Osteoarthritis

Question 1

What is osteoarthritis?

Answer 1

degenerative, non inflammatory joint disease

Question 2

Pathology

Answer 2

deterioration of articular cartilage in synovial joints or the fibrocartilage in intervertebral discs
Most commonly weight bearing joints
secondary inflammatory changes
underlying pathological changes are both destructive and productive

Question 3

How does OA occur?

Answer 3

abnormal joint deteriorating with normal use

normal joint deteriorating being exposed to abnormal stresses

Question 4

contributing factors of OA

Answer 4

Orthopaedic conditions- things that have been previously treated and haven’t healed properly in children
Occupational overuse
Previous disease
Hereditary factors- occupation and lifestyle
Obesity

Question 5

How can secondary osteoarthritis occur?

Answer 5

joints being malalined
localised
repetitive strain
metabolic disease 
previous disease 
endemic

Question 6

What happens to the sub articular bone?

Answer 6

thickens and hardens
cysts and cracks form
osteocytes- joint becomes unstable because bone has lost stability
Eburnation

Question 7

What happens to the synovial membrane and capsule?

Answer 7

Inflammation
Fibrosis
Contraction

Question 8

What are the clinical features?

Answer 8

pain
deformity
stiffness
decreased RoM
decreased ADL
muscle wasting
altered gait
depression 
crepitus

Question 9

Pathological changes in OA

Answer 9

Osteocytes
thickened and inflamed synovium
thickened and stretched capsule
roughened and thinning cartilage

Question 10

Joint destruction in OA

Answer 10

Thickened and crunched up bone with no covering cartilage 
Inflamed synovium 
Tight and thickened capsule 
little remaining cartilage 
Bone deformity 
Osteocytes

Question 11

Treatment

Answer 11

Relieve load- diet
arthroscopy, arthroplasty- surgery 
physiotherapy- to relieve symptoms, decrease pain, increased RoM, relieve joint stiffness and load
improve ADL
guidelines of OA