OSTEOARTHRITIS KNEE

Haeril Fitra Haermiansyah

111 2016 1011

SUPERVISOR:
dr. Muh. Ali Hasbi, Sp.OT
 Osteoarthrosis or osteoarthritis (OA) is a degenerative
joint disease that is associated with damage to the
articular cartilage. Vertebrae, pelvis, knee, and ankle
most often affected by OA (Soeroso, 2009).

 Osteoarthritis is a non-inflammatory joint disorder

that affects the weight of the joint spine with
pathological features in the form of deteriorating joint
cartilage, which is the end result in biochemistry,
metabolic metabolism that occurs in or pathological
joints(Dharmawirya, 2000).
 OA is a rheumatic disease that mostly affects the joints, especially in
people over 50 years. Over 85% of people aged 65 years describe OA on
x-ray picture, although only 35% -50% just having symptoms. Age under
45 years of age the prevalence of osteoarthritis is more common in men,
while at the age of 55 years is more common in women. In several studies
show that an increase in the occurrence of obesity Osteoarthritis, the
weight-bearing joints of the body (Ariani, 2009),
 Progression of OA usually walk slowly, occurring within a few years or
even decades. Pain that arises normally be the initial and primary source
of morbidity in patients with OA. Patients may become progressively
more sedentary activity, leads to morbidity due to reduced physical
activity (including significant weight loss). OA prevalence varies in
different races. OA of the knee is more common in African American
women compared with other races. There is a tendency that the chances
of developing OA increases with age. The disease is usually proportional
to the number of events in men and women at the age of 45-55 years.
After age 55, tends to be more common in women.
 Age
 Gender
 Tribes.
 genetic
 Obesity and metabolic diseases
 Joint injury (trauma), employment and sport
 growth abnormalities
 Other factors
 Primary osteoarthritis: do not have a
relationship with other systemic diseases or
changes in the joints, meaning only in the form
of osteoarthritis alone

 Secondary osteoarthritis: osteoarthritis is

accompanied by systemic disorders, such as
endocrine disorders, inflammation, metabolic
disorders, growth, heredity, trauma micro-
macro, long immobilization.
 Joint pain
 Stiffness in the morning (morning stiffness)
 Barriers of motion
 crepitations
 Changes in the form joints
 Changes in gait
Diagnosis of knee osteoarthritis is clinical, clinical
and radiological, as well as clinical and laboratory :
A. Clinical:
Knee joint pain and 3 of the following criteria:
 age> 50 years
 stiff joints <30 minutes
 crepitus
 bone tenderness edge
 enlargement of the bones of the knee joint
 no palpable warmth in the joints
 Note: sensitivity 95% and specificity of 69%.
Clinical and radiological:

Joint pain and at least 1 of the 3 following

criteria:
 age> 50 years
 stiff joints <30 minutes
 crepitus with osteophytes

Note: sensitivity 91% and specificity of 86%.

Clinical and laboratory:
Joint pain plus any 5 of the following criteria:
 age> 50 years
 stiff joints <30 minutes
 crepitus
 bone tenderness edge
 bone enlargement
 no palpable warmth in the affected joint
 LED <40 mm / h
 RF <1:40
 according osteoarthritis synovial fluid analysis
Note: sensitivity 92% and specificity of 75%.
 Examination of Radiology
 Laboratory Tests
 Examination Marker
Destination management of patients with
osteoarthritis are:
1. Relieves pain
2. Optimizing joint function
3. Reduce dependence on others and
improve quality of life
4. Inhibit the progression of the disease
5. Preventing complications
Terapi non-farmakologis:
 Education
 Lose weight
 Physical therapy and rehabilitation medical /
physiotherapy
Pharmacologic therapy:
A. Systemic Medications:
1. oral Analgesik
2. Nonsteroidal Anti-inflammatory (NSAIDs)
3. Chondroprotective
4. Tranuzemad (latest medikamentosa, still in
the research)
B.Topical Medications:
1. Rubefacients and capsaicin cream
2. cream NSAIDs

C. Injection intraarticular / intra lesion :

1. steroids Intra-articular (triamsinolone
hexacetonide and methyl prednisolone)
2. hyaluronic acid
3. stem sells
D. Surgery
There are 2 types of surgical therapy: Realignment
osteotomy and joint replacement
 Realignment osteotomy
Joint surface was repositioned by cutting the bone and
changing the angle of weightbearing. Goal: Make karilago
healthy joint support much of the weight of the body.
 arthroplasty
Arthritis joint surface is moved, and a new joint surface
planted. Support surface is usually made of metals that are in
high-density polyethylene.
Various kinds of surgery for osteoarthritis of the knee joint:
a) Partial replacement / unicompartemental
b) High tibial osteotmy: young people
c) the patella and condyle resurfacing
d) Minimally constrained total replacement: the stability of
the joints is done in part by the original ligament and
partially enumerated by the artificial joint.
e) Cinstrained joint: fixed hinges: used when a bone is
missing and severe instability