Long-term treatment and follow-up of patients with osteoarthritis should include which of the following?

• A. Early referral to orthopedic surgery for joint replacement.
• B. Daily glucosamine with chondroitin sulfate supplementation.
• C. Weekly intraarticular corticosteroid injections.
• D. Muscle strengthening exercises.

Answer: (D)

Strengthening the muscles around the affected joint is central to long-term osteoarthritis management because stronger muscles improve joint stability, optimize load distribution, and reduce pain and functional limitation. In knee OA, for example, quad strengthening is particularly important because it supports the joint during activity and helps preserve function. A practical long-term plan includes regular resistance training (2–3 days per week) in addition to overall aerobic activity, with ongoing adjustments as symptoms change and as functional goals evolve. Weight management and a progressive home exercise program are also key parts of follow-up care to sustain these gains and prevent deterioration.

Other options aren’t the mainstay of chronic management. Referal to orthopedic surgery is reserved for cases unresponsive to optimal medical and nonpharmacologic treatment or when joint replacement is clearly indicated, not as a routine long-term plan. Daily supplements like glucosamine with chondroitin have not shown consistent, meaningful benefit for most patients. Weekly intraarticular corticosteroid injections may help with short-term symptom relief but are not appropriate as a long-term, ongoing strategy due to limited duration of effect and potential risks.