This document discusses osteoarthritis (OA), which is characterized by the progressive destruction of cartilage in joints followed by bone changes. It is the most common form of arthritis. Risk factors include aging, joint injury, poor posture, overuse, and obesity. Symptoms include pain, swelling, and stiffness in the joints that is worsened with use. Diagnosis is made based on symptoms and confirmed with x-rays showing bone changes and loss of cartilage. Treatment includes medications like NSAIDs, physical therapy focusing on exercises, bracing, and lifestyle modifications like weight loss.

1. Osteoarthritis
Dr. Ashish P
Asst. Professor
Dept. Musculoskeletal Sciences
DVVPF’s College of Physiotherapy,
Ahmednagar

2. Introduction
• OA (degenerative joint disease) is
characterized by progressive destruction
of hyaline cartilage followed by remodeling
of affected joint.
• The term osteoarthrosis is preferred as
primary pathological process is more
degenerative than inflammatory.
4/12/2018 2OA

3. • OA is separated in to primary and
secondary forms.
• Primary- when there is no obvious
underlying cause.
• Secondary – when there is an identifiable
etiological factor such as inflammatory
arthropathy (R.A), infection, fracture with
disruption of articulating surfaces, LLD etc
• Families with early onset OA due to rare,
inherited mutations of collagen have been
described.
4/12/2018 3OA

4. Epidemiology
• OA is the most common form of arthritis.
• Its prevalence steadily increases with age,
radiological changes of OA are seen in the
knee of more than 50 % of the population
older than the age of 60 yrs.
• At of after 75 yrs virtually every one has
evidence of OA in at least one joint.
• Men and women are equally affected
before age of 45, but after age 45 the
prevalence is higher in women.
4/12/2018 4OA

5. Etiology
• Aging
• Trauma
• Faulty posture
• Occupation involving repeated knee
bending
• obesity
4/12/2018 5OA

6. Classification
• Grade 0
• Grade 1
• Grade 2
• Grade 3
• Grade 4
4/12/2018 6OA

7. Pathology
water content
Loss of PG in cartilage
Loss of stiffness and elasticity of cartilage
Fibrillation
Destruction of cartilage
Jt space reduction
Compressive forces on bone
4/12/2018 7OA

8. Clinical presentations
Osteoarthritis
Etiology Aging, overuse, obesity
Onset gradual
Dominance M = F
Occurance >40
C/F Pain, swelling, stiffness, felling of
instability of joint, locking.
Heberden's node
4/12/2018 OA 8

9. 4/12/2018 OA 9

10. X- Rays
OA
4/12/2018 OA 10

11. Management
• Pharmacological
o NSAIDS
o DMARD
o Corticosteroids
o Anthrocentesis technique and
intrasynovial therapy
o Somatic gene therapy
4/12/2018 11OA

12. • Surgical procedures
o Debridement
o Synovectomy
o Bursectomy
o Joint replacement
o Osteotomy
o Arthrodesis
o For wrist and hand – procedures using
silastic posthesis.
4/12/2018 12OA

13. PT management
• Osteoarthritis
o Electrotherapy- SWD, cryo, therapeutic US,
TENS
o Ultrasound - controversial use
o Coldtherapy- to be applied for 15 to 20 min.
4/12/2018 OA 13

14. o TENS-Applied for a period of 30 to 45 min,
leads to approximately three hours of pain
relief, improves sleep, and reduces intake
of pain relieving med.
o Mobilization- to improve joint mobility and
decrease pain by using selected grading,
gentle distraction and stretching the
capsule tissue can be useful to increase
mobility.
4/12/2018 OA 14

15. o Exercise- dynamic preferred over
isometric.
o Walking- at least 3 times a week for 30
minutes, provided lower extremity will
tolerate walking or same can be done in a
swimming pool.
o Knee bracing- the use of knee bracing for
pain relief.
o Assistive devices- canes and crutches.
o Taping
4/12/2018 OA 15

16. Lifestyle modification
• Assistive modification
4/12/2018 16OA

17. 4/12/2018 17OA

18. Allied therapy
• Yoga
• Acupuncture
• Tai chi
4/12/2018 OA 18

19. Thank You
4/12/2018 19OA