presentation on oteoarthritis

2. OSTEOARTHRITIS
Lecturer Sir Awal Sher
INS-KMU

3. Classification of AO
• Osteoarthritis is classified into two classifications
• Primary or idiopathic OA The cause of primary OA is unknown.
However, it is associated with aging and tends to develop around age
55 to 60.
• Secondary OA results from previous joint injury or inflammatory
disease.

4. Pathophysiolog
yo Due to degeneration of articular cartilage and calcification of ligament.
o Weight bearing joints become immobile
o begins with erosion of the joint cartilage
o causing fissures/ cracking loss of cartilage bone contact
o Joint immobility and bone destruction /remodeling
o Peritonsillar abscess
o (puss formation)

6. • Obesity
• Joint injury or trauma
• Joint overuse (occupational or recreational)
• Abnormal alignment of the legs
• A family history of osteoarthritis

7. Causes of OA:
• Age factors
• Gender
• Genetic and hormones
• Obesity
• Occupational or physical activates /sports injury

8. Clinical Features
• Pain. Affected joints might hurt during or after movement.
• Stiffness.
• Tenderness. joint might feel tender when you apply light pressure to or
near it.
• Loss of flexibility.
• Grating sensation.
• Bone spurs. These extra bits of bone, which feel like hard lumps, can
form around the affected joint.
• Swelling. This might be caused by soft tissue inflammation around the
joint.

11. Cont...
• MRI gives a better view of cartilage and other parts of the joint.
• Joint fluid analysis; . Your doctor might use a needle to draw fluid from an
affected joint. The fluid is then tested for inflammation and to determine
whether your pain is caused by Gout or an infection rather then AO.

12. Medical management of AO
• Management focuses on slowing and treating symptoms because there is
no treatment available that stops the degenerative joint disease process.
• The main treatments for the symptoms of osteoarthritis include:
• lifestyle measures – such as maintaining a healthy weight and exercising
regularly
• Weight reduction is strongly recommended
• Pharmacologic therapy. Initial analgesic therapy is acetaminophen, while
some are responsive to NSAIDs and opioids.
• Joint rest. The patient should avoid joint overuse and rest the joints
regularly.

13. Cont.…..
• Supportive treatments
• Hot or cold packs Applying hot or cold packs to the joints can relieve
the pain and symptoms of osteoarthritis in some people.

14. Cont…
• Nutritional supplements vitamin D supplements.
• Vitamin C
• Diet: vegetables, fruits, grains
• Manual therapy physiotherapy
• Manual therapy is a technique where a physiotherapist uses their
hands to stretch, mobilize and massage the body tissues to keep your
joints supple and flexible.

15. Surgical management:
• Joint replacement
• Joint replacement, also known as an arthroplasty, is most commonly
done to replace hip and knee joints.
• Arthrotomy ;surgical opening of joint
• Arthrodesis (joint fusion)

16. Nursing Interventions
• The major goals of the nursing intervention are pain management and
optimal functional ability.
•
Weight loss. Weight loss is an important approach to pain and
disability improvement.
• Assistive devices. Canes and other ambulatory devices are very helpful
for ambulation.
• Exercise. Exercises such as walking should begin moderately and
increase gradually.
• Analgesic. Adequate pain management is essential to the success of an
exercise program.
• Physical therapy. A referral for physical therapy for people with similar
problems can be very helpful.

17. Nursing Care Plans
Nursing diagnosis and intervention
• Nursing care plan for clients with osteoarthritis involves relieving pain promoting
comfort measures, maintaining optimal joint function, and preventing progressive
disability.
• Nursing diagnosis for patients with osteoarthritis:
1.Acute Pain/Chronic Pain
2.Impaired Physical Mobility
3.Activity Intolerance
4.Risk For Injury

18. Pain acute/chronic
• Acute Pain Chronic Pain
• Assess the client’s description of pain.
• Assess the client’s previous experiences with pain and pain relief. Apply a hot or
cold pack.
• Change positions frequently.
• Medicate for pain before activity and exercise therapy.
• Provide for adequate rest.
• Support joints in a slightly flexed position through the use of pillows, rolls, and
towels.
• Instruct the client to take prescribed analgesics and/or anti-inflammatory
medications e.g
• Acetaminophen NSAIDs ophoids

19. 2.. Impaired Physical Mobility
• May be related to Fatigue Muscle weakness Pain Restricted joint
movement Stiffness.
• Assess the client’s posture and gait.
• Assess the client’s weight.
• Excessive weight may add stress to painful joints. Assess the client’s
ability to perform ADLs.
• Assess the client’s comfort with and knowledge of how to use assistive
devices.
• Provide the client with access to and support during weight-reduction
programs
• Weight reduction results in decreased trauma to bones, muscles, and
joints
• Consult physical therapy staff to prescribe an exercise program

20. 3..Activity Intolerance
• Activity Intolerance may be related to decrease muscle tone Joint pain
• Assess the physical activity level and mobility of the client
• Assess the client’s nutritional status. Adequate energy reserves are
needed during activity.
• Assess the need for ambulation aids (e.g., cane, walker)
• Exercise maintains muscle strength, joint ROM, and exercise tolerance.

21. 4 ..Risk For Injury
• Risk for Injury May be related to Altered mobility Decreased bone
function Pain/discomfort
• Assist client with active and passive ROM exercises and as tolerated.
Maintains and enhances muscle strength, joint function.
• Encourage client to lose weight to decrease stress on weight-bearing
joints Excess weight adds extra stress on the joints.
• Instruct the client to use the softest surface available during exercise.
• Instruct the use of adaptive mobility equipment such as walkers, canes,
and crutches as indicated.

22. Cont.…
• Instruct the client regarding safety measures
• Raised chairs and toilet seat
• Use of handrails
• Accurate use of mobility equipment and wheelchair safety.
• Helps prevent accidental injuries and falls

23. Evaluation
• Identified negative factors affecting activity intolerance and eliminate or
reduce their effects when possible.
• Used identified techniques to enhance activity intolerance.
• Reported measurable increase in activity intolerance.
• Reported pain is relieved or controlled.
• Followed prescribed pharmacologic regimen.
• Participated in ADLs and desired activities.

24. ANY QUESTION?