Osteoarthritis Flashcards
What is osteo-arthritis?
The gradual abrasion of articular cartilage layer
Osteoarthritis symptoms
Pain
Inflammation
Joint stiffness & deformity
Crepitus
Bony spurs
Loss of cartilage
Most common sites of OA
- Knee
- Hip
Ages affected from OA
> 30 = increased prevalence iwth age
Why are women more heavily affected by OA?
Hormone changes (< estrogen after menopause).
Relationship between OA and osteoporosis?
Inverse relationship (typically you either have OA or osteoporosis not both)
How is OA genetically caused?
Vitamin D receptor gene (causes it not to be absorbed properly resulting in OA)
What age group is most at risk of OA
70-79
Prevalence of knee arthritis
Women = 1100/100,000
Men = 800/100,000
Prevalence of hip arthritis
Women = 600/100,000
Men = 400/100,000
Prevalence of hand arthritis
Women = 550/100,000
Men = 300/100,000
Typical osteoarthritis arthritis
Cartilage erosion
Exposed bone (accelerates degradation)
Movement is painful/ROM decreased due to meniscus and cartilage degradation (these structures are meant to be protective cushioning)
Bone spurs - heightened osteoblast activity = new bone laid down (further limits ROM/causes pain)
Role of X-ray in OA
Determines extent of damage
Can identify presence of bony spurs, lesions and subchondral sclerosis (thickening of bone)
Role of MRI in OA
Higher level of detail
T2 mapping (colour scale) can estimate the amount of cartilage collagen
Sodium imaging (heat scale) can estimate cartilage glycosaminoglycan content
What is rheumatoid arthritis
Synovial disease characterised by joint inflammation and destruction
Affects the joint capsule.
Rheumatoid arthritis symptoms
Joint deformity
Stiffness
Swelling
Pain
What type of disease is rheumatoid arthritis
Autoimmune disease - joint tissue perceived as foreign
What happens to the broken down tissue in rheumatoid arthritis
It is replaced with non-functional scar tissue
Causes of rheumatoid arthritis
Hereditary and overactive
How does the inflammation affect the jont?
Inflammation of the synovial capsule leads to destruction of the joint (causes pain, discomfort, inability to function under high intensity)
What site of arthritis causes the greatest amount of pain & what site affects quality of life the most?
Knee = Highest level of pain
Hand = Greatest effect on QOL
OA medication
Pain relief
Anti-inflammatories
Corticosteroids
Hyaluronic acid
How long should you exercise per week to reduce symptoms of OA?
75 minutes
What vitamins are important for OA?
Vitamin C (anti-oxidant)
Vitamin D - bone resilience building capability helps with swelling/joint pain
What is the focus of exercise in OA?
Reducing body mass (less load on joint)
Aerobic capacity
Treatments for OA
Cartilage replacement therapy: synthetic hydrogels painted directly onto damaged cartilage
Joint replacement (last resort). Now lasts between 25-30 years.
RA medication
DMARD - disease modifying non-steroidal anti inflammatory drug eg ibuprofen (anti-rheumatic drug)
Celebrex
Immunomodulators
Glucocorticoids
Rose hip berries
RA surgical options
Synovectomy - synovial fluid removed from joint capsule
Joint replacement surgery
What supplements can be taken for arthritis
Glucosamine and chondroitin
Can assist in the integrity of glycosaminoglycans which assist in cartilage formation
Meta-analysis reported no significant effect of chondroitin on pain in OA patients
Physical assessments for arthritis
X-ray/MRI
Blood tests
CV assessment (treadmill, etc)
HR, ECG, RPE, dyspnea monitored
What is the rheumatoid factor in a blood test?
Low hematocrit or c-reactive protein
What 3 factors contribute to symptoms of OA
Deconditioned muscle
Inadequate motion
Periarticular stiffness
Osteoarthritis and rheumatoid cardiovascular guidelines
Initially: 3/week, 40-50% MHR, 20 mins
Progress to: 5/week, 80-85% MHR, 60 mins
Osteoarthritis and rheumatoid strength guidelines
2-3/week, high rep range, compound, max vol effort
Osteoarthritis and rheumatoid flexibility guidelines
4-5/week, no pain, 15-30s stretch, all major muscle groups x 2-4
