A common joint disease characterized by degeneration of the cartilage that lines joints or by formation of osteophytes, leading to pain, stiffness, and occasionally loss of function. Osteoarthritis is due to wear and tear on joints, weight-bearing joints being the most commonly affected. Weakness and shrinkage of surrounding muscles may occur if pain prevents the joint from being used regularly. Affected joints become enlarged and distorted by osteophytes. Osteoarthritis occurs in almost all people over 60, although not all have symptoms. Factors that lead to its earlier development include excessive wear of, or injury to, a joint; congenital deformity or misalignment of bones in a joint; obesity; or inflammation from a disease such as gout. Severe osteoarthritis affects 3 times as many women as men.
There is no cure for osteoarthritis. Symptoms can be relieved by nonsteroidal anti-inflammatory drugs, analgesics, injections of corticosteroid drugs into affected joints, and physiotherapy. In overweight people, weight loss often provides relief of symptoms. Surgery for severe osteoarthritis includes arthroplasty and arthrodesis.
Despite major e?orts, it has proved impossible to produce a single clear de?nition of osteoarthritis and this probably reffects the muddled nature of a concept which will need replacing. Unfortunately, there is confusion because the term is also used to cover joint pain that appears to have a mechanical basis in the absence of clinical or radiographic evidence of CARTILAGE loss.
The primary problem is seen as a change in structure of cartilage and BONE, rather than an in?ammatory SYNOVITIS. Osteoarthritis usually implies a loss of the central load-bearing area of articular hyaline cartilage, with outgrowth of cartilage at the articular margin and subsequent ossi?cation to form bony outgrowths known as OSTEOPHYTES. Osteophytes form with increasing age, whether or not there is signi?cant cartilage loss, and in the elderly may lead to local frictional symptoms, and in the spine, to nerve compression.
The condition has a wide range of causes, of which some, like dysplasia and trauma, are known and others have yet to be identi?ed. The main clinical problems occur in the hip and knee. The cartilage loss in the hip usually occurs in the sixth or seventh decade. It may affect both hips in fairly rapid succession, or only one hip; such patients often have no problems in other joints. Cartilage loss in the knee occurs from the ?fth decade onwards and is often associated with cartilage loss in small joints in the hand and elsewhere. Cartilage loss in the distal interphalangeal joints of the hand is associated with the formation of bony swellings known as Heberden’s nodes.
Treatment Management is largely directed at maintaining activity, with physical and social support as necessary. ANALGESICS may be of some value, particularly in the management of night pain. NON-STEROIDAL ANTIINFLAMMATORY DRUGS (NSAIDS) may help patients with early-morning sti?ness and may also reduce pain on movement and night pain. Their bene?t, however, tends to be less marked than in RHEUMATOID ARTHRITIS and their long-term usage has considerable toxicity problems. Advanced cartilage loss is best treated by joint replacement. Hip- and knee-joint replacements – with a wide variety of arti?cial joints – are now common surgical procedures which greatly improve the mobility of affected individuals. (See ARTHROPLASTY.)
People with arthritis and their relatives can obtain help and advice from Arthritis Care.
(osteoarthrosis) n. a degenerative disease of joints resulting in loss of the articular cartilage, remodelling of adjacent bone, and inflammation. It can be primary or it can occur secondarily to abnormal load to the joint or damage to the cartilage from inflammation or trauma. The joints become painful and stiff with restricted movement. Osteoarthritis is recognized on X-ray by narrowing of the joint space (due to loss of cartilage) and the presence of *osteophytes, *osteosclerosis, and cysts in the bone. The condition is treated with analgesics, by reducing the load to the joint by weight loss or the use of a walking stick, or surgically by *osteotomy, *arthrodesis, or *arthroplasty.
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