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OSTEOARTHRITIS

OSTEOARTHRITIS. Dr S ami Abdallah. Anatomy of synovial joints:. MECHANISMS FOR MAINTAININGJOINT STABILITY Alignment of joint components Shape and fit of articular surfaces Adhesive property of synovial fluid Integrity of capsule and ligaments Muscle tone and power

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OSTEOARTHRITIS

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  1. OSTEOARTHRITIS Dr Sami Abdallah

  2. Anatomy of synovial joints:

  3. MECHANISMS FOR MAINTAININGJOINT STABILITY • Alignment of joint components • Shape and fit of articular surfaces • Adhesive property of synovial fluid • Integrity of capsule and ligaments • Muscle tone and power • Neurological control of balance

  4. THREATS TO CARTILAGE INTEGRITY • Loss of joint stability • Localized increase in loading stress • Increased stiffness of the cartilage • Inflammatory (enzymatic) degradation • Restriction of free joint movement • Sclerosis in the subchondral bone

  5. Osteoarthritis (OA) is a slowly progressive chronic disorder of synovial joints in which there is progressive softening and disintegration of articularcartilage • The commonest of all joints diseases

  6. Asymmetrical affection • No systemic manifestations • Degenerative disease with some inflammatory process

  7. New growth of cartilage and bone at the joint margins(osteophytes) • Cyst formation and sclerosis in the subchondral bone • Mild synovitis and capsular fibrosis

  8. Prevalence • Universal disorder • Males = females • All people > 65 years • 40 % of people reaching 40 years • Racial distribution • Hips, knees and spine are commonly affected

  9. Prevalence Risk factors • Joint dysplasia • Obesity • Bone density • Trauma • Family history • Occupation

  10. Pathology • The cardinal features are: • Progressive cartilage destruction • Subarticularcyst formation • Sclerosis of the surrounding bone • Osteophyte formation • Capsular fibrosis

  11. Clinical features Symptoms • Pain • Swelling • Deformity • Stifness • Loss of function

  12. Signs • Swelling • Muscle wasting • Tenderness • Instability • Crepitus

  13. Clinical types: • Monoarticular The classic form of OA

  14. Clinical types: • Monoarticular • Pauciarticular

  15. Clinical types: • Monoarticular • Pauciarticular • Generalized The commenest type of OA Affects middle aged women Small joints

  16. Complications • Capsular herniation • Loose bodies • Rotator cuff dysfunction • Spinal canal stenosis

  17. Imaging • X rays

  18. Radioisotope scanning

  19. CT and MRI

  20. Arthroscopy

  21. EARLY TREATMENT PRINCIPLES • To maintain movement and muscle strength • To protect the joint from overload • To modify the daily activities

  22. Physeotherapy

  23. Physeotherapy • Load reduction

  24. Physeotherapy • Load reduction • Analgesia

  25. INTERMEDIATE TREATMENT • Joint debridement • Corrective osteotomy

  26. LATE TREATMENT • Re-alignment osteotomy • Joint replacement • Arthrodesis

  27. THANK YOU

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