Osteoarthritis osteoarthrosis degenerative joint disease
This presentation is the property of its rightful owner.
Sponsored Links
1 / 55

OSTEOARTHRITIS OSTEOARTHROSIS DEGENERATIVE JOINT DISEASE PowerPoint PPT Presentation


  • 100 Views
  • Uploaded on
  • Presentation posted in: General

DR. IMTIAZ AHMED TAGO MBBS,FCPS ( ORTHOPEDIC SURGERY ) ASSISTANT PROFFESSOR DOST UNIT II LUMHS JAMSHORO. OSTEOARTHRITIS OSTEOARTHROSIS DEGENERATIVE JOINT DISEASE. DEFINITION. Osteoarthritis OA is a degenerative disease of diarthrodial ( synovial ) joints , characterized by

Download Presentation

OSTEOARTHRITIS OSTEOARTHROSIS DEGENERATIVE JOINT DISEASE

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Dr imtiaz ahmed tago mbbs fcps orthopedic surgery assistant proffessor dost unit ii lumhs jamshoro

DR. IMTIAZ AHMED TAGOMBBS,FCPS (ORTHOPEDIC SURGERY)ASSISTANT PROFFESSORDOST UNIT II LUMHS JAMSHORO


Osteoarthritis osteoarthrosis degenerative joint disease

OSTEOARTHRITISOSTEOARTHROSISDEGENERATIVE JOINT DISEASE


Definition

DEFINITION

  • Osteoarthritis OA is a degenerative disease of diarthrodial (synovial) joints, characterized by

  • Breakdown of articular cartilage

  • and proliferative changes of surrounding bones


Epidemiology

EPIDEMIOLOGY

  • Osteoarthritis(OA) is the most common joint disease

  • OA of the knee joint is found in 70% of the population over 60 years of age

  • Radiological evidence of OA can be found in over 90 % of the population


Limited function

LIMITED FUNCTION

  • OA may cause functional loss

  • Activites of daily living

  • Most important cause of disability in old age

  • Major indication for joint replacement surgery


Character i st i cs of oa

CHARACTERISTICS OF OA

  • OA is a chronic disease of the musculoskeletal system,without systemic involvement

  • OA is mainly a noninflammatory disease of synovial joints

  • No joint ankylosis is observed in the course of the disease


Classification of oa

CLASSIFICATION OF OA

  • Primary OA Secondary OA

    Etiology is unknown Etiology is known


Osteoarthritis osteoarthrosis degenerative joint disease

AGE

  • Primary OA > 40 years

  • Direct correlation

  • Aging process


Risk factors for primary oa

RISK FACTORS FOR PRIMARY OA

  • Age

  • Sex

  • Obesity

  • Genetics

  • Trauma (daily)


Secondary ostoarthritis

SECONDARY OSTOARTHRITIS

  • Trauma

  • Previous joint disorders;

  • Congenital hip dislocation

  • Infection: Septic arthritis, Brucella, Tb

  • Inflammatory: RA, AS

  • Metabolic: Gout

  • Hematologic: Hemophilia

  • Endocrine: DM


Etiology of oa

ETIOLOGY OF OA

  • Cartilage properties

  • Biomechanical problem


Morphology of primary oa

Morphology of Primary OA


Primary generalized oa

Primary Generalized OA


Structure of joint cartilage

STRUCTURE OF JOINT CARTILAGE

  • Collagen (Type 2)

  • Proteoglycan

    - Hyaluronic acid

    - Glycoseaminoglycan

  • Water

  • Condrocyte

    Regeneration and Degeneration


Pathology of oa

PATHOLOGY OF OA

  • Fibrillation

  • Eburnation

  • Osteophytes

  • Subcondral cysts


Laboratory findings of oa

LABORATORY FINDINGS OF OA

  • There are no pathognomonic laboratory findings for OA

  • Laboratory analysis is performed for differential diagnosis


Radiologic findings of oa

RADIOLOGIC FINDINGS OF OA

  • Narrowing of joint space

    (due to loss of cartilage)

  • Osteophytes

  • Subchondral (paraarticular) sclerosis

  • Bone cysts


Radiologic grade of oa

RADIOLOGIC GRADE OF OA

  • G1 Normal

  • G2 Mild

  • G3 Moderate

  • G4 Severe

  • Kellgren Lawrence Classification


Diagnosis of oa

DIAGNOSIS OF OA

CLINICAL FINDINGS

Joint pain

+

RADIOLOGIC FINDINGS

Osteophytes


Clinic of oa signs and symptoms

CLINIC OF OA SIGNS AND SYMPTOMS

  • Joint pain - degenerative

  • Stiffness following inactivity – 30 min

  • Limitation of ROM – later stages

  • Deformity – restricition of ADL


Oa of knee joint gonarthrosis

OA OF KNEE JOINT (GONARTHROSIS)

