Osteoarthritis Flashcards
Define Osteoarthritis
Progressive disease that involves ALL tissues of a joint and involves failure tissue to repair joint damage due to abnormal joint stress. It is NOT a “wear and tear” disease. Characterized by a thickening of subchondral bone and biological breakdown of cartilage.
Describe osteoarthritis
OA is an active disease process with ALL cells of joint.
- Synovium and joint capsule -> inflammation and fibrosis
- Bone -> Subchondral bone thickening, increased vascularity, and osteophytes formation (spiny bone projections that form adjacent to joint)
- Cartilage -> loss of aggrecan and erosion; leads to cartilage breakdown (biological process, not wear and tear)
- Meniscus and ligament degeneration -> tears and loss of mechanical strength
Outline the prevalence of osteoarthritis
- Most common form of arthritis
- Most common in late middle to old age
- 1/8 Australians have OA
- 2:1 ratio of female: male
- Risk increases with age
Common causes of OA?
- Joint trauma: repetitive overloading of joints
- Obesity
- Inflammation
List risk factors of OA
Susceptible joint:
- injury (i.e. joint trauma)
- Alignment
- Occupation
- Bone shape
- Muscle weakness
Susceptible individual
- Obesity - Most important risk factor for Knee OA
- Age
- Race/ethnicity
- Bone metabolism
- Gender
- Dietary
List the signs and symptoms of OA
- Pain is mechanical in nature and gradual onset: pain occurs due to activity of the joint.
- Morning stiffness is absent or short
- Joint swelling
- Reduction in joint range of motion
- Joint deformity
- “Grating” sensation of joint (since it’s bone-on-bone contact)
- Few joints affected and unilaterally affected.
List the involved joints of OA
Bilateral joint movement on hands and unilateral joint involvement on limbs
- Usually affects one or few joints
- Hands: finger tips -> distal and proximal interphalangeal joints; base of thumb -> 1st carpalmetacarpal joint (squaring of thumb)
- Hips
- Knee
- Cervical and lumbar vertebrae
Describe appropriate investigations for OA
Laboratory tests -> OA is considered a non-inflammatory arthritis, so laboratory testing doesn’t contribute.
List radiology features of OA
- Osteophyte formation
- Narrowing of joint space
- Subchondral bone sclerosis - increase bony density and bone mass in thin layer under cartilage
- Subchondral bone cysts - Radiolucent regions in bone under cartilage
List the non-pharmacological treatments of osteoarthritis
- Education
- Exercise
- Weight loss
- Appropriate footwear
- Physiotherapy
- Braces
Describe the procedures involved in joint protection
Prevention includes:
- Maintain low obesity
- Maintain minimal joint injury
Describe the role of physiotherapy in managing osteoarthritis and its components
Physiotherapy is more important than pharmacological treatment
- Strength training
- AErobic conditioning
Outline the surgical management of OA
if OA is main pathology, treating meniscal tear or loose body won’t treat symptoms. Need to totally replace the affected joint.
Identify the implications of osteoarthritis in clinical dentistry e.g. mobility, dexterity
Two factors to consider:
- Ability to manipulate oral hygiene aids (e.g. tooth brush)
- Ability to maneuver to and within dental office
