Treatment Options for Osteoarthritis Flashcards
What are the clinical symptoms of osteoarthritis?
Joint pain with use, morning stiffness lasting less than 30 minutes, joint instability/buckling, loss of function and crepitus
What are the clinical signs of osteoarthritis?
Bony enlargement at affected joints, limited range of motion, crepitus on motion, mal-aligment and/or joint deformity, muscle atrophy and weakness
What are the non-pharmacological treatments for osteoarthritis?
Exercise, diet (omega 3, chondroitin sulphate and glucosamine supplements), TENS, acupuncture, aid/devices
What are the pharmacological treatments for osteoarthritis?
Paracetamol, topical NSAID or topical capsaicin. If ineffective replace with oral NSAID or COX-2 inhibitor (celexocib)
What are the surgical treatments for osteoarthritis?
Arthroscopic lavage (plus debridement), micro fracture, mosaicplasty, chondrocyte grafts, joint replacement and viscosupplementation
How does microfracture compare to chondrocyte grafts in the treatment of osteoarthritis?
Microfracture leads to the formation of fibrocartilage which is slightly less durable than hyaline cartilage, whereas in chondrocyte grafts more hyaline cartilage is formed. However, in the grafts, the cells can hypertrophy and this has an unreliable biological potential of the implanted cells.
Name a COX-2 inhibitor
Celexocib
What is arthroscopic lavage in the treatment of OA?
To get rid of all of the loose bits (wash-out), debridement is removal of the edges to make a smoother surface
What is micro fracture in the treatment of OA?
Drilling into the subchondral bone and bone marrow which stimulates the repair of the articular cartilage (cartilage recovers within 4-6 months)
What is mosiacplasty in the treatment of OA?
This is an osteochondral transplant
What is chondrocyte grafting in the treatment of OA?
Grafting of autologous chondrocytes to repair larger defects.
How long do joint replacements last?
15-20 years
What is viscosupplementation used in the treatment of OA?
Where hyaluronic acid is given as it’s responsible for the viscoeleastic poperties of the synovial fluid, and in OA there is lower concentration and low molecular weight of hyaluronic acid
What are the advantages of viscosupplementation in the treatment of OA?
Works well at all stages of OA, improves pain, well-tolerated and is effective in the long-term
What are the disadvantages of viscosupplementation in the treatment of OA?
Severe OA may not respond as well, may be some local adverse effects at injection site
