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OsteoarthritisDownload Word file here

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PPT

Osteoarthritis

Definition:

• Chronic (long term) joint disorder
• Progressive softening and disintegration of articular cartilage accompanied by new growth of cartilage and bone at the joint margin (osteophytes) and capsular fibrosis
• More common in weight-bearing joints; hip joint, knee joint, spine

Designation:

• Primary: No cause is obvious
• Secondary: Follow a demonstrable abnormality

Cause:

• Genetic predisposition
• Metabolic & hormonal influences on cartilage
• Patterns of joint usage
• Local mechanical stresses
• Pre-existing joint disease and specific incidents of cartilage damage


• Susceptibility: Body build, heredity, reproductive variables, osteoporosis, smoking, other diseases
• Mechanical factor: Trauma, joint shape, repetitive use

Pain origin:

Physical factor:

• Capsular fibrosis, with pain on stretching the shrunken capsule
• Muscular fatigue
• Bone pressure due to vascular congestion and intraosseous hypertension
• Synovium (reactive synovitis)
• Maldisribution of load
• Stress on cartilage

Psychological factor:

• Pain cycle

Please refer to Appendix I

Hip replacement (HR):

Indication:

• Progressive increase in pain
• Severe restriction of activities
• Marked deformity
• Progressive loss of movement (especially abduction)
• X-ray signs of joint destruction

Consideration:

• Blood banking
• CV condition
• GH

Choice:

• Patients over 60 with a long history and increasing disability: THR
• Younger patients with some preservation of articular cartilage: Intertrochanteric realignment osteotomy

Appendix I

Pain===>Depression===>Stress/No movement===>Leading to more severe condition===>More pain

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