Osteoarthritis(OA)

Lecturer: Ms. Mehreen Rommel

 Introduction
Osteoarthritis is the most common form of
arthritis, affecting millions of people worldwide. It
occurs when the protective cartilage that cushions
the ends of your bones wears down over time.
• Although osteoarthritis can damage any joint,
the disorder most commonly affects joints in
your hands, knees, hips and spine
• Also known as degenerative arthritis or
degenerative joint disease.(DJD).
 Pathophysiology
Osteoarthritis is traditionally thought of as a
‘wear and tear’ disease which occurs as we age.
• The pathogenesis of OA involves a
degradation of cartilage and remodelling of
bone due to an active response of
chondrocytes in the articular cartilage and the
inflammatory cells in the surrounding tissues.
 Conti…
• The release of enzymes from these cells break
down collagen and proteoglycans, destroying
the articular cartilage.
• The exposure of the underlying subchondral
bone results in sclerosis, followed by reactive
remodelling changes that lead to the
formation of osteophytes and subchondral
bone cysts. The joint space is progressively
lost over time.
Etiology and risk factors

• Obesity: causes increased pressure on hips and knees

• Genes: various genetic traits can make a person more
likely to develop OA
• Injury and overuse: repetitive movements or injuries
to joints such as a fracture, surgery or ligament tears
can lead to OA
• Muscles weakness
• High impact activities
• Long sitting and standing
• Osteoprosis
 Symptoms
Pain.
• Stiffness in morning <1hour
• Tenderness
• Loss of flexibility
• Grating sensation. When you use the joint,
you might hear popping or crackling.
• Bone spurs
• swelling
 Diagnostic studies
• X-rays can reveal assymetric joint space
narrowing, osteophytes at the joint margins,
joint space narrowing, and subchondral bone
sclerosis.
• Computed tomography.
• Ultrasound
• MRI
• Joint fluid analysis
 Medical Treatment
• Osteoarthritis can't be reversed, but treatments
can reduce pain and help move better.
• Acetaminophen.
• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Duloxetine (Cymbalta).
• Omega-3 fatty acids.
• Glucosamine and chondroitin.
• Physical therapy.
 Surgical and other procedures

• Injections of corticosteroid medications may

relieve pain in your joint.
• Lubrication injections: Injections of hyaluronic
acid may offer pain relief by providing some
cushioning in your knee.
 Conti…
• Realigning bones: If osteoarthritis has
damaged one side of knee more than the
other, an osteotomy might be helpful.
• Joint replacement: In joint replacement
surgery (arthroplasty), surgeon removes
damaged joint surfaces and replaces them
with plastic and metal parts. Surgical risks
include infections and blood clots.
 Life style and home remedies
• Exercise: bicycling, walking or water aerobics.
• Lose weight.
• Movement therapies like low intense yoga.
• Heat and cold. Both heat and cold can relieve
pain and swelling in your joint.
• Capsaicin. Topical capsaicin, a chili pepper
extract, applied to your skin over an arthritic
joint might help some people.
• Braces or shoe inserts.
 Nursing Management
• Balance exercise and rest.
• Psychologic support
• Pain management
• Nutrition and weight management
• Educate use of assistive devices.