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OSTEOARTHRITIS Ýngilizce
OSTEOARTHRITIS Ýngilizce
OSTEOARTHROSIS
Osteoarthritis OA is a degenerative
disease of diarthrodial (synovial)
joints, characterized by
Breakdown of articular cartilage
and proliferative changes of
surrounding bones
EPIDEMIOLOGY
Primary OA Secondary OA
Direct correlation
Aging process
RISK FACTORS FOR PRIMARY
OA
Age
Sex
Obesity
Genetics
Trauma (daily)
SECONDARY OSTOARTHRITIS
Trauma
Previous joint disorders;
Congenital hip dislocation
Infection: Septic arthritis, Brucella, Tb
Inflammatory: RA, AS
Metabolic: Gout
Hematologic: Hemophilia
Endocrine: DM
ETIOLOGY OF OA
Cartilage properties
Biomechanical problem
Morphology of Primary OA
Primary Generalized OA
STRUCTURE OF JOINT
CARTILAGE
Collagen (Type 2)
Proteoglycan
- Hyaluronic acid
- Glycoseaminoglycan
Water
Condrocyte
Regeneration and Degeneration
PATHOLOGY OF OA
Fibrillation
Eburnation
Osteophytes
Subcondral cysts
LABORATORY FINDINGS OF
OA
Osteophytes
Bone cysts
RADIOLOGIC GRADE OF OA
G1 Normal
G2 Mild
G3 Moderate
G4 Severe
CLINICAL FINDINGS
Joint pain
+
RADIOLOGIC FINDINGS
Osteophytes
CLINIC OF OA
SIGNS AND SYMPTOMS
Physical examination:
Antalgic limping
Limitation of ROM (first internal rotation)
Painful ROM
Trendelenburg test positivity
Leg length discrepancy
Laboratory analysis within normal limits
BIOMECHANICS
X-RAY OF HIP OA
Peripheral Joints
Hands
Feet
ETIOPATHOGENESIS OF OA
Age,gender
Local
Genetic OA
biochemical effects
Other factors
ETIOPATHOGENESIS OF OA
Cell destruction
Membrane phospholipids
Arachidonic acid
Cox-1, Cox-2
IL-1 and metalloproteases have been
found to play an important role in
cartilage destruction.
Symptomatic treatment
Surgical treatment
STRUCTURE MODIFYING
TREATMENT
Regular exercises
Weight control
Prevention of trauma
AIMS OF OA TREATMENT
Pain relief
Education
Non-Pharmacologic
Treatment of OA
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
PHARMACOLOGIC TREATMENT OF OA
Intraarticular agents:
Hyaluronan
Glucocorticoids (effusion)
Topical agents
HAND OA - RESTING SPLINT
SYMPTOMATIC TREATMENT OF OA
Joint lavage
Arthroscopy
Cartilage grefting- genetic engineering
Surgery
Osteotomy
Joint replacement
QUESTIONS?