Osteoarthritis (OA) OA Osteoarthritis is a poor name for - - PowerPoint PPT Presentation

Osteoarthritis (OA)

OA

• Osteoarthritis is a poor name for

degenerative joint disease. Articular cartilage is involved more than bone, and inflammation is secondary to the disease, not the cause.

• ‘Osteoarthrosis’ is sometimes used as an

alternative, and ‘Osteochondrosis’ would be more accurate.

• Dandy. D.J.(1989)

Classifying OA

• Primary OA – no clear-cut cause (although there

are well-known risk factors)

• Secondary OA – Known cause

For example Trauma Skeletal abnormalities Inflammatory arthritis Metabolic causes (eg Acromegaly, CPPD, Haemochromatosis)

Risk factors for primary OA

• Obesity
• There is a hereditary influence on some forms of

OA, especially hand and knee OA in women, the genetic basis of this is yet to be discovered.

• Occupation (OA in hips in farmers, midfoot joint

OA in ballet dancers, finger OA in rock climbers)

• Women with osteoporosis have a lower risk of

developing OA and vice versa.

• (Stein,M. & Taylor,G. 2004)

Symptoms of OA

• Pain
• Stiffness
• Joint swelling
• Altered function

Conservative treatment for OA

• Explanation of the condition and reassurance

(widespread and severe OA can be disabling, but it is fairly uncommon)

• Advice to be active, but to modify activities to protect the

joints.

• Assistive aids
• Physiotherapy
• Drug therapy (Analgesics, NSAIDs, Steroid injections)
• Complementary therapies
• Weight loss (if overweight)
• Heat and cold

Surgical treatment of OA

• Debridement If osteophytes seriously obstruct joint movement, or

are unsightly, it is possible to remove them. They can recur, however.

• Arthrodesis, the fusion of the joint, converts a stiff, painful joint in a

bad position, to a stiff, painless joint in a good position. It should

• nly be performed if the neighbouring joints are healthy and have a

good range of movement. The joint should be fixed in the most functional position.

• Osteotomy can correct deformity and alters the architecture at the

site of healing, allowing for some remodelling. The operation can be painful, can require a long period of rehabilitation, and the symptoms can recur. In its favour, the operation does not destroy the joint irreparably.

• Joint replacement surgery can give remarkable results. But

infection is a possibility and can be catastrophic. The prosthesis can also fail or become loose, usually requiring further surgery.

References

• Dandy,D.J. 1989 Essential Orthopaedics

and Trauma. Churchill Livingstone, Edinburgh

• Stein,M. & Taylor,G. 2004. The

Encylopedia of Arthritis. Facts on File, New York

Questions……?