Osetoarthritis (Hip)

Question 1

What is osteoarthritis?

Answer 1

A disorder of synovial joints characterised by articular surface wear and formation of new bone (attempts at repair)

Question 2

Pathophysiology of osteoarthritis.

Answer 2

Degradation of cartilage and remodeling of bone due to an active response of chrondocytes in the articular cartilage and the inflammatory cells in the surrounding tissues. The release of enzymes from these cells break down collagen and proteoglycans, destroying the articular cartilage. The exposure ot the underlying subchondral bone results in sclerosis following by remodeling changed that lead to the formation of osteophytes and subcondral bone cysts. Joint space progressively loss over time.

Question 3

What are the pathological changes in osteoarthritis? (9)

Answer 3

1. Cartilage degeneration- fibrillation/erosion at bone ends.
2. Subdural bones become exposed
3. Loss of shock absorbing properties
4. Increased forces-through area
5. Increased bone production leading to sclerosis ot bone ends (eburnation)
6. Formation of cysts/osteophytes
7. Joint space narrowing
8. Ligaments may become lax
9. Synovitis

Question 4

What is the epidemiology of osteoarthritis? (Prevalance/who?)

Answer 4

1. 1 in 9 over 45 years
2. Higher prevalence in male for OA but women for arthritis in general
3. Obesity

Question 5

What is the aetiology of osteoarthritis? (Causes)(9)

Answer 5

1. Age
2. Genetics
3. Cogenital-developmental dysplasia of the hip
4. Previous injury
5. Overuse from employment or sporting activities
6. Obesity
7. Osteoporosis
8. Contradictary evidence of low level vitamin D
9. Occupation i.e manual labor

Question 6

What are the clinical features of osteoarthritis?

Answer 6

1. Pain and stiffness in joints- worsened with activity and relieved by rest.
2. Pain worse throughout the day- stiffness tends to improve
3. Deformity
4. Reduced ROM
5. Trendelenberg
6. Leg length discrepency