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Osteoarthritis

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What is it?

Osteoarthritis (OA) is a degenerative joint disease that occurs when the protective cartilage between bones wears down, most commonly affecting weight-bearing joints like the knees, hips, spine, and hands. It is prevalent in older adults but can affect people of all ages.
Causes include aging, joint injuries or overuse, obesity, genetics, and joint abnormalities.
Symptoms include joint pain, stiffness, swelling, reduced range of motion, tenderness, and a grating sensation during movement. Diagnosis is made through physical exams, imaging tests, and sometimes joint fluid analysis. Treatment focuses on pain relief, improving joint function, and slowing progression, using lifestyle modifications, physical therapy, medications, injections, assistive devices, and in severe cases, surgery such as joint replacement.
Prevention includes maintaining a healthy weight, regular low-impact exercise, and protecting joints. Early diagnosis and management are key to maintaining mobility and quality of life.It often affects areas like the shoulder (rotator cuff), elbow (tennis or golfer's elbow), wrist, knee (patellar tendon), or ankle (Achilles tendon).

Osteoarthritis (OA) is a degenerative joint disease that occurs when the protective cartilage that cushions the ends of bones gradually wears down. In an orthopedic setting, osteoarthritis is one of the most common conditions treated, particularly in older adults, though it can affect people of all ages. It primarily affects weight-bearing joints like the knees, hips, spine, and hands, leading to pain, stiffness, and reduced mobility.

Causes

Osteoarthritis develops due to the progressive breakdown of cartilage in the joints.
Common causes and risk factors include:

  • Aging: The risk of developing OA increases with age as cartilage naturally wears down over time.
  • Joint injury or overuse: Previous injuries, repetitive stress from occupational or athletic activities, or overuse of joints can accelerate cartilage degeneration.
  • Obesity: Excess body weight places additional stress on weight-bearing joints, particularly the knees and hips, increasing the risk of OA.
  • Genetics: Family history can play a role, as some people are genetically predisposed to developing osteoarthritis.
  • Joint abnormalities: Conditions like hip dysplasia or other congenital joint
    malformations can lead to uneven wear and tear.

Symptoms

  • Pain: Joint pain during or after movement, often worsening with prolonged use.
  • Stiffness: Especially after periods of inactivity, such as in the morning or after sitting for long periods.
  • Swelling: Mild swelling around the joint due to inflammation. – Decreased range of motion: Limited flexibility and difficulty moving the affected joint.
  • Joint tenderness: Sensitivity to pressure or touch around the joint.
  • Crepitus: A grating or cracking sensation with joint movement due to the roughened surfaces of the bones.

Diagnosis

Orthopedic specialists use the following methods to diagnose osteoarthritis:

  • Physical examination: Evaluating pain, swelling, range of motion, and joint function.
  • Imaging tests: X-rays are used to identify joint space narrowing, bone spurs, and other signs of cartilage loss. MRI may be employed in certain cases to assess soft tissue damage.
  • Laboratory tests: While no specific blood test diagnoses OA, joint fluid analysis may be used to rule out other forms of arthritis.

Treatment

The goals of osteoarthritis treatment are to reduce pain, improve joint function, and slow
disease progression. Treatment options include:

  • Lifestyle modifications: Weight loss to reduce joint stress, and activity modifications to prevent further damage.
  • Physical therapy: Strengthening exercises, flexibility training, and aerobic
    conditioning to improve joint stability and function.
  • Medications: NSAIDs for pain relief and inflammation reduction, and topical analgesics to ease discomfort.
  • Injections: Corticosteroid, Platelet-Rich Plasma or hyaluronic acid injections may
    be used to reduce pain and improve joint lubrication temporarily.
  • Assistive devices: Braces, canes, or orthotics to reduce joint load and enhance mobility.
  • Surgical intervention: In severe cases, surgery may be recommended.
    • Procedures include:
      • Arthroscopy: Minimally invasive surgery to clean out damaged cartilage or repair small areas.
  • Osteotomy: Bone realignment surgery to relieve pressure on the affected joint.
  • Joint replacement: Total or partial joint replacement (arthroplasty) for end-stage OA, typically in the hip or knee.

Prevention

While osteoarthritis cannot always be prevented, certain measures can reduce the risk:

  • Maintaining a healthy weight: To minimize stress on weight-bearing joints.
  • Regular exercise: Low-impact activities like swimming, cycling, and walking help strengthen muscles around joints without excessive strain.
  • Joint protection: Avoiding repetitive motions and using proper techniques in physical activities to reduce joint stress.

Prognosis

Osteoarthritis is a chronic condition that tends to worsen over time, but early diagnosis and treatment can help manage symptoms and improve quality of life.
Many patients benefit from a combination of lifestyle changes, physical therapy, and medical treatments.
In advanced cases, joint replacement surgery offers long-term relief and restores function to the affected joint.
In the orthopedic setting, the focus is on managing symptoms, maintaining mobility, and preventing further joint damage, with a treatment plan tailored to each patient’s needs and lifestyle.
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