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OSTEOARTHRITIS
Osteoarthritis (OA) is a common,
degenerative disease, which is
characterized by local degeneration of
joint cartilage and new bone
formation at the base of the cartilage
lesion (subchondral bone) and at the
joint margins (osteophytes).
Osteoarthritis is the result of both mechanical and biologic events that destabilize the normal coupling of degradation and synthesis of articular cartilage and subchondral bone
Risk factors• Older age - Osteoarthritis typically occurs in older adults. People
under 40 rarely experience osteoarthritis. • Sex - Women are more likely to develop osteoarthritis, though it
isn't clear why. • Bone deformities - Some people are born with malformed joints or
defective cartilage, which can increase the risk of osteoarthritis. • Joint injuries - Injuries, such as those that occur when playing
sports or from an accident, may increase the risk of osteoarthritis. • Obesity - Carrying more body weight places more stress on your
weight-bearing joints, such as your knees. But obesity has also been linked to an increased risk of osteoarthritis in the hands, as well.
• Other diseases - that affect the bones and joints. Bone and joint diseases that increase the risk of osteoarthritis include gout, rheumatoid arthritis, Paget's disease of bone and septic arthritis.
Risk factors
Older age Osteoarthritis typically occurs in older adults. People under 40 rarely experience osteoarthritis.
Risk factors
Sex Women are more likely to develop osteoarthritis, though it isn't clear why.
Risk factors
Bone deformities Some people are born with malformed joints or defective cartilage, which can increase the risk of osteoarthritis.
Risk factors
Joint injuries Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis.
Risk factors
Obesity Carrying more body weight places more stress on your weight-bearing joints, such as your knees. But obesity has also been linked to an increased risk of osteoarthritis in the hands, as well.
Risk factors
Other diseases That affect the bones and joints. Bone and joint diseases that increase the risk of osteoarthritis include gout, rheumatoid arthritis, Paget's disease of bone and septic arthritis.
FACTORS
1. Genetic
2. Developmental
3. Metabolic
4. Traumatic
Classification
Primary• Aging• Sex
Secondary• Congenital disorders of joints • Diabetes. • Inflammatory diseases (such as
Perthes' disease), (Lyme disease), and all chronic forms of arthritis (e.g. costochondritis, gout, and rheumatoid arthritis). In gout, uric acid crystals cause the cartilage to degenerate at a faster pace.
• Injury to joints, as a result of an accident or orthodontic operations.
• Septic arthritis (infection of a joint ) • Ligamentous deterioration or
instability may be a factor. • Marfan syndrome • Obesity • Alkaptonuria • Hemochromatosis and
Wilson's disease
OA may affect every joint
OA may affect every joint
DEGENERATION OF THE ARTICULAR CARTILAGE
Symptoms• Pain in a joint during or after use, or after a
period of inactivity • Tenderness in the joint when you apply light
pressure • Stiffness in a joint, that may be most noticeable
when you wake up in the morning or after a period of inactivity
• Loss of flexibility may make it difficult to use the joint
• Grating sensation when you use the joint • Bone spurs, which appear as hard lumps, may
form around the affected joint • Swelling in some cases
DiagnosisX-RAY
Primary osteoarthritis of the left knee. Note the osteophytes, subchondral cyst formation, narrowing of the joint space (arrow), and increased subchondral bone density (arrow).
Diagnosis
Arthroscopy
NON-DRUG TREATMENT
•weight loss (normal weight people have a 20% risk of hip OA, overweight have 25% risk, and obese have 39% risk) •water exercise programs •physical therapy (range of motion and strengthening exercises) •occupational therapy (assistive devices, joint protection) •patient education
DRUG TREATMENT
• Acetaminophen• Non-steroidal anti-inflammatory drugs • Tanezumab (monoclonal antibody)• Chondroitin sulfate • Glucosamine • S-Adenosyl methionine
Surgery
INTRAARTICULAR INJECTION
• Artificial synovial fluid• Steroids• Enzyme inhibitors• Chondroprotectors
INTRAARTICULAR INJECTION
Surgeory
• Autologous chondrocyte implantation • Microfracture surgery • Arthroscopic surgery• Osteotomy • Limb lengthening• Arthrodesis• Joint replacement
Deformity correction
Deformity correction
Limb lengthening
Arthrodesis of ankle joint
Arthrodesis of ankle joint
Subtalar arthrodesis
Subtalar arthrodesis
TOTAL SHOULDER REPLACEMENT
TOTAL ELBOW REPLACEMENT
TOTAL HIP REPLACEMENT
TOTAL KNEE REPLACEMENT
TOTAL ANKLE REPLACEMENT
