What is osteoarthritis?
What is osteoarthritis?
Osteoarthritis (OA), also known as degenerative joint disease is characterized by progressive degradation ( breakdown) of cartilage. OA is the most common joint disease for middle-aged and older people. In advanced stages of the disease, limb dysfunction due to joint pain, deformity, contracture and muscle atrophy is a handicap in daily living. Although osteoarthritis can affect any joint in the body, it primarily affects the knees, fingers, thumbs, spine, hips, and the great (big) toes.
What causes osteoarthritis?
- Mostly related with age
- Most common
- Joint abnormality,
- Malignment of the lower extremity,
- Repetitive ( sports related) or acute trauma,
- Infllamatory arthritis (rheumatoid, psoriatic, gout arthritis),
- Septic arthritis (infectious arthritis),
- Metabolic disorders ( acromegali, ocranosis, wilson’s disease, hyperparatiroidism,
- Blount’s disease
- Perthes disease
- Ehler Danlos Syndrome
- Epiphyseal Dysplasia
- Slipped Capital Femoral Epiphysis
- Lower limb Length Discrepancy
Who is affected by primary osteoarthritis?
- Among adults 60 years of age or older the prevalence of symptomatic knee OA is approximately 10% in men and 13% in women
- Post-menopausal women have an increased incidence of knee osteoarthritis compared to men.
Symptoms of osteoarthritis?
- Pain : develops gradually over months or years. Increases with activities that put stress on the joint, such as running or prolonged walking.
- Joint swelling: tends to increase slowly over time.
- Sensation of grinding : seen in more advanced disease.
- Deformity: usually varus deformity of the knee.
Diagnosis of osteoarthritis
- A complete history ( trauma, metabolic disease, systemic disease, inflammatory disease, genetic disease…)
- Evaluation of prominent symptoms
- A thorough examination of the effected joints and extremities
- Imaging : weight bearing X-rays ( gold standart). Computerized Tomography Scan and Magnetic resonance imaging (MRI) if necessary.
- Blood tests and tests on joint fluid aspiration material may be essential to rule out inflammatory, infectious and metabolic arthritis especially if the joint is particularly swollen and
Treatment of osteoarthritis
The type of treatment depends on the patient’s age, overall health, activities, occupation, and stage of OA.
- Non-surgical Treatment :
- Medications: (topical pain medicines and oral analgesics including nonsteroidal anti-inflammatory medications, NSAIDs).
- Intra-articular injections: Platelet rich plasma (PRP), autologous adult mesechymal stem cell, steroid, hyaluronic acid .
- Exercise: isometric land- and water-based
- Intermittent hot and cold packs (local modalities).
- Physical, occupational, and exercise therapy.
- Weight loss (if overweight).
- Healthy eating, managing diabetes and cholesterol.
- Supportive devices : braces, orthotics, shoe inserts, cane, or walker.
- Surgery: will help to relieve pain and restore function when other medical treatments are ineffective especially with advanced stages of OA.