Osteoarthritis CUE CARDS Flashcards
What is Osteoarthritis?
Degenerative joint disorder associated with pain, stiffness and reduced mobility
How is OA diagnosed?
Is diagnosed on the basis of clinical symptoms
No tests useful to help diagnose disease
What joints are involved in OA?
Typically, the involved joints are the hands, spine, knees and hips
What are the clinical features of OA?
> Increased age (unusual before 40 yrs)
Pain (use-related, relieved by rest)
Stiffness (short-lasting inactivity stiffness or gelling)
Reduced movement (restricted, pain on movement)
Swelling (joints develop palpable firm swelling at joint margin)
Crepitus (joints often crack or creak on movement)
No systemic symptoms
What are the risk factors of OA?
> Systemic Factors (increasing age and female predisposition)
> Lifestyle (previous occupations [laborers, famers], sports)
> Genetic (family predisposition)
> Local factors (malalignment, muscle weakness, meniscal damage)
> Loading (obesity, joint damage)
What are the Treatment Goals and Strategies of OA?
Not curable, goals of treatment are to:
> reduce/control pain
> optimise and maximise function
> prevent associated disability
Combination approach usually recommended:
> add non-pharmacological treatments to drug-therapy
Toxicity of surgery and drugs is generally unfavourable compared to non-pharmacological therapies
What is the OA treatment Hierarchy?
- Information and advice (education, weight loss, exercise)
- Self-help (simple analgesics)
- Simple non-surgical interventions (NSAIDs, OT, Physio)
- Advance non-surgical interventions (injections)
- Surgery (partial or total joint replacement and osteotomy, resurfacing)
What are the non-pharmacological treatments for OA?
> Patient self-education/self-management (improving knowledge and counsel on modifiable risk factors)
> Low impact exercise (e.g. swimming, walking, cycling, aerobic fitness, strengthening of quads)
> Weight loss
> Physical Therapy/Physio
> Knee braces, orthotics with knee instability and malalignment
