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A 64 year old male presented with left knee pain• Insidious onset of pain over last 6

months• History of ACL repair due to football

injury in his late 20's• Pain of 5/10 with walking distances

>500m• C/o knee 'locking' & 'giving way'• C/o increased stiffness in mornings

lasting about 20minsCase Study

A lecture about OSTEOARTHRITISReported by: Stephanie Kaye Gabit and

Joseph Vincent Ladra

“I think my knee just popped…”

And other tales of joint popping truths…

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Osteoarthritis

Osteoarthritis is a form of arthritis that features

the breakdown and eventual loss of the

cartilage of one or more joints.

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Osteoarthritis

Osteoarthritis is a disorder of synovial joints that results in

loss of hyaline cartilage.

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Osteoarthritis

Also known as degenerative arthritis or

degenerative joint disease or

osteoarthrosis.

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Pain on movement of the affected jointManifestati

ons

ClinicalPain is generally described as a

sharp ache, or a burning

sensation in the associate muscle

s and tendons

Reduced range of

movement

Joint stiffnes

s

Crepitus

Mild Synovitis

Heberden's nodes (on the distal

interphalangeal joints) and/or Bouchard's

nodes (on the proximal

interphalangeal joints

OA at the toes leads

to the formation of bunions

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Specific genes are associated with a higher risk of certain types of osteoarthritis.Congenital bone deformities or defective cartilage.

Non-Modifiable Risk FactorsAgeGene

sGende

r

The risk of developing most types of arthritis increases with age.

Most types of arthritis are more common in women; 60% of all people with arthritis are women.  Gout is more common in men.

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Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee.

Modifiable Risk FactorsObesit

yOccupatio

nJoint

Injuries

Excess weight can contribute to both the onset and progression of knee osteoarthritis.

Damage to a joint can contribute to the development of osteoarthritis in that joint. Joint injuries such as anterior cruciate ligament (ACL) and meniscal tears.

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www.rightcare.com|Physiology

Anatomy andCartilage is a

flexible connective

tissue found in many areas of the body.

It is not as hard and rigid as bone but is

stiffer and less flexible than muscle

CartilageChondrocytescomposed

ofthat

produce

Extra-cellular matrix

Elastin fibers

Proteoglycan

Collagen fibers

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Anatomy and Physiology

Cartilage acts as a cushion between joints, to prevent the bones from rubbing against each other (such as the cartilage in the

knees and elbows) and also reduces friction in the joint with movement. It also holds some bones together, such as rib cartilage.

Cartilage also forms bone when you are growing - the ends of your long bones (arm and leg bones) are formed of cartilage when you are young, and this gradually changes

into bone and grows longer. 

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Pathophysiology

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www.rightcare.com|Osteoarthritis

DiagnosingX-rays of

the affected joints can suggest

osteoarthritis

Bone spur formation

Loss of joint cartilage,

narrowing of the joint space

between adjacent bones

During arthrocentesis,

a sterile needle is used

to remove joint fluid for

analysis

Arthroscopy is a surgical

technique whereby a

doctor inserts a viewing tube into the joint

space

Abnormalities of and damage to

the cartilage and ligaments can be

detected and sometimes

repaired through the arthroscope

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www.rightcare.com|Manifestations

Clinical• Topical pain

relievers• NSAIDS• Acetaminophe

n

• Corticosteroid

INJECTIONS

• COX-2 inhibitors

• Dietary Supplement

• Hyaluronate injections

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Medical management (conservative)

• Exercise/physiotherapy.• Heat/cold application.• Mobility aids, for example, a stick

or a frame.• Weight loss.• Splints/bracing/insoles.

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Surgical Management

•Osteotomy•Arthrodesis•Total Hip Arthroplasty (Replacement)

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www.rightcare.com|Prevention

•1 - Maintain Your Ideal Body Weight•2 - Exercise Regularly and Participate in Regular Physical Activity•3 - Protect Your Joints•4 - Avoid Repetitive Stress on the Joints•5 - Listen to Your Pain•6 - Avoid Injury to Joints

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www.rightcare.com|Prognosis

Osteoarthritis is viewed by most people as a gradual wearing out of the joints — you could say it's slowly progressive. The most current research, though, indicates that not all osteoarthritis patients worsen; some actually stabilize.