Osteoarthritis Flashcards
What is osteoarthritis?
OA is a progressive disorder of the joints caused by gradual loss of cartilage and resulting in the development of bony spurs and cysts at the margins of joints. It is a degenerative joint disease affecting all of the weigh-bearing components of a joint.
Where in the body does osteoarthritis most commonly appear?
Ends of the fingers and thumbs The neck The lower back The knees The hips
What are the characteristics of a joint with OA compared to a normal joint?
Thickened capsule Cyst formation Sclerosis in subchondral bone Shelving fibrillated cartilage Osteophytic lipping Synovial hypertrophy Altered contour if bone
What changes occur to the articular cartilage due to OA?
Water content decreases Proteoglycan synthesis decreases Collagen cross linking decreases Size of aggrecan, GAGs and hyaluronic acid decreases Traumatic damage
Secondary OA can result from…?
Trauma
Dysplasia
Infection
Diabetes
What are the systemic risk factors of OA?
Age
Geneetics
Gender
Low vitamin C and D intake
What are the joint biomechanical risk factors of OA?
Joint trauma Obesity Occupation Abnormal joint mechanics (dysplasia, malalignment, instability, abnormal innervation) Knee extensor weakness Sports which can damage joints
What are the key symptoms of OA?
Pain during load bearing activities which goes away with rest
Short lived (30mins or less) stiffness in the morning
Decreased walking distance
Sleep disturbance
Positive Trendelenburg sign (limp)
What is a classic sign of hip OA?
The patient is unable to stand on one leg because the pain of using the joint has resulted in lack of use and muscle wasting, so that they can no longer support themselves.
How can OA be diagnosed from X-rays?
Joint space narrowing
Osteophytes
Subchondral sclerosis
Cyst formation
OA cannot currently be cured, therefore the treatments are aimed at…?
Decreasing pain
Increasing range of motion
Increasing muscle strength
Non-operative treatments for OA include…?
Medications - paracetamol then NSAID’s
Physiotherapy - increases range of motion, strengthens muscle and aids weight loss
Walking aids - transfers load to other side
Joint injections - to be used sparingly and only if patients have severe pain and inflammation
What are the possible surgical treatments for OA?
Arthroscopy - not always beneficial
Cartilage transplantation - only in under 30s
Joint replacement - worn cartilage is removed and replaced wit synthetic material
