The PPT helps the nursing students to understand about osteoarthritis clearly

1. OSTEOARTHRITIS
By
Mr.Anandh Sam Perera. S
Professor

4. Etiological factors/ Risk factors
• Osteoarthritis has a multifactorial aetiology and can be primary (with no obvious
cause) or secondary (due to trauma, infiltrative disease or connective tissue
diseases, genetic).
• Risk factors for primary OAinclude obesity, advancing age, female gender,
and manual labour occupations.

5. Pathophysiology
▶ Osteoarthritis is traditionally thought of as a ‘wear and tear’disease which occurs as we
age.
▶ The pathogenesis of OAinvolves a degradation of cartilage and remodelling of
bone due to an active response of chondrocytes in the articular cartilage and the
inflammatory cells in the surrounding tissues.
▶ The release of enzymes from these cells break down
collagen and proteoglycans, destroying the articular cartilage.
The exposure of the underlying subchondral bone results in
sclerosis, followed by reactive remodelling changes that lead to
the formation of osteophytes and subchondral bone cysts. The
joint space is progressively lost over time.

6. Clinical Manifestations
▶ Swollen, creaky joints are a hallmark of osteoarthritis.
▶ The bony growths generally occur on the
finger joints nearest the fingertip is called as
Heberden’s node, also called as the distal
interphalangeal joints.
▶ Similar swellings located on the lower joints, or the proximal
interphalangeal joints, are called Bouchard’s nodes.

7. Pain. Affected joints might hurt during or after movement.
Stiffness. Joint stiffness might be most noticeable upon awakening or after being inactive.
Tenderness. Your joint might feel tender when you apply light pressure to or near it.
Loss of flexibility. You might not be able to move your joint through its full range of motion.
Grating sensation. You might feel a grating sensation when you
use the joint, and you might hear popping or crackling.
Bone spurs. These extra bits of bone, which feel like hard lumps,
can form around the affected joint.
Swelling.

8. Diagnostic Evaluation
• H.C
• P.E
• X-ray
• MRI
• Blood test – RF negative
• Synovial fluid analysis

9. Management
Conservative to Medical to Surgical.
Conservative:
🠶 Patients should be educated about their condition and its progression,
including advise on joint protection and emphasising the importance
of strengthening and exercise. Patients who are overweight should also
be advised on weight loss.
🠶 Some non-pharmacological interventions that can be offered include local
heat or ice packs, joint supports, and physiotherapy (most effective
option for longer-term outcomes).

10. Medical
• Simple analgesics and topical NSAIDs are the mainstay of most medical
management for OA, alongside the conservative measures.
• Calcium
• Vit. D
• Chondroprotective agents: is a specific compound or chemical that delays progressive
joint space narrowing characteristic of arthritis and improves the biomechanics
of articular joints by protecting chondrocytes. chondroitin sulfate, glucosamine and
hyaluronic acid.

11. Surgical:
Surgical management choice will depend on the site affected.
▶ Osteotomy
▶ Arthrodesis (joint fusion)
▶ Arthroplasty

12. Nursing Management
• Acute pain related to degenerated bony surface
• Immobility related to pain in the joints
• Self care deficit related to arthritis
• Sleep pattern disturbances
• Anxiety

13. Difference between OA and RA
• OA and rheumatoid arthritis
(RA) share the same symptoms but
are very different conditions. OA
is a degenerative condition, which
means that it increases in severity
over time. RA, on the other hand,
is an autoimmune disorder.
• Anti-cyclic citrullinated peptide