Osteoarthritis 🦵

Question 1

Epidemiology of osteoarthritis in Aus..

Answer 1

9.3% have OA
62% of all arthiritis = are OA

2X MORE LIKELY IN WOMAN

Question 2

Define OA

Answer 2

1. Chronic condition
2. Involves movable joints
   Characterised by cell stress
   Initiated by micro and macro injury
   That activates maladaptive repair responses
   Including pro inflammatory pathways of innate immunity

Question 3

Pathophysiology of OA

Answer 3

Synovial activation:
Synovial membrane become irritated and activated, releasing proteases which break down collagen and release inflammatory factors and activate macrophages.

Physical activation: induces cartilage breakdown
Physical stress and damage reduce collagen formation as we get an increase in enzymes

Question 4

Symptoms of OA

Answer 4

• pain with activity
• limited range of motion
• joint stiffness
• joint swelling
• knee tenderness .

Question 5

Treatments of OA

FIRST LINE?

Answer 5

1. Weight control.
2. Therapeutic exercise
3. Patient education

EDUCATED ON
- Likelihood of slow or minimal disease progression
- fluctuating nature of symptoms
- poor correlation between symptoms and radiological findings

Question 6

Pharmacological treatments of OA
1st and 2nd line

Answer 6

1st line = topical NSAIDS qnd capsaicin (depletes substance P)

2nd line = Paracetamol or oral NSAID

3rd line = Intra articular injection:
Duloxetine = inhibit serotonin and noradrenaline re-uptake

Question 7

Last resort therapy for OA

Answer 7

Surgery (replacement)
- osteotomy = cuts and reshapes bone
Arthroplasty = joint replacement (w artificial joint)