Osteoarthritis

By
Dr. Ayman Shawki
Assist. lecturer, Orthopaedic
department
Faculty of medicine, port said university
Outline
Definition :Treatment
Pathology A- medical
Causes B- surgical
Sign and symptoms c- physical therapy
Joint affected
Features
Diagnosis
Complication
 :Definition
Osteoarthritis (OA): is a degenerative joint disease
characterized by the breakdown of the joint's
cartilage. It called degenerative joint disease.

the most common form of arthritis.

 :Pathology

It is caused by the breakdown of cartilage.

Cartilage is the tough elastic material that

covers and protects the ends of bones. Bits of
cartilage may break off and cause pain and
swelling in the joint between bones.
 This pain and swelling is called inflammation.
pathology
:In healthy joints :Osteoarthritic joints
Cartilage acts as - - the cartilage gradually -
a shock absorber becomes rough and
when you put thin, and the bone
.weight on the joint - .underneath thickens
The slippery - -
surface of the Over time the -
cartilage allows the cartilage may wear
bones to move away entirely, and the
.smoothly bones will rub
. together
 Causes
.unknown-1
.heredity-2
excess weight (obesity) :puts extra stress on -3
the weight-bearing joints, especially the knees
.and hips
:joint injury (trauma)-4
.a- sport (wear and tear in joint)
.b- Accident
.other disease RA-5
.high heel shoes-6
 :Sign and symptoms

.pain, especially when moving a joint-1

.swelling or bumps-2
.sore and stiff (fingers and foot)-3
hear grating sound when the roughened -4
cartilage on the surface of the bones rubs
.together
.hard movement (walk and up stair) -5
 :Joint affected

OA commonly affects weight-bearing joints

such as hips, knees, feet and spine.
However, non-weight bearing joints such as
.finger joints

Knee OA is more common

 Facts
Osteoarthritis usually occurs in older people-1
.after the age 45 years, but occur at any age
.It is usually located in only one or a few joints-2
The joints are less inflamed than in other-3
.arthritic conditions
.Progression of pain is almost always gradual-4
It affects men and women in equal numbers-5
.but after the 50 age the women is more
 Diagnosis

history of symptoms-1
..physical exam-2
blood test to detect-3
.)OA or RA(
x-ray -4
 Complication of OA

The muscles that hold the joint in place weaken-1

.because they are not being used

Over time, the joint looses its shape and does-2

.not work at all
 Changes in Joint

Muscle Weakness
Pain
Loss of Normal Function

Decreased Physical
Activity
 Prevention of OA
Regular exercises

Weight control

Prevention of trauma
 Treatment
Medical:
1-Analgesics drugs: oral or systemic

2-Cream and gels: to temporary pain relive.

3-Nonsteroidal anti-inflammatory drugs
(NSAIDs):
a) Non-selective NSAIDs.
B) Selective NSAIDs (Cox-2 inhibitor): are as effective as non-
selective NSAIDs and less cause gastrointestinal injury and
side effect.
Intrarticulr injection :
1-Corticosteroid:
May be injected into the joint to relive severe inflammation.

2- Hyaluronic acid
 Physical Therapy
 Physical therapy and exercise improve flexibility and strengthen
the muscles surrounding the joints.

 People who exercise regularly their arthritis will typically have less
pain and better function than those who are inactive.

physiotherapy treatment program will help:

• Reduce pain
• Improve movement and posture
• Strengthen muscles
• Improve independent function
• Assess and treat biomechanical problems that may exacerbate the
pain and loss of function
 Surgical
1-Arthroscopy: use to
1-invistigation of joint.
2-treatment:
a) To remove damage (debridement)
b) To flush the joint to remove any
loose part (lavage or irrigation)
*Advantage: *Disadvantage:
1-delay the need fore more serious surgery 1-Risk of anesthesia.
e.g. joint replacement. 2-infection
2-the incision is small size. 3-damage to nerve or
3-the pain that result of surgery is minimal blood vessels
4-restore function and decrease pain. 4-DVT
2-osteotomy:
Is procedure change the position or alignment of knee so your
weight shift away from the damage area.
This procedure only be done when only one area or side of knee
damage.
*Advantage:
Decrease pain and restore function.
*Disadvantage:
May need knee replacement surgery in future.
3-arthroplasty:(joint replacement)
Procedure done by artificial joint replace all joint (total replacement)
or part of knee damage (Unicompartmental knee arthroplasty).
Artificial joint made from metal and plastic.

Advantage:
1- the result of the joint replacement are generally excellent (there are
significant pain relief and improve function).
Disadvantages:
1-rehabilitation may take 3to6 month.
2-the artificial joint may loosen or wear out so that second surgery is
needed.
* The life span or artificial is about 10 years in 9%of the people.