Osteoarthritis Flashcards
Role of inflammation in OA
Catabolic cytokines - IL1 increased in synovium
Correlates with osteophytes
Cardiovascular risk in OA
3 times increased CV mortality and double all cause mortality in knee OA, higher if symptomatic
Symptomatic hand OA also has higher CV risk
Role of gender in OA
Before age 50, men have more radiological OA
After age 50 OA increases in women
Women -twice at risk of developing bilateral knee OA
Hereditary disorders
Sticklers syndrome - hereditary arthro-opthalmopathy
Rare AD disorder linked to type II procollagen gene
Dysplasia of hip -risk for premature OA
Protective factor for OA in hip in older women
Osteoporosis!!
Higher bone mass is associated with increased hip OA
Obesity in OA
Obesity increases OA risk 2.4 times
Overweight increases by 35%
Knee injury and OA
Normal joints are not at risk of OA with adequate exercise
Abnormal joints - at increased risk with repetitive low impact recreational exercise
Meninscal and cruciate tears -increase risk by 5-10%
Strongest risk factor for hip and knee OA
Older age
Risk factors for developing symptoms and disability
Advanced radiological changes, female sex, lower education level, obesity, poor muscle strength
CV risk with NSAIDS in OA
1% over 3 yrs if no CV risk
3% with CV risk
Celecoxib doubles this risk
DOC in patients with OA who fail NSAID
Duloxetine
Topical treatment in OA
Capsaicin, topical NSAIDS
Opioid in OA
Only short term benefit
Role of nutritional supplements -chondriotin,glucosamine
Does not help in improving arthritis, may minimally improve pain
Most effective for management of OA long term
Muscle strengthening exercises