  • More common in obese females

  • over 50 years of age

  • Joint stiffness (<30 minutes)

  • Mechanical pain

  • Physical examination findings: Crepitus

  • Pain on pressure

  • Painful ROM and functional limitation

  • Limitation of ROM in later stages of OA (first extension)

  • Laboratory analysis within normal limits


Genu valgum orthosis

GENU VALGUM - ORTHOSIS


Radiologic findings grade 1 4

RADIOLOGIC FINDINGS? GRADE 1 - 4?


Oa of hip joint

OA OF HIP JOINT

  • More common in males over 40 years of age

  • Joint stiffness

  • Pain of hip,gluteal and groin areas radiating to the knee (Nobturatorius)

  • Mechanical pain

  • Limited walking function


Coxarthrosis

COXARTHROSIS

Physical examination:

  • Antalgic limping

  • Limitation of ROM (first internal rotation)

  • Painful ROM

  • Trendelenburg test positivity

  • Leg length discrepancy

    Laboratory analysis within normal limits


Biomechanics

BIOMECHANICS


X ray of hip oa

X-RAY OF HIP OA


Peripheral joints

Peripheral Joints

  • Hands

  • Feet


Etiopathogenesis of oa

ETIOPATHOGENESIS OF OA

  • Age,gender

    Local

  • Genetic OA biochemical effects

  • Other factors


Etiopathogenesis of oa1

ETIOPATHOGENESIS OF OA

  • Dysfunction of joint cartilage

  • Condrocyte function:1- Degredative enzymes

    (metalloproteases)

    2- Inhibitors

    Degeneration and regeneration functions are balanced

  • IL-1  , degredative enzymes + synovial inflammation results:Breakdown of cartilage


Pathogenesis of oa

PATHOGENESIS OF OA

  • Cytokines IL-1, IL-6, TNF-

  • Cell destruction

  • Membrane phospholipids

  • Arachidonic acid

  • Cox-1, Cox-2


Osteoarthritis osteoarthrosis degenerative joint disease

  • IL-1 and metalloproteases have been found to play an important role in cartilage destruction.

  • Local growth factors,especially transforming growth factor (TGF) are involved in the formation of osteophytes


Treatment of oa

TREATMENT OF OA

  • Symptomatic treatment

  • Structure modifying treatment

  • Surgical treatment


Structure mod i fy i ng treatment

STRUCTURE MODIFYING TREATMENT

  • Hyaluronic acid injection (HA)

  • Glycose amino glycans (GAG)


Primary prevention of oa

PRIMARY PREVENTION OF OA ??

  • Regular exercises

  • Weight control

  • Prevention of trauma


Aims of oa treatment

AIMS OF OA TREATMENT

  • Pain relief

  • Preservation and restoration of joint function

  • Education


Non p harmacolog i c treatment o f o a

Non-Pharmacologic Treatment of OA

  • Patient education

  • Weight loss (if overweight)

  • Aerobic exercise programs

  • Physical therapy

  • Range-of-motion exercises Muscle-strengthening exercises

  • Assistive devices for ambulationPatellar tapingAppropriate footwear Lateral-wedged insoles (for genu varum)

  • Bracing

  • Occupational therapy

  • Joint protection and energy conservation


Pharmacologic treatment of oa

PHARMACOLOGIC TREATMENT OF OA

  • Oral Systemic Medical Agents

    - Analgesics (acetaminophen)

    - NSAIDs

    - Opioid analgesics

  • Intraarticular agents:

    Hyaluronan

    Glucocorticoids (effusion)

  • Topical agents


Hand oa resting splint

HAND OA - RESTING SPLINT


Symptomatic treatment of oa

SYMPTOMATIC TREATMENT OF OA

  • Decrease of joint loading

    -Weight control

    - Splinting

    - Walking sticks

  • Exercises

    - Swimming

    - Walking

    - Strengthening

  • Patient education


Indications of surgical intervention

INDICATIONS OF SURGICALINTERVENTION

  • Severe joint pain,

    resistant to conservative treatment methods

  • Limitation of daily living activities

  • Deformity, angular deviations, instability


Invas i ve methods

INVASIVE METHODS

  • Joint lavage

  • Arthroscopy

  • Cartilage grefting- genetic engineering

  • Surgery

    Osteotomy

    Joint replacement


Questions

QUESTIONS?


  • Login