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Knee osteoarthritis — CCFP MCQ

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HardChronic disease managementKnee osteoarthritisCCFP

A 69-year-old has severe knee osteoarthritis with night pain and major walking limitation despite weight management, exercise, topical therapy and an intra-articular corticosteroid trial. She is medically fit and would consider surgery. What is the next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Refer for joint-replacement assessment using shared decision-making

Explanation lettering: D = shown as A · E = shown as C · C = shown as D · A = shown as E

E is correct. Persistent severe pain and functional loss despite comprehensive nonsurgical care justify referral for joint-replacement assessment when the patient is willing and medically appropriate. A adds long-term opioid harm and delays definitive review. B adds unnecessary imaging when clinical assessment and weight-bearing radiographs suffice. C uses excessive injections without durable benefit. D does not improve routine degenerative osteoarthritis. Referral is an assessment, not a commitment to surgery.

Reference: Ontario Health: Osteoarthritis quality standard: https://www.ontariohealth.ca/clinical/quality-standards/qs-details?cf=osteoarthritis