OSTEOARTHRITIS

Osteoarthritis (OA) is a common,

degenerative disease, which is
characterized by local degeneration
of joint cartilage and new bone
formation at the base of the cartilage
lesion (subchondral bone) and at the
joint margins (osteophytes).
Osteoarthritis is the result of both mechanical
and biologic events that destabilize the normal
coupling of degradation and synthesis of
articular cartilage and subchondral bone
 Risk factors

• Older age - Osteoarthritis typically occurs in older adults. People

under 40 rarely experience osteoarthritis.
• Sex - Women are more likely to develop osteoarthritis, though it
isn't clear why.
• Bone deformities - Some people are born with malformed joints or
defective cartilage, which can increase the risk of osteoarthritis.
• Joint injuries - Injuries, such as those that occur when playing
sports or from an accident, may increase the risk of osteoarthritis.
• Obesity - Carrying more body weight places more stress on your
weight-bearing joints, such as your knees. But obesity has also been
linked to an increased risk of osteoarthritis in the hands, as well.
• Other diseases - that affect the bones and joints. Bone and joint
diseases that increase the risk of osteoarthritis include gout,
rheumatoid arthritis, Paget's disease of bone and septic arthritis.
 Risk factors
Older age
Osteoarthritis typically
occurs in older adults.
People under 40 rarely
experience
osteoarthritis.
 Risk factors
Sex
Women are more likely to
develop osteoarthritis,
though it isn't clear why.
Risk factors

Bone deformities
Some people are born
with malformed joints or
defective cartilage,
which can increase the
risk of osteoarthritis.
 Risk factors

Joint injuries
Injuries, such as those
that occur when playing
sports or from an
accident, may increase
the risk of osteoarthritis.
 Risk factors

Obesity
Carrying more body
weight places more stress
on your weight-bearing
joints, such as your
knees. But obesity has
also been linked to an
increased risk of
osteoarthritis in the
hands, as well.
 Risk factors

Other diseases
That affect the bones and
joints. Bone and joint
diseases that increase
the risk of osteoarthritis
include gout, rheumatoid
arthritis, Paget's disease
of bone and septic
arthritis.
 FACTORS

1.Genetic

2.Developmental

3.Metabolic

4.Traumatic
 Classification
Primary Secondary
• Aging • Congenital disorders of joints
• Sex • Diabetes.
• Inflammatory diseases (such as
Perthes' disease), (Lyme disease),
and all chronic forms of arthritis
(e.g. costochondritis, gout, and
rheumatoid arthritis). In gout,
uric acid crystals cause the cartilage
to degenerate at a faster pace.
• Injury to joints, as a result of an
accident or orthodontic operations.
• Septic arthritis (infection of a joint )
• Ligamentous deterioration or
instability may be a factor.
• Marfan syndrome
• Obesity
• Alkaptonuria
• Hemochromatosis and
Wilson's disease
OA may affect every joint
OA may affect every joint
DEGENERATION OF THE ARTICULAR CARTILAGE
 Symptoms

• Pain in a joint during or after use, or after a period of

inactivity
• Tenderness in the joint when you apply light pressure
• Stiffness in a joint, that may be most noticeable
when you wake up in the morning or after a period
of inactivity
• Loss of flexibility may make it difficult to use the joint
• Grating sensation when you use the joint
• Bone spurs, which appear as hard lumps, may form
around the affected joint
• Swelling in some cases
Heberden's nodes may form in
osteoarthritis
 Diagnosis
X-RAY

Primary osteoarthritis of
the left knee. Note the
osteophytes,
subchondral cyst
formation, narrowing of
the joint space (arrow),
and increased
subchondral bone
density (arrow).
 Diagnosis

Arthroscopy
 NON-DRUG TREATMENT

•weight loss (normal weight

people have a 20% risk of hip
OA, overweight have 25% risk,
and obese have 39% risk)
•water exercise programs
•physical therapy (range of
motion and strengthening
exercises)
•occupational therapy
(assistive devices, joint
protection)
•patient education
 DRUG TREATMENT

• Acetaminophen
•
Non-steroidal anti-inflammat
ory drugs

• Tanezumab (monoclonal
antibody)
• Chondroitin sulfate
• Glucosamine
• S-Adenosyl methionine
Surgery
INTRAARTICULAR INJECTION

• Artificial synovial fluid

• Steroids
• Enzyme inhibitors
• Chondroprotectors
INTRAARTICULAR INJECTION
 Surgeory
• Autologous chondrocyte implantation
• Microfracture surgery
• Arthroscopic surgery
• Osteotomy
• Limb lengthening
• Arthrodesis
• Joint replacement
Deformity correction
Deformity correction
Limb lengthening
Arthrodesis of ankle joint
Arthrodesis of ankle joint
Subtalar arthrodesis
Subtalar arthrodesis
TOTAL SHOULDER REPLACEMENT
TOTAL ELBOW
REPLACEMENT
TOTAL HIP REPLACEMENT
TOTAL KNEE REPLACEMENT
TOTAL ANKLE REPLACEMENT