slide1
Download
Skip this Video
Download Presentation
OSTEOARTHRITIS OSTEOARTHROSIS DEGENERATIVE JOINT DISEASE

Loading in 2 Seconds...

play fullscreen
1 / 55

OSTEOARTHRITIS OSTEOARTHROSIS DEGENERATIVE JOINT DISEASE - PowerPoint PPT Presentation


  • 147 Views
  • Uploaded on

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

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' OSTEOARTHRITIS OSTEOARTHROSIS DEGENERATIVE JOINT DISEASE' - fordon


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
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

slide9
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
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
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

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
slide42

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
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

ad