Osteoarthritis Flashcards
What is osteoarthritis?
Progressive disorder of the joints caused by loss of cartilage and resulting in the development of bony spurs and cysts at the margins of joints.
What is the main tissue affected by osteoarthritis?
Articular cartilage
What changes happen in articular cartilage during osteoarthritis?
- Increased swelling
- Change in colour
- Cartilage fibrilation
- Cartilage erosion down to subchondral tissue
What are the differences between the types of osteoarthritis?
- Primary; degenerative disorder
- Secondary; -trauma
- infection
- hip dysplasia
- diabetes
What are the systemic risk factors involved in osteoarthritis?
- Age
- More common in women
- Genetics
- Nutritional, low vitamin C and D intake
What are the biochemical risk factors of osteoarthritis?
- Joint trauma
- Obesity
- Occupation
- Abnormal joint biomechanics
What are some of the symptoms and other clinical signs of osteoarthritis?
Symptoms;
-Pain, especially when doing load bearing activities
-Short lived stiffness in morning, improves in 30 mins or less when you start to move
-Difficulty moving affected joints or doing certain activities
Other signs;
-Sleep disturbance
-Limp (trendelburg sign)
What sort of things would be visible in an x-ray of an osteoarthritis patient?
- Narrowing of joint space
- Osteophytes (extra pieces of bone at joint preriphary?
- Subchondral sclerosis (some extra bone formation)
- Cyst formation
Describe the pathogenesis of OA?
Decreases in :
- water content (initial increase then decrease), therefore ECM becomes less robust biomechanically and function starts to be lost
- proteoglycan synthesis, less cushioning
- collagen X-linking, loss of main structure
- Size of aggrecan, GAG and hyaluronic acid
Is there a cure for OA?
NO
What are the goals for OA management/treatment?
- Manage symptoms by:
- decreasing pain
- increasing range of motion
- increased muscle strength
What possible medications could be used in OA management?
-paracetemol (pain management)
-glucosamine and chondroitin sulfate for articular cartilage repair
-Non-steroidal anti inflammatory drugs (NSAIDS) eg ibruprofen
-
What use are physiotherapy and walking aids in OA management?
Physiotherapy; -to increase range of motion, muscle strengthening, aerobic condition
-weight loss
Walking aids;- transfer load to unnafected side, reducing load on hip by 40%
What are examples of joint injections we may use for OA patients?
- Cortisone
- Corticosteroid
Why may we use joint injections for OA patients?
- Reduce inflammation around joints (tend to have more rapid response than NSAID’s)
- Replace modified synovial fluid in joints
- Increase elasticity and viscosity of fluid
