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Osteoarthritis-Degenerative Joint Disease PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "OSTEOARTHRITIS - DEGENERATIVE JOINT DISEASE”.

This medical PowerPoint presentation is about Osteoarthritis, a degenerative joint disease that occurs when the cartilage that cushions the joints wears down over time. It is also known as degenerative arthritis or wear-and-tear arthritis.

The cartilage is a firm, rubbery material that covers the ends of bones in a joint and helps absorb shock and allows the bones to glide over each other. When the cartilage breaks down, the bones rub against each other, causing pain, swelling, and stiffness in the joint.

Osteoarthritis can affect any joint, but it is most commonly found in the knees, hips, hands, and spine. It can occur due to aging, injury, or obesity. There are also genetic factors that may increase the risk of developing osteoarthritis.

Symptoms of osteoarthritis include joint pain, stiffness, tenderness, loss of flexibility, and a grinding sensation when the joint is moved. There is no cure for osteoarthritis, but there are treatments that can help manage the symptoms, such as medication, physical therapy, weight loss, and surgery.

It is important to seek medical attention if you are experiencing joint pain or stiffness that does not go away, as early treatment can help slow the progression of the disease and improve quality of life.

Tags : Osteoarthritis, degenerative joint disease, cartilage, degenerative arthritis, Orthopaedic Surgery, Orthopaedic Surgery PowerPoint presentation

Published on : Jun 20, 2023 | Views : 1936 | Downloads : 8

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Slide 1-

OSTEOARTHRITISDEGENERATIVE JOINT DISEASE
Slide 2-

DEFINITION Osteoarthritis OA is a degenerative joints disease, characterized by Breakdown of articular cartilage and proliferative changes of surrounding bones. Synovial inflammation OA is a chronic disease of the musculoskeletal system, without systemic involvement
Slide 3-

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
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LIMITED FUNCTION OA may cause functional loss Activites of daily living (ADL) Most important cause of disability in old age Major indication for joint replacement surgery
Slide 5-

CLASSIFICATION OF OA Primary OA Secondary OA Etiology is unknown Etiology is known
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AGE Primary OA > 40 years Direct correlation Aging process
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RISK FACTORS FOR PRIMARY OA Age Sex Obesity Genetics Trauma (daily)
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SECONDARY OSTOARTHRITIS Trauma Previous joint disorders; Congenital hip dislocation Infection: Septic arthritis, Brucella, Tb Inflammatory: RA Metabolic: Gout Hematologic: Hemophilia Endocrine: DM
Slide 9-

ETIOLOGY OF OA Cartilage properties Biomechanical problem
Slide 10-

OA: Symptoms and Signs Pain is related to use Pain gets worse during the day Minimal morning stiffness (<20 min) and after inactivity (gelling) Range of motion decreases Joint instability Bony enlargement Deformity – restricition of ADL Restricted movement Crepitus Variable swelling and/or instability
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Morphology of Primary OA
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Primary Generalized OA
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LABORATORY FINDINGS OF OA There are no pathognomonic laboratory findings for OA Laboratory analysis is performed for differential diagnosis
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RADIOLOGIC FINDINGS OF OA Narrowing of joint space (due to loss of cartilage) Osteophytes Subchondral (paraarticular) sclerosis Bone cysts
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RADIOLOGIC GRADE OF OA G1 Normal G2 Mild G3 Moderate G4 Severe Kellgren Lawrence Classification
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DIAGNOSIS OF OA CLINICAL FINDINGS Joint pain + RADIOLOGIC FINDINGS Osteophytes
Slide 19-

OA OF KNEE JOINT 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
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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 Mechanical pain Limited walking function
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Hip Osteoarthritis Physical examination: Antalgic limping Limitation of ROM Painful ROM Leg length discrepancy Laboratory analysis within normal limits
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X-RAY OF HIP OA
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Peripheral Joints Hands Feet
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STRUCTURE OF JOINT CARTILAGE Collagen (Type 2) Proteoglycan - Hyaluronic acid - Glycoseaminoglycan Water Condrocyte Regeneration and Degeneration
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ETIOPATHOGENESIS OF OA Age,gender Local Genetic OA biochemical effects Other factors
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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
Slide 31-

