OSTEOARTHRITIS Dr Sami Abdallah. Anatomy of synovial joints:
Osteoarthritis. Osteoarthritis OA is a degenerative disease of diarthrodial ( synovial ) joints,...
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Transcript of Osteoarthritis. Osteoarthritis OA is a degenerative disease of diarthrodial ( synovial ) joints,...
Osteoarthritis
Osteoarthritis OA is a degenerative disease of diarthrodial (synovial) joints, characterized by
Breakdown of articular cartilage and proliferative changes of
surrounding bones
Osteoarthritis(OA) is the most common joint disease
OA of the knee joint is found in 70% of the population over 60 years of age
Radiological evidence of OA can be found in over 90 % of the population
OA may cause functional loss Activites of daily living Most important cause of disability in
old age
Major indication for joint replacement surgery
OA is a chronic disease of the musculoskeletal system, without systemic involvement
OA is mainly a noninflammatory disease of synovial joints
No joint ankylosis is observed in the course of the disease
Primary OA Secondary OA
Etiology is unknown Etiology is known
Age Sex Obesity Genetics Trauma (daily)
Trauma Previous joint disorders; Congenital hip dislocation Infection: Septic arthritis, Brucella, Tb Inflammatory: RA, AS Metabolic: Gout Hematologic: Hemophilia Endocrine: DM
There are no pathognomonic laboratory findings for OA
Laboratory analysis is performed for differential diagnosis
Narrowing of joint space (due to loss of cartilage)
Osteophytes
Subchondral (paraarticular) sclerosis
Bone cysts
G1 Normal G2 Mild G3 Moderate G4 Severe
Kellgren Lawrence Classification
CLINICAL FINDINGS Joint pain + RADIOLOGIC FINDINGS Osteophytes
More common in males over 40 years of age
Joint stiffness Pain of hip, gluteal and groin areas
radiating to the knee Mechanical pain Limited walking function
Hands Feet
Symptomatic treatment
Structure modifying treatment
Surgical treatment
Regular exercises
Weight control
Prevention of trauma
Pain relief
Preservation and restoration of joint function
Education
Patient education Weight loss (if overweight) Aerobic exercise programs Physical therapy Range-of-motion exercises
Muscle-strengthening exercises Assistive devices for ambulation
Patellar tapingAppropriate footwear Lateral-wedged insoles (for genu varum)
Bracing Occupational therapy Joint protection and energy conservation
Oral Systemic Medical Agents - Analgesics (acetaminophen) - NSAIDs - Opioid analgesics
Intraarticular agents: Hyaluronan Glucocorticoids (effusion)
Topical agents
Severe joint pain, resistant to conservative treatment
methods Limitation of daily living activities Deformity, angular deviations,
instability
Joint lavage Arthroscopy Cartilage grefting- genetic
engineering Surgery: Osteotomy Joint replacement