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What Is Osteoarthritis?

Osteoarthritis is a group of overlapping distinct diseases, which may have different aetiologies but with similar biologic, morphologic, and clinical outcomes. The disease processes not only affect the articular cartilage, but also involve the entire joint, including the subchondral bone, ligaments, capsule, synovial membrane, and peri-articular muscles. Ultimately, the articular cartilage degenerates with fibrillation, fissures, ulceration, and full thickness loss of the joint surface
Symptoms of Osteoarthritis

What Happens In Osteoarthritis?

  • Synovitis
  • Eburnation of exposed bone
  • Bony remodelling
  • Osteophytes
  • Subchondral cysts
  • Degeneration of menisci
  • Peri-articular muscle atrophy.
  • Thickening of joint capsule
  • Loss of articular cartilage (although cartilage may be thicker than normal in earlier stages)

What Are The Causes And Preailance? -

The Greek word ‘Arthro' means joint while ‘itis' means swollen. Arthritis may be found in common viral fever, malaria or Typhoid etc. Other common causes are Rheumatoid Arthritis, Gout, Ankylosing Spondylitis, Systemic Lupus Erythematosis (SLE), Psoriasis, etc. Children may get Juvenile Rheumatoid Arthritis (JRA) and Juvenile Idiopathic Arthritis (JIA). Other factors to be considered are
as follows:
  • Genetic -

    It is seen in families due to similar environmental factors & anthropological features
  • Age -

    Usually effects after 40 years of age, by 50 to 60 almost 80-90% of the population is effected.
  • Sex -

    Female are affected more than male, with a ratio of 3:1
  • Trauma -

    Injuries to the joints leads to degenerative changes
  • Occupation -

    Occupations that cause continuous micro-trauma
  • Obesity -

    Increased weight bearing causes increased degeneration
  • Infection -

    An episode of joint infection leaves scarring

What Is The Clinical Presentation Of OA?

  • Pain -

    The pain may arise from the following joint structures:
    • Muscles -

      due to strain of misalignment
    • Joint capsule -

      due to stretching by increased I.A. pressure Subchondral bone because of micro-fractures Bursa due to inflammation Enthesis due to inflammation
    • Synovium -

      due to inflammation cartilage degradation products Ligaments due to stress and strain
  • Stiffness -

    Better known as Gelling or stiffness after rest
  • Tenderness -

    The joints will be painful to touch and crepitus will be felt
  • Swelling -

    Effusion or joint swelling in OA is cold, while it is hot in RA
  • Loss Of Function -

    There will be decreased range of movement and muscle wasting

What Is The Management Of OA?


  • A clear diagnosis and Grading of the stage of the disease

Treat Secondary Causes

  • Specific treatment for Gout and
    Rheumatoid Arthritis
  • Weight loss in Obesity
  • Occupation and work related causes should
    be prevented

Patient Motivation

  • Patient education
  • Motivation for cure

Self Help Measures

  • Self-management programs
  • Personalised social support
  • Aerobic exercises programs

Secondry Health Care

  • Physical therapy, R.O.M. & muscle
    strengthening exercises
  • Lateral-wedged insoles (for Genu varum) Bracing
  • Patellar taping
  • Appropriate footwear
  • Assistive devices for ambulation & activities of daily living
  • Joint protection and energy conservation
  • Physiotherapist and others
  • Occupational therapy

Pharmacological Therapy


  • Acetaminophen
  • COX-2 specific inhibitor
  • Non-selective NSAID plus gastro-protection
  • Nonacetylated salicylate
  • Other pure analgesics like Tramadol
  • Opioids


  • Glucocorticoids
  • Hyaluronan


  • Capsaicin
  • Methylsalicylate


  • Osteotomy -

    Wedge removal in Hallus Valgus
  • Arthrodesis -

    Salvage procedure - joint fusion
  • Arthroplasty -

    Replace joint (10-15 yrs life)
Note: A joint that has not moved for two years will not move immediately after surgery