Osteoarthritis

1. Osteoarthritis
Alpesh C. Jadhav
B. Sc. (Hons) Sports and Exercise Science

2. Overview
• Introduction
• Epidemiology
• Classification
• Risk Factors
• Changes
• Symptoms & Signs
• Investigations
• Management

3. Osteoarthritis
• A type of Arthritis caused by inflammation, breakdown, and eventual
loss of cartilage in the joints
• Most common form of arthritis and
• The most common joint disease
• Known as Degenerative Joint Disease
• Most often occurs at the ends of the fingers, thumbs, neck, lower back,
knees, and hips
• There is focal destruction of articular cartilage, exposure of
subchondral bone and new bone formation at the margins

4. Osteoarthritis
• Affects about 4-6% of adult population
• One of the top 5 chronic diseases in India
• According to World Health Organization (WHO) 9.6% of men and 18.0% of
women aged over 60 years has symptomatic osteoarthritis worldwide
• 80% of those with osteoarthritis have limitations in movement, and 25%
cannot perform their major daily activities of life
• Prevalence of 22% to 39% in India.
• Incidence:
 Age- Women > 55 years of age, Men > 65 years of age
 Women are more commonly affected than men

5. Classification
• Primary (idiopathic):
 No prior event or disease related to the OA
 Affect DIP, PIP, 1st Carpometacarpal, knee, hip, spine
• Secondary:
 Resulting from previous joint injury or inflammatory disease
 Affect less common joint as wrist, metacarpophalangeal,
shoulder
• Distinction between primary and secondary OA is not always
clear

6. Osteoarthritis
A disease of
joints that
affects all of the
weight-bearing
components of
the joint

7. Articular cartilage is the main tissue affected
OA results in:
•Increased tissue swelling
•Change in color
•Cartilage fibrillation
•Cartilage erosion down to subchondral bone

8. Risk Factors
• SECONDARY OA
• Injury to joint : Traumatic or
inflammatory
• Heamoartharosis
• Congenital/Developmental
• Neuropathic joint
• Metabolic (Paget's Disease)
• PRIMARY OA
• Age
• Gender
• Obesity
• High Bone Mass
• Mechanical : Repetitive
bone use squatting

9. Macro structural &
Pathological Changes
• Pathological
• Cartilage Fibrilation
• Subchondral new bone
• Myxoid degeneration
• Trabecular compression
• Macro structural
• Loss of articular cartilage
• Subchondral cyst
• Osteophytes
• Sclerosis
• Muscle wasting

10. Symptoms and signs

11. Investigations
• ESR (Erythrocyte sedimentation rate), CRP(C-reactive
protein)
• X-rays, weight bearing
• MRI
• Synovial Fluid Aspiration
• Arthroscopic Intervention - Diagnostic and Therapeutic

12. Management
(i) Early OA-
o initial short course of analgesics
o weight loss regimens & physical activity routine
o simple exercises for quadriceps strength- isometric exercises and
basic stability exercises
o gait training
o ROM exercises
o hydrotherapy
o cryotherapy and contrast baths
o correction of associated biomechanical aggravating factors with
insoles etc.

13. Management
(ii) Moderate to severe OA-
o short term course of analgesics
o intra articular corticosteroid injections
o commencement of exercise regimen as soon as pain decreases to
tolerable level
o intra articular synovial fluid replacement therapy
✦ If all the above fails > 6 months- joint replacement may be considered
✦ Age, obesity, activities of daily living are all taken into account while making
the decision
✦ Rehabilitation after joint replacement

14. Heberden's Nodes
Hard or bony
swellings that can
develop in the distal
interphalangeal
joints (DIP)

15. Knee Osteoarthritis

16. Hand Osteoarthritis

17. Hip Osteoarthritis

18. Spine Osteoarthritis

19. THANKS