Symptomatic osteoarthritis Management Of Osteoarthritis ± ...
Osteoarthritis. Osteoarthritis OA is a degenerative disease of diarthrodial ( synovial ) joints,...
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Transcript of Osteoarthritis. Osteoarthritis OA is a degenerative disease of diarthrodial ( synovial ) joints,...
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Osteoarthritis
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Osteoarthritis OA is a degenerative disease of diarthrodial (synovial) joints, characterized by
Breakdown of articular cartilage and proliferative changes of
surrounding bones
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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
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OA may cause functional loss Activites of daily living Most important cause of disability in
old age
Major indication for joint replacement surgery
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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
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Primary OA Secondary OA
Etiology is unknown Etiology is known
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Age Sex Obesity Genetics Trauma (daily)
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Trauma Previous joint disorders; Congenital hip dislocation Infection: Septic arthritis, Brucella, Tb Inflammatory: RA, AS Metabolic: Gout Hematologic: Hemophilia Endocrine: DM
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There are no pathognomonic laboratory findings for OA
Laboratory analysis is performed for differential diagnosis
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Narrowing of joint space (due to loss of cartilage)
Osteophytes
Subchondral (paraarticular) sclerosis
Bone cysts
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G1 Normal G2 Mild G3 Moderate G4 Severe
Kellgren Lawrence Classification
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CLINICAL FINDINGS Joint pain + RADIOLOGIC FINDINGS Osteophytes
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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
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Hands Feet
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Symptomatic treatment
Structure modifying treatment
Surgical treatment
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Regular exercises
Weight control
Prevention of trauma
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Pain relief
Preservation and restoration of joint function
Education
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Patient education Weight loss (if overweight) Aerobic exercise programs Physical therapy Range-of-motion exercises
Muscle-strengthening exercises Assistive devices for ambulation
Patellar tapingAppropriate footwear Lateral-wedged insoles (for genu varum)
Bracing Occupational therapy Joint protection and energy conservation
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Oral Systemic Medical Agents - Analgesics (acetaminophen) - NSAIDs - Opioid analgesics
Intraarticular agents: Hyaluronan Glucocorticoids (effusion)
Topical agents
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Severe joint pain, resistant to conservative treatment
methods Limitation of daily living activities Deformity, angular deviations,
instability
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Joint lavage Arthroscopy Cartilage grefting- genetic
engineering Surgery: Osteotomy Joint replacement