Osteoarthritis

 Osteoarthritis OA is a degenerative disease of diarthrodial ( synovial ) joints, characterized by  Breakdown of articular cartilage  and proliferative changes of surrounding bones

 Osteoarthritis(OA) is the most common joint disease  OA of the knee joint is found in 70% of the population over 60 years of age  Radiological evidence of OA can be found in over 90 % of the population

 OA may cause functional loss  Activites of daily living  Most important cause of disability in old age  Major indication for joint replacement surgery

 OA is a chronic disease of the musculoskeletal system, without systemic involvement  OA is mainly a noninflammatory disease of synovial joints  No joint ankylosis is observed in the course of the disease

 Primary OA Secondary OA Etiology is unknown Etiology is known

 Age  Sex  Obesity  Genetics  Trauma (daily)

 Trauma  Previous joint disorders;  Congenital hip dislocation  Infection: Septic arthritis, Brucella, Tb  Inflammatory: RA, AS  Metabolic: Gout  Hematologic: Hemophilia  Endocrine: DM

 There are no pathognomonic laboratory findings for OA  Laboratory analysis is performed for differential diagnosis

 Narrowing of joint space (due to loss of cartilage)  Osteophytes  Subchondral (paraarticular) sclerosis  Bone cysts

 G1 Normal  G2 Mild  G3 Moderate  G4 Severe  Kellgren Lawrence Classification

CLINICAL FINDINGS Joint pain + RADIOLOGIC FINDINGS Osteophytes

 More common in males over 40 years of age  Joint stiffness  Pain of hip, gluteal and groin areas radiating to the knee  Mechanical pain  Limited walking function

 Hands  Feet

 Symptomatic treatment  Structure modifying treatment  Surgical treatment

 Regular exercises  Weight control  Prevention of trauma

 Pain relief  Preservation and restoration of joint function  Education

 Patient education  Weight loss (if overweight)  Aerobic exercise programs  Physical therapy  Range-of-motion exercises Muscle-strengthening exercises  Assistive devices for ambulation Patellar taping Appropriate footwear Lateral-wedged insoles (for genu varum)  Bracing  Occupational therapy  Joint protection and energy conservation

 Oral Systemic Medical Agents - Analgesics (acetaminophen) - NSAIDs - Opioid analgesics  Intraarticular agents: Hyaluronan Glucocorticoids (effusion)  Topical agents

 Severe joint pain, resistant to conservative treatment methods  Limitation of daily living activities  Deformity, angular deviations, instability

 Joint lavage  Arthroscopy  Cartilage grefting- genetic engineering  Surgery: Osteotomy Joint replacement