This was a lecture in the course "Significant Medical Conditions in Seniors" presented at Peer Learning in Chapel Hill, NC, USA in 2016 by Michael C. Joseph, MD, MPH.

1. OSTEOARTHRITIS
Michael C. Joseph, MD
(Peer Learning)
October 12, 2016

2. Outline
 ARTHRITIS
− Epidemiology
− Symptoms
− Subtypes
 OSTEOARTHRITIS
− Definition
− Symptoms
− Treatment
− Research
 RESOURCES
 CREDITS

3. ARTHRITIS
U.S. Prevalence
 Arthritis is the most common cause of
disability.
 Prevalence (2015):
− 1 in 250 children;
− 1 in 5 people over 18;
− 1 in 2 people over 65;
− more than 50 million adults.
 Prevalence (2030): 67 million adults.

4. ARTHRITIS
Sex-Ethnicity Variations
 More common in women (26%) than in
men (18%).
 Minorities (Blacks, Hispanics, Asians):
− have lower rates of arthritis;
− but they experience greater severity of pain
and disability than Whites.

5. ARTHRITIS
Risk Factors
Those you cannot change:
Family History of arthritis;
Older Age;
Female Sex.
Those you can change:
Overuse of the joint;
Muscle weakness;
Overweight.
Other:
Joint injury.

6. ARTHRITIS
Major Subtypes
 Osteoarthritis - the most common form;
 Rheumatoid Arthritis.
 Other auto-immune diseases (such as Lupus).
 Gout.
 Psoriatic Arthritis.
 Septic Arthritis.

7. ARTHRITIS
Joint Symptoms
Chronic: Pain, Swelling, Stiffness
Acute Flare: Warmth, Redness
Outcome: Instability, Deformity

8. OSTEOARTHRITIS
Definition
 Chronic joint disorder, with:
− Progressive softening and disintegration of
joint cartilage;
− New growth of cartilage and bone at the joint
margins (spurs);
− Fibrosis (scarring) of the joint capsule.

9. OSTEOARTHRITIS
Major Types
 Primary or Idiopathic:
− Most common type;
− When there is no known cause.
 Secondary:
− Diagnosed when there is an identifiable cause
(e.g. trauma).

10. OSTEOARTHRITIS
Joints Affected

11. OSTEOARTHRITIS
Joint Changes

12. OSTEOARTHRITIS
Hand Changes

13. OSTEOARTHRITIS
Pharmacologic Treatments
 Oral
Acetaminophen
Aspirin
Celebrex
Motrin, Aleve, etc.
Tramadol, Oxycontin, etc.
Chondroitin/glucosamine
Topical
Capsaicin
Aspercreme
Salonpas
Voltaren
Intra-articular
Cortisone
Synvisc

14. OSTEOARTHRITIS
Non-pharmacologic Treatments
Patient Education
Weight loss
PT/OT
Exercises: ROM, Balance
Muscle strengthening
Assistive devices
Cane, Crutches, Walkers
Appropriate footwear
Orthotics
Braces, Splints
Joint protection

15. OSTEOARTHRITIS
Surgical Options
 Arthroscopy
− Mainly for knee and shoulder
− Removal of loose cartilage
− Treatment of damage to joint structures
 Osteotomy
− Mainly for knee and hip
− Reposition of bone by a wedge-shaped cut
− For younger patients
 Joint Replacement
− Reconstruction of a joint
− For patients over 50, or with severe progression

16. Knee Replacement
Before After

17. Knee Replacement
Complications
 Limited Range-of-Motion (ROM);
 Patellar (kneecap) Instability (3-5%);
 Loosening (> 90%);
 Blood Clots:
− from deep leg veins (Deep Venous Thrombosis) (DVT);
− to the Lung (Pulmonary Embolism) (PE).
 Infection (2%).

18. RESOURCES
 Arthritis Foundation:
http://www.arthritis.org/
 National Institue of Arthritis and
Musculoskeletal and Skin Diseases
(NIAMS) (NIH):
www.niams.nih.gov

19. CREDITS
 Arthritis Foundation
http://www.arthritis.org/about-arthritis
 National Institute of Arthritis and
Musculoskeletal and Skin Diseases (NIAMS)
(NIH):
www.niams.nih.gov/Health_Info/Osteoarthritis/
 https://en.wikipedia.org/wiki/Arthritis
 SLIDESHARE.NET
www.slideshare.net

20. CREDITS - SLIDESHARE.NET
http://www.slideshare.net/olivercw/arthritis?utm_source=slideshow
02&utm_medium=ssemail&utm_campaign=share_slideshow
http://www.slideshare.net/saimedical/arthritis-
6071800?utm_source=slideshow02&utm_medium=ssemail&utm_ca
mpaign=share_slideshow
http://www.slideshare.net/chirostarpresentations/arthritis-
1911482?utm_source=slideshow02&utm_medium=ssemail&utm_ca
mpaign=share_slideshow
http://www.slideshare.net/drangelosmith/osteoarthritis-
35866521?utm_source=slideshow02&utm_medium=ssemail&utm_c
ampaign=share_slideshow
http://www.slideshare.net/smsmo0o/osteoarthritis-
13336753?utm_source=slideshow02&utm_medium=ssemail&utm_c
ampaign=share_slideshow