Knee arthritis in active individuals: matching treatment to the diagnosis.

Even among the active middle-aged population, knee arthritis is a common condition that can greatly decrease quality of life. The 45 degrees flexion weight-bearing radiograph, a crucial diagnostic step, can show joint space loss. Each patient must be treated individually, but conservative treatment with medication, activity modification, exercise, physical therapy, braces, and joint injections may be effective for long periods. Operative modalities include joint arthroscopy and reconstructive procedures such as osteotomy and joint arthroplasty. In injured knees, meniscus and cartilage transplants may prevent the development or progression of osteoarthritis. Total knee arthroplasty should be considered in active patients only when all other options have been exhausted.