Osteoarthritis is a degenerative condition of articular cartilage. Contents : Definition Etiology Risk factors Classification Pathophysiology Clinical features Differential diagnosis Investigation Treatment

1. By :YASH ANGHAN

2. ▪ 1. Definition
▪ 2. Etiology (Causes)
▪ 3. Risk factors
▪ 4. Classification
▪ 5. Pathophysiology
▪ 6. Clinical Features
▪ 7. Differential diagnosis
▪ 8. Investigation
▪ 9.Treatment

3. ▪“Osteoarthritis is a disease
characterized by degeneration
of cartilage and its underlying
bone within a joint as well as
bony overgrowth”

4. O – Obesity
S – Senility or old age
T – Trauma
E – Emotional stress
O – Osteoporosis
A – Alcohol
R – Rigorous lifestyles
T – Taxing professions
H – Hormonal imbalances
R – Repetitive injuries
I – Indian cultural habits
T – Axing sports
I – Improper postural habits
S – Smoking
▪ Multifactorial : Not understood well
▪ Ediopathic
▪ Wear and Tear

5. Primary OA
▪ Age related
▪ Mostly occures in weight bearing joints
like HIP, KNEE AND SPINE
▪ Trapeziometacarpal joint of thumb is
commonly affected
▪ Distal interphalangeal joints of fingers
are also commonly affected
▪ More common than Secondary OA
Secondary OA
▪ It is not age related
▪ Due to previous underlying bone or joint
disease or trauma
▪ Commonly at hip
▪ Predeposing fectors are as follows
1. Congenital malformations
2. Previous Trauma
3. Previous related injuries
4. Internal derangement of Joint
5. Malalignment of joint
6. Obesity and excessive weight

6. This degenerative
condition starts with
affecting to the
articular cartilage
Increase
water contant
Depletion of
protioglycans
Cartilage
erosion and
fibrillation
Abraded by
grinding
mechanism
Underlying
bone is now
exposed to get
erosed
Further rubbing
Subchondral
bonebecomes
hard and & Glossy
Margines of
rim of bone get
hypertrophied
Forms projecting spurs
known as osteophytes
formation
Same process occurs at
subchondral bone
forming spurs here it is
called subchondral cyst
Loose flacks of cartilage in
synovial fluid initiate synovial
inflammation
Thickening of
the capsule
Bony
deformities

7. • Mostly in elderly people
• Bilateral affection
• Morning stiffness (no longer than
an hour)
Earliest symptom : Pain
• In beginning :
• Dull pain
constant for 2-3
months to years
• Coared crepitus
• Late features
• Swelling due to
inflammation
• Stiffness due to
pain and muscle
spasm
• Locking and
instability due to
frayed maniscus
Geographical variation
Western lifestyle
Hip commonly affected
Asian lifestyle
Knee Commonly affected
On Examination
• Tenderness over joint line
• Crepitus
• Irregular & enlarged looking joint
• Deformities : Knee : varrus or valgus
: Hip : Flexion adduction
. And internal rotation
• Effusion mostly rare and transiant
• Limitations of movement
• Subluxation
• Wasting of related musculatures

8. ▪Rheumatoid arthritis
▪Gout
▪Septic arthritis

9. Radiological investigation Other investigation
• Nerrowing of joint space
• Subchondral cyst
• Dense bone under the articular
surface
• Osteophytes formation
• Loose bodies
• Deformities
• Serologicall test :To rule out
Rheumatoid Arthritis
• Serum test :To rule out gout
• Sinovial fluid examination :To rule
out septic arthritis

10. PRINCIPLES
• Disease once started
progresses gradually
there is no way to stop it
1. Delay Occurance of
disease : if disease has
not yet begun
2. To stall progress of the
disease and relieve
symptoms : if the disease
is in early stage
3. To rehabilitatethe patient
if if his disabilities can be
partially or completely
elivated
Methods of treatment
Pharmacological
Treatment
Supportive
Therapy
Surgical
Method
Drugs :analgesics
( for pain relief)
Chondroprotactive
agents :
- Glusulphate
- Chondroitin sulphate
(Does not modify the
disease but it acts as an
mechanic of cartilage)
Viscosuplementation
Sodium hylarunon
(Improve cartilage
function)
• Weight loss
• Avoidance of
stress and
strain activities
in daily life
• Local heat
• Exercise
• Application of
local counter
irritants and
liniments
1. Osteotomy:
(A) High tibial osteotomy or
(B) Intertrochantaric osteotomy
2. Joint Replacement
Most common nowadays
3. Joint Debridement
Less common nowadays
4. Arthroscopic Procedure
Most popular these days