OSTEOARTHRITIS

Chronic joint disorder in which there is progressive softening and disintegration of the cartilage accompanied by new growth of cartilage and bone at the joint margins (osteophytes) and capsular fibrosis.

Commonly called also as degenerative arthritis caused with age. The cartilage decreases its elasticity and decrease in breaking strength.
 
Classification:  

Primary

Cause is not known
Genetic predisposition
Marked obesity         
Increased joint strain following – Squatting, sitting cross-legged, climbing staircases 
Occupation – Lower limb osteoarthritis in people having lot of knee bending and standing for long time (Using Indian toilets / sitting cross-legged)             
Upper limb osteroarthritis common with people working with vibrating tools.
Boxers more for hand osteoarthritis
Footballers / Baseball pitches – shoulder

   

Secondary

Secondary to anatomical defects – Following fractures, loss of cartilage, dysplasia of the joint.

Secondary to Disease: Ankylosis spondylitis
Rheumatoid Arthritis
Haemophelia
Neuropathic – Syphyllis
Avascular Necrosis
Metabolic  - Gout.
Ochronic arthritis.
 
Commonly involved joint:

Weight bearing joints

Knee
Hip
Ankle
Spine
 
  Non-weight bearing Fingers
   
Clinical features Clinical features are characterized by waxing and waning

Pain:

Increases over years
Later stages night pain
Stiffness: Constant and Progressive
Swelling: Intermittent- suggestive of effusions
Continuous – thickened capsule and osteophytes
Deformities: Due to capsular contractures and joint instability
Loss of Function: Difficulty in climbing staircase, locking   
sensation in joint – due to loose bodies.
   
X-Ray

Narrowing of the joint space
Sclerosis of the subchondral bone under the cartilage loss.
Osteophytes
Mechanical malaligament
Loss bodiesáááááááááááááááááá ááááááááááááááááááááá

   
Treatment:  
Early stages

Maintaining movement and muscle strength
Weight Control
Modify daily activities
Pain Killers

   
Intermediate treatment

1) Arthroscopic joint debridement- removal of loose bodies, osteophytes.
2)  Realignment osteotomies around the joint.

   
Late treatment

Joint replacement
Joint fusion
Joint excision

   
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