OsteoarthritisArranged by :

Lazuardhi DwipaAnita LilianaIntan RenataRukin Aman

IntroductionOsteoarthritis : a degenerative joint disorderProgressive loss of articular cartilage & new bone formation & capsular fibrosisCauses, pathology, clinical, X-rays, DD. treatment

CauseIncreases with ageTwo types of cartilage degeneration :

Limited cartilage loss Progressive cartilage destructionResult from stress to articular cartilages, the ability of cartilage to withstand stress, & poor subchondral bone.

Cause ...Normally : loading forces are widely distributed over the articular surfaces & stress is minimal instability, subluxation, deformity decrease the area of contact the force is concentrated over a smaller area the stress is greatly increased surface may break down

PathologyArticular Cartilage & Bone

- Increase water content of cartilage disruption of the large chondromucoprotein molecules loss of proteoglycans cartilage becomes oedematous & soft the clefts more pronounced chondrocyte clusters in the matrix depleted cartilage

Articular Cartilage & Bone ...Proteoglycan increases subarticular thickens cracks in the subchondral plate pressure transmission to the cancellous bone cysts formation progressive cartilage disintegration lead to surface abration instability increase the intact cartilage in peripheral unstressed areas proliferates & ossifies (osteophytes)

Synovial Membrane & CapsuleDeposition of cartilage&bone detritus onto the synovium inflammation particles penetrate to subsynovial layers results fibrosis fibrosis extend to the capsules thickens and inelastic limiting movement

SymptomsA history of previous disorder or injury of the jointIntermittent with periods of symptomatic remission lasting for months or yearsPainStiffnessSwellingDeformity

SignsSwelling & deformityMuscle wastingTell-tale scarsLocal tendernessSynovial thickening or osteophytes feltMovement restrictedAbduction & internal rotation limitedJoint instability

X-RayNarrowing of the joint spaceSubarticular sclerosisBone cystsosteophytes

Differential DiagnosisMonoarticular synovitisCrystal Deposition DiseaseAseptic Necrosis

TreatmentEarly :

pain reliefMobilizationLoad reductionIntermediaterealignment osteotomy Late- surgery : arthrodesis, arthroplasty