Osteoarthritis, commonly known as wear-and-tear arthritis, is a condition in which the natural cushioning between joints -- cartilage -- wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage. The rubbing results in pain, swelling, stiffness, decreased ability to move and, sometimes, the formation of bone spurs.
• In India, about 5-6% of the population has joint or related diseases. Among these, osteoarthritis is the most common.
•Demographic analysis revealed:
* Most affected were females(63.1%).
* Maximum patients were in the age group of 40-60 years(59.5%).
* Most of the patients had osteoarthritis of the back (50%) followed by knee (45.23%) and hips (14.3%).
• Age
• Heredity - People born with defective cartilage or abnormalities in their joints which lead to OA
• Obesity - Excess weight has been found to be a risk factor in Knee OA
• Trauma - Injury to a joint (e.g. Fracture)
• Physical inactivity
• Overuse of joints (e.g. Athletes)
• Misalignment
History
• SOCRATES pain questions
• Inflammatory sx e.g. fever, hot joint
• History of trauma or surgery
• Instability
• Functional loss
• Prior treatment
Physical Exam
• Vitals, BMI
• Palpation: isolate tenderness, effusion, crepitus
• ROM: measure degree of flexion
• Stability: ligaments, menisci
• Alignment: genu varus or valgus
• Function: gait, duck waddle
• Kellgren-Lawrence radiographic criteria for assessment
• Order weight-bearing X-rays to reveal different views
* Reveals compression of the knee
* Reveals joint space narrowing
* Provides a clear frontal view to help rule out patellofemoral syndrome
Primary Goals
• Relieve Pain
• Improve muscle strength, conditioning
• Preserve independence, mobility, quality of life
• Minimize complications of therapy
Key principles: EULAR guidelines
• Treatment should be tailored to the patient
• The relationship between the healthcare team and the patient should be a two-way process
• Using tools can help to assess the patient’s pain and disability
• Patient education has a significant impact on pain management
• Treatment should be a combination of non-pharmacological and pharmacological measures