Osteoarthritis And Management

Question 1

What is the definition and classification of osteoarthritis?

Answer 1

“Tear, flare and repair”

Question 2

What are the causes, pathology and epidemiology of osteoarthritis?

Answer 2

Bio mechanical factors: DDH, intra articular fracture, ligament rupture, meniscal injury, occupation, persistent heavy physical activity, elite running, obesity

inflammation and pain: synovial hypertrophy increases size and amount of fluid giving swelling

repair processes: increased pressure and damage from the factor changes/weakness on subchondrium, joint effusion

Question 3

What are the clinical features of osteoarthritis?

Answer 3

Activity related joint pain
+
No morning joint related stiffness or <30 min morning stiffness

Question 4

What is the investigation and management of osteoarthritis?

Answer 4

Investigations: x ray, ideally weight bearing and 2 xrays at 90*

Management:
1. Holistic approach eg occupation, pain assessment and self management
2. Information, exercise and weight loss
3A. Non pharmacological
3B. Pharmacological eg oral analgesia, topical treatments (NSAIDs, capsaicin), intra articular injections (steroid)
3C. Referral for consideration of joint surgery (impact on QoL, not responding to non surgical TM) -> surgical options
4. Follow up and review