osteorathritis/degenerative/hypertrophic arthritis

1. Osteoarthritis
(degenerative arthritis/hypertrophic
arthritis/osteoarthrosis)
By Muthu Rohini

2. Definition
● It is a non inflammatory, degenerative condition
of joints characterized by degeneration of
articular cartilage and subchonral bone and
formation of new bone ie osteophytes
● Results in deformity and ligamentous laxity

3. Classification
Primary OA Secondary OA
Etiology is unknown Etiology is known

4. Causes of secondary OA
● Trauma – intra articular #,occupational
● Developmental – CHD
● Infection – septic arthritis, brucella, tb
● Inflammation – RA, gout
● Endocrine – DM, acromegaly
● Previous joint disorders
● Obesity and excessive weight

5. Structure of joint cartilage

6. Pathology of OA
● Fibrillation
● Eburnation
● Osteophytes
● Subchondral cyst
loose flakes of the cartilage incite synovial infln
and thickening of the capsule, leading to
deformity and stiffness of joint

7. symptoms
● Pain is the earliest sympom
● Coarse crepitus
● Swelling
● Stiffness
● Feeling of instability

8. Signs
● Joint line tenderness
● Crepitus on moving joint
● Deformity
● Effusion
● Terminal limitation of joint movement
● Wasting of muscle

9. Radiological examination
● Narrowing of joint space
● Subchondral sclerosis
● Subchondral cyst
● Osteophyte formation
● Loose bodies
● Deformity of joint

11. OA knee joint

12. OA hip joint

13. Other inv
● Serological tests and ESR to ruleout
rheumatoid arthritis
● Sreum uric acid to rule out gout
● Arthroscopy, if a loosebody or freyed meniscus
is suspected

14. Medical management
Oral Systemic Medical Agents
- Analgesics (acetaminophen)
- NSAIDs
- Opioid analgesics
Intraarticular agents:
Hyaluronon
Glucocorticoids (effusion)
Topical agents

15. Supportive therapy
● Weight reduction
● Avoidance of stress and strain
● Local heat to relieve pain and stiffness
● Exercises

16. Surgical treatment
1-Arthroscopy: use to
Flush the joint to remove any
loose part and degenerated meniscal tears (lavage
or irrigation)
Advantage:
1-delay the need for more serious surgery
e.g. joint replacement.
2-the incision is small size.
3-the pain that result of surgery is minimal
4-restore function and decrease pain.
Disadvantage:
1-Risk of anesthesia.
2-infection
3-damage to nerve or
blood vessels
4-DVT

17. 2-osteotomy:
Is procedure change the position or alignment of knee so your
weight shift away from the damage area.
●
eg. high tibial osteotomy for OA of knee with genu varum
intertrochanteric osteotomy for OA of hip
*Advantage:
Decrease pain and restore function.
*Disadvantage:
May need knee replacement surgery in future.

18. 3-arthroplasty:(joint replacement)
For cases with advanced damage to joint
Advantage:
1-there are significant pain relief and improve function
Disadvantages:
1-rehabilitation may take 3to6 month.
2-the artificial joint may loosen or wear out so that second surgery is
needed.
* The life span or artificial is about 10 years in 9%of the people.

19. Thank you