CSS Osteoarthritis genu

Oleh kelompok 18b

Anatomi lutut
• Lutut adalah sendi engsel
melibatkan tiga tulang: tulang
femur, tibia, dan patella, dengan
tiga permukaan artikular, dua di
antara tulang femur dan tibia dan
satu antara tulang femur dan
patela.
Anatomi lutut
Anatomi lutut
• Sendi
Anatomi Lutut
• Otot
The quadriceps femoris extends
the knee, covering the anterior,
medial, and lateral aspects of the
thigh
The hamstring muscles lie on the
posterior aspect of the thigh and
flex the knee.
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Meniscus dan ligament
menisci and two important pairs
of ligaments, the collaterals and
the cruciates, are crucial to
stability of the knee.
The medial and lateral menisci
cushion the action of the femur on
the tibia.
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Medial collateral ligament (MCL)
broad, flat ligament connecting
the medial femoral epicondyle to
the medial condyle of the tibia.
The medial portion of the MCL
also attaches to the medial
meniscus
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The lateral collateral ligament
(LCL) connects the lateral femoral
epicondyle and the head of the
fibula.
The MCL and LCL provide medial
and lateral stability to the knee
joint.
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ACL
The ACL crosses obliquely from the anterior
medial tibia to the lateral femoral condyle,
preventing the tibia from sliding forward on the
femur.
PCL
The (PCL) crosses from the posterior tibia and
lateral meniscus to the medial femoral condyle,
preventing the tibia from slipping backward on
the femur. Although the ACL and PCL lie within
the knee joint so are not palpable, they are
nonetheless crucial to the anteroposterior
stability of the knee
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Bursae
Several bursae lie near the knee.
The prepatellar bursa lies between the
patella and the overlying skin.
The anserine bursa lies 1 to 2 cm below
the knee joint on the medial surface,
proximal and medial to the attachments
of the medial hamstring muscles on the
proximal tibia. It cannot be palpated
due to these overlying tendons.
Osteoarthritis
Definisi
• OA is a disease that involves degeneration in
various structures of the joint, including
cartilage, bone, synovium, muscles, and
ligaments. This can result in stiffness, loss of
mobility, swelling and pain.
• In contrast to RA, OA is primarily a
noninflammatory disorder, but inflammation
eventually occurs and is progressive.
Epidemiologi
• The prevalence of OA increases sharply for women after age 40 years
and after age 50 for men.
• OA of the hand is more prevalent in women, whereas men are slightly
more likely to have hip OA.
• Genetics is likely to contribute to the development of primary OA.
Inhibited bone abnormalities or inherited traits (e.g., dysplasia,
malalignment) that subject the joint to unusual stress increase the
likelihood of its development
Etiologi &Faktor risiko
• No single known cause of OA exists.
• Factors that might contribute to a diagnosis of OA include genetic
disposition, age, injury, weight, stress on the joint, and previous
surgery involving the joint.
• Age is the most commonly identified risk factor for OA of all joints.
Manisfestasi klinik
OA genu :
Nyeri gerak dan krepitus positif
Efusi sendi
Adanya kista popliteal
Instabilitas dan perubahan gaya berjalan
Deformitas valgus atau varus
Diagnosis
Terapi
• Goals of OA therapy are to decrease pain, increase function in
activities of daily living (ADL) and mobility, prevent and correct
deformity, and slow disease progression
Medikasi
• The first line of pharmacotherapy is
acetaminophen or NSAID
• In patients for whom NSAIDs are
contraindicated, or when combined
acetaminophen and NSAID therapy is
ineffective, tramadol can be started or a low-
dose opioid and titrated as needed and
tolerated.
• NSAIDs and opioids are mutually dose-sparing,
and combining low doses of a drug from each
class provides synergistic analgesia while
limiting toxicities
Medikasi
• Additional therapies might include the external application of local
anesthetics and topical NSAIDs as a patch or gel over the painful join
• Injections of corticosteroids into the knee joint (intraarticular [IA])
might relieve inflammation and reduce pain and disability.
Non Medikasi
• Nonpharmacologic treatment recommendations by the Osteoarthritis
Research Society include thermal modalities, acupuncture, and
transcutaneous electrical nerve stimulation
Musculoskeletal
provocative manuvers