PATHOGENESIS OF OA Cytokines IL-1, IL-6, TNF- Cell destruction Membrane phospholipids Arachidonic acid Cox-1, Cox-2
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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
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TREATMENT OF OA Symptomatic treatment Structure modifying treatment Surgical treatment
Slide 34-

PRIMARY PREVENTION OF OA ?? Regular exercises Weight control Prevention of trauma
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AIMS OF OA TREATMENT Pain relief Preservation and restoration of joint function Education
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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 ambulationAppropriate footwear Lateral-wedged insoles Bracing Occupational therapy Joint protection and energy conservation
Slide 37-

Pharmacologic Management of OA Non-opioid analgesics Topical agents Intra-articular agents Opioid analgesics NSAIDs Unconventional therapies
Slide 38-

Non-opioid Analgesic Therapy First-line—Acetaminophen Pain relief comparable to NSAIDs, less toxicity Beware of toxicity from use of multiple acetaminophen-containing products Maximum safe dose = 4 grams/day
Slide 39-

Non-opioid Analgesic Therapy (cont’d) NSAIDs Use generic NSAIDs first If no response to one may respond to another Lower doses may be effective Do not retard disease progression Gastroprotection increases expense Side effects: GI, renal, worsening CHF, edema Antiplatelet effects may be hazardous
Slide 40-

Non-opioid Analgesics in OA Cyclooxygenase-2 (COX-2) inhibitors Pain relief equivalent to older NSAIDs Probably less GI toxicity Side effects: Renal, edema Older populations with multiple CV medical problems should be tested Cost similar to generic NSAIDs plus proton pump inhibitor or misoprostol
Slide 41-

Opioid Analgesics in OA Tramadol Affects opioid and serotonin pathways Nonulcerogenic May be added to NSAIDs, acetaminophen Side effects: Nausea, vomiting, lowered seizure threshold, rash, constipation, drowsiness, dizziness
Slide 42-

Opioid Analgesics for OA Codeine, oxycodone Long-acting oxycodone may have fewer CNS side effects Propoxyphene Morphine and fentanyl patches for severe pain interfering with daily activity and sleep
Slide 43-

Topical Agents for Analgesia in OA Local cold or heat: Hot packs, hydrotherapy Capsaicin-containing topicals Use well supported by evidence Use daily for up to 2 weeks before benefit Compliance poor without full instruction Avoid contact with eyes Liniments = methyl salicylates Temporary benefit
Slide 44-

OA: Intra-articular Therapy Intra-articular steroids Good pain relief Most often used in knees, up to q 3 months With frequent injections; risk infection, worsening diabetes, or CHF Joint lavage Significant symptomatic benefit demonstrated Hyaluronate injections Symptomatic relief Improved function Require series of injections No evidence of long- term benefit Limited to knees Expensive
Slide 45-

OA: Unconventional Therapies Polysulfated glycosaminoglycans—nutriceuticals Glucosamine +/- chondroitin sulfate: Symptomatic benefit, no known side effects, long-term controlled trials pending Tetracyclines as protease/cytokine inhibitors Under study Have disease-modifying potential
Slide 46-

Surgical Therapy for OA Arthroscopy May reveal unsuspected focal abnormalities Results in tidal lavage Expensive, complications possible Osteotomy: May delay need for TKR for 2 to 3 years Total joint replacement: When pain severe and function significantly limited
Slide 47-

OA: Management Summary First: Be sure the pain is joint related (not a tendonitis or bursitis adjacent to joint) Initial treatment Muscle strengthening exercises and reconditioning walking program Weight loss Acetaminophen first Local heat/cold and topical agents
Slide 48-

OA: Management Summary (cont’d) Second-line approach NSAIDs if acetaminophen fails Intra-articular agents or lavage Opioids Third-line Arthroscopy Osteotomy Total joint replacement