Rheumatology, Paediatric Rheumatology, Sports & Exercise Medicine, Physiotherapy, Orthopaedic Surgery

Osteoarthritis

Introduction to Osteoarthritis

Osteoarthritis is a joint condition primarily caused by the breakdown of cartilage in the joint cavity, in particular where individual bones articulate with each other.

Written by Doctify Team 27/04/2020

What is Osteoarthritis?

Osteoarthritis is a joint condition primarily caused by the breakdown of cartilage in the joint cavity, in particular where individual bones articulate with each other. Most joints allow you to move one bone relative to another and at the point where two bones articulate with each other they are covered with a layer of cartilage that allows you to move them smoothly. This layer of cartilage becomes dysfunctional in osteoarthritis. By the age of 35 many people will have some form of osteoarthritis in at least one joint and this most commonly occurs in more frequently used joints such as the knees, hips and the finer joints of the hand.

What are the causes for Osteoarthritis?

As mentioned many joints in the body allow you to smoothly move bones relative to each other due to a layer of cartilage on each bone surface and lubricating joint fluid between them. However with use this cartilage suffers from wear and tear and eventually this can lead to the underlying bone articulating with bone. As the condition progresses the joint capsule can become inflamed due to degraded collagen fragments in the joint fluid. This causes the pain commonly associated with osteoarthritis.

The joint can present with other features such as ligament degradation and the development of osteophytes. These are bony outgrowths either side of the joint and it is thought that this is an attempt by the body to improve joint function.

People may have a predisposition for osteoarthritis because of increased age, their weight (obese individuals experience greater load on weight-bearing joints), other joint conditions such as gout, past injuries and their family history.

What are the symptoms of Osteoarthritis?

Osteoarthritis can present itself in a number of ways such as joint pain, crepitus (popping and cracking sounds when moving), a reduced range of motion, osteophytes (bony growths either side of the joint) and stiffness that may improve as the day goes on.

How is Osteoarthritis treated?

The first line of treatment for osteoarthritis usually involves lifestyle changes such as exercise, stretching and weight loss if deemed necessary. Manual therapy, hot and cold packs and physical assistance such as specialist footwear can also be recommended.

Beyond that, painkillers and anti-inflammatories can be used. If with these initial therapies prove ineffective further treatments can be used such as opioids, corticosteroid injections and topical capsaicin creams.

In serious, debilitating cases of osteoarthritis various forms of surgery can be considered. Arthroplasty is a minimally invasive keyhole procedure which smoothes out the joint surfaces. In the most extreme cases arthrodesis is a procedure that can fuse a joint into a fixed position. This can strengthen the joint and reduce pain though it will permanently “lock” the joint. A full joint replacement is a common end stage therapy but for people for whom it might not be suitable a surgeon can perform an osteotomy. This involves adding or removing bone material to realign a joint and reduce stress on the affected area.

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