1. Osteoarthritis Dr. Faik Altıntaş Yeditepe Üniversitesi Tıp Fakültesi
Ortopedi ve Travmatoloji AD

2. Osteoarthritis
Osteoarthritis (OA) is a degenerative joint disease, occurring primarily in older persons, characterized by
Erosion of the articular cartilage,
Hypertrophy of bone at the margins (osteophytes),
Subchondral sclerosis,
Range of biochemical and morphologic alterations of the synovial membrane and joint capsule
Pathologic changes in the late stages of OA include softening, ulceration, and focal disintegration of the articular cartilage; synovial inflammation also can occur

3. Osteoporosis

4. Osteoarthritis
Catabolism of cartilage results in release of breakdown products into synovial fluid which then initiates an inflammatory response by synoviocytes
These antigenic breakdown products include: chondrointon sulfate, keratan sulfate, PG fragments, type II collagen peptides and chondrocyte membranes
Activated synovial macrophages then recruit PMNs establishing a synovitis
They also release cytokines, proteinases and oxygen free radicals (superoxide and nitric oxide) into adjacent and synovial fluid

5. Osteoarthritis
Proinflammatory cytokines are believed to play a pivotal role in the initiation and development of the disease process
Antiinflammatory cytokines are found in increased levels in OA synovial fluid
TNF-α and IL-1 appear to be the major cytokines involved in OA
Other cytokines involved in OA are: IL-6, IL-8, leukemic inhibitory factor (LIF), IL-11, IL-17

6. Osteoarthritis Symptoms Acute Pain Loss of ability Stiffness
Crackling noise (called "crepitus")
The joints may also be filled with fluid (Effusion)

7. Osteoarthritis
OA commonly affects the hands, feet, spine, and the large weight bearing joints, such as the hips and knees
In smaller joints, such as at the fingers, hard bony enlargements, called Heberden's nodes (on the distal interphalangeal joints) and/or Bouchard's nodes (on the proximal interphalangeal joints), may form, and though they are not necessarily painful, they do limit the movement of the fingers significantly.
OA at the toes leads to the formation of bunions, rendering them red or swollen.
OA is the most common cause of water on the knee, an accumulation of excess fluid in or around the knee joint

8. Osteoarthritis Classification Primary OA Secondary OA Idiopathic
When the cause is not known (as in the large majority of cases)
Secondary OA
When the cause is another disease or condition
Infection,
Deformity
Injury
Abnormal use of a joint
Metabolic disorder (hemochromatosis, Wilson's disease
Disorder that damages joint cartilage (rheumatoid arthritis, gout)

9. Osteoarthritis Risk Factors and Possible Causes: Age Female Obesity
Muscle weakness
Genetics

10. Osteoarthritis Diagnosis Normally done through x-rays
Loss of cartilage, subchondral sclerosis, subchondral cysts from synovial fluid entering small microfractures under pressure, narrowing of the joint space between the articulating bones, and bone spur formation (osteophytes)

11. Osteoarthritis Treatment
The process of clinically detectable osteoarthritis is irreversible, and typical treatment consists of medication or other interventions that can reduce the pain of OA and thereby improve the function of the joint
Gene therapy has future for cure
Conservative
Medical
Surgical

12. Osteoarthritis Conservative Treatment Weight control
Appropriate rest and exercise
TENS
Mechanical support devices
Knee braces
Cane
Walker
Applying local heat before, and cold packs after exercise, can help relieve pain and inflammation, as can relaxation techniques
Schock absorbing heels and pads

13. Osteoarthritis Medical Treatment Analgetics
Acetominophen
Metamizol sodium
Nonsteroidal anti-inflammatory drugs (NSAIDs) (traditional and COX 2 selective)
Both relieve pain and reduce inflammation.
Topical pain relievers (creams, gels, and sprays)
Temporarily relieve arthritis pain and reduce inflammation in joints close to the surface of the skin
Antidepressants
Glucosamine , chondroitin sulfate, MSM
Diacetylrhein
Intraarticular corticosteroid injections
Viscosupplementation
Hyaluronate

14. Osteoarthritis Surgical Treatment Arthroskopic Debridement
For meniscal tears
Loose bodies
Catilage repair or debridement
Diluation of enflamatory substances and enzymes

15. Osteoarthritis Surgical Treatment
Correction osteotomy for malalignment

16. Osteoarthritis
High Tibial Osteotomy

17. Osteoarthritis
Surgical Traetment
Arthroplasty

18. Osteoarthritis
Total knee arthroplasty

19. Osteoarthritis
Arthroplasty

20. Osteoarthritis

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