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