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Osteoarthritis: A Comprehensive Guide

Osteoarthritis is a common joint disease caused by cartilage breakdown that leads to pain and stiffness. It typically affects older individuals and can be triggered by injury or genetic factors. Symptoms include joint pain and reduced mobility. Diagnosis involves examining medical history, physically inspecting the affected joints, and obtaining imaging like x-rays. Treatment focuses on pain relief through medications, physical therapy, braces, and surgery for severe cases. Lifestyle changes like exercise and weight control can also help manage symptoms.

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Phannyta Cherry
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62 views37 pages

Osteoarthritis: A Comprehensive Guide

Osteoarthritis is a common joint disease caused by cartilage breakdown that leads to pain and stiffness. It typically affects older individuals and can be triggered by injury or genetic factors. Symptoms include joint pain and reduced mobility. Diagnosis involves examining medical history, physically inspecting the affected joints, and obtaining imaging like x-rays. Treatment focuses on pain relief through medications, physical therapy, braces, and surgery for severe cases. Lifestyle changes like exercise and weight control can also help manage symptoms.

Uploaded by

Phannyta Cherry
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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OSTEOARTHRITIS

By: Vien Hardiyanti


Definition
• Osteoarthritis is a joint inflammation that results
from cartilage degeneration.
• Osteoarthritis can be caused by aging, heredity,
and injury from trauma or disease.
• The most common symptom of osteoarthritis is pain
in the affected joint(s) after repetitive use.
Epidemiology
 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
Type of Osteoarthritis
Idiopathic osteoarthritis
 No identifiable cause

 May be localized (confined to one or two joints)


or generalized (present in three or more joints)
Secondary osteoarthritis
 Caused by an underlying condition: joint injury,
accumulation of calcium inside the joint, other
bone and joint conditions (eg, rheumatoid
arthritis), or a medical condition, such as diabetes
 Fibrillation

 Eburnation

 Osteophytes

 Subcondral cysts
Symptoms of osteoarthritis
 Joint pain
 Tenderness
 Swelling
 Stiffness
 Locking
 Sometimes an effusion
 Reduced motion
 Decreased movement can lead to pain, regional muscles
may atrophy, and ligaments may become more lax
Osteoarthritis
sites
Diagnosis

The diagnosis of osteoarthritis includes 3 major stages:


1. Patient history analysis
2. Physical examination
3. Imaging and Laboratory tests
Patient history analysis

 The diagnosis begins with medical history, or information


about :

 Patient’s health background


 Conditions running in the family as some disorders are
inherited
 Symptoms that prompts a patient to seek medical attention
Physical Examination
 Based on the symptoms and the physical signs found
when examining the joints. The doctor checks for:
 joint tenderness
 creaking or grating (crepitus) sounds
 bony swelling
 excess fluid
 reduced movement
 joint instability
 muscle thinning
Imaging and Laboratory Tests
Imaging Tests:
 X-ray

 Magnetic Resonance Imaging (MRI)

 Arthroscopy

Laboratory Tests:
 Blood tests

 Joint Fluid Analysis/Joint aspiration


Imaging Tests

X-ray
 Most useful test to confirm osteoarthritis

 Cartilage doesn't show up on X-ray images

 Cartilage loss is revealed by a narrowing of the


space between the bones in your joint
 Bone spurs may be observed around a joint.

 Patients may have X-ray evidence of osteoarthritis


before experiencing any symptoms
 Detect calcium settling in joints
Magnetic resonance imaging
(MRI)

 Uses radio waves and a strong magnetic field


to produce detailed images of bone and soft
tissues, including cartilage
 Not commonly needed for diagnosis, but, may
help provide more information in complex cases
 Expensive than X-ray

 Does not involve radiation risk

 Provides 2-D view resulting in better images


Arthroscopy

 Minimally invasive surgical


procedure
 An Arthroscope is inserted
into the joint area through
small incisions to find or even
repair damage done to the
joint
 Reduced recovery time
 High success rate due to less
damage done to connective
issue
 Less scarring
 Advantageous to athletes
Laboratory Tests
Blood test
 No blood test for osteoarthritis as such

 Suggested to rule out other types of arthritis e.g.


rheumatoid arthritis

Joint Fluid Analysis/Joint aspiration


 A needle is used to draw fluid out of the affected joint
after the administration of anesthesia
 Examination and testing of the fluid to determine
presence of inflammation , crystals or joint deterioration
Management: Algorithm
Lifestyle Modifications Acetaminophen

NSAIDs Celecoxib

Steroid Injections Opioids

Hyaluronan Injections

Surgical Referral
PRIMARY PREVENTION OF OA ??

 Regular exercises

 Weight control

 Prevention of trauma
SYMPTOMATIC TREATMENT OF OA

 Decrease of joint loading


- Weight control
- Splinting
- Walking sticks
 Exercises
- Swimming
- Walking
- Strengthening
 Patient education
Non-Pharmacologic Treatment of OA

 Patient education
 Weight loss (if overweight)
 Aerobic exercise programs
 Physical therapy
 Range-of-motion exercises
Muscle-strengthening exercises
 Assistive devices for ambulation
Appropriate footwear
Lateral-wedged insoles (for genu varum)
 Bracing
 Occupational therapy
 Joint protection and energy conservation
PHARMACOLOGIC TREATMENT OF OA

 Oral Systemic Medical Agents


- Analgesics (acetaminophen)
- NSAIDs
- Opioid analgesics

 Intraarticular agents:
Hyaluronan
Glucocorticoids (effusion)

 Topical agents
INDICATIONS OF SURGICAL
INTERVENTION

 Severe joint pain,


resistant to conservative treatment methods
 Limitation of daily living activities

 Deformity, angular deviations, instability


Management: Surgical
When to Refer
 Knee pain or functional status
has failed to improve with
non-operative management

Types of Procedures
 Arthroscopic Irrigation
 Arthroscopic Debridement
 High Tibial Osteotomy
 Partial Knee Arthroplasty
 Total Knee Arthroplasty
Management: Surgical
Partial Knee Arthroplasty
 Indication:
 Unicompartmental arthritis

 Ligaments spared

 Increased ROM

 Faster recovery

 Prosthesis 10-yr survival: 84%


Management: Surgical
High Tibial Osteotomy
 Indication:
 Unicompartmental arthritis
 Genu varus or valgus

 Realign mechanical axis


 Age < 60yo
 < 15 degrees deformity19
Management: Surgical
Total Knee Arthroplasty
 Indication:
 Diffuse arthritis
 Severe pain
 Functional impairment
 Pain relief > functional gain
 ACL sacrificed
 PCL also may be sacrificed
 Prosthesis 10-yr survival: 90%
Thank you

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