepitasi
◦ Compression test  nyeri
◦ Traction test  hilangnya nyeri
 Pemeriksaan Capsul sendi:
◦ Passive test: ROM  capsular pattern; end feel.
◦ Joint play movement  nyeri dan end feel
◦ Stability test  lig laxity
 Pemeriksaan otot
◦ Isometric test: muscle strength and stability  functional test
 Pemeriksaan gait:
◦ Pathological gait: antalgic gait, trendelen’s berg gait, dll
 Pemeriksaan disabilitas

Sugijanto, 2015
 TES KHUSUS
• Tes khusus
– JPM test fleksi, ekstensi tibio femoral joint, firm end
feel.
– Patello femoral test
– Ballotement test
– Fluktuation test
• Pemeriksaan lain
– X ray: penyempitan sela sendi; penebalan tulang
subchondrale; osteophyte.
• Diagnosis
– Nyeri gerak tibio femoral joint dan Capsular pattern
tibio femoral joint secondary to Osteoarthrosis tibio
femoral joint

Sugijanto, 2015
FISIOTERAPI YG DIBUTUHKAN
 MODALITAS DAN METODA
◦ Anatomic Impairment target:

◦ Functional Impairment target

◦ Disability target
 Contoh:
◦ US pd sela sendi
◦ Mobilisasi Patella
◦ Strengthening Pes anserinus/Iliotibial band
◦ Strengthening Vastus medialis/-lateralis
◦ Latihan fungsional
◦ Dll

Sugijanto, 2015
TEST & INTERVENSI
 Intervensi

Ultra Sound
Joint mobilization

Active mobilization

 Reevaluasi:
Pain, ROM, Gait

Sugijanto, 2013
2015
ALAT UKUR/EVALUASI
FISIOTERAPI YG DIBUTUHKAN
 Pengukuran nyeri:

 Pengukuran stabilitas sendi:

 Pengukuran mobilitas sendi:

◦ ROM,
 Analisis berjalan

 Pengukuran movement disfunction

 Pengukuran disabilitas
Sugijanto, 2015