Osteoarthritis

Arranged by :
Lazuardhi Dwipa
Anita Liliana
Intan Renata
Rukin Aman

Introduction
Osteoarthritis : a degenerative joint
disorder
Progressive loss of articular cartilage &
new bone formation & capsular fibrosis
Causes, pathology, clinical, X-rays, DD.
treatment
Cause
Increases with age
Two types of cartilage degeneration :
Limited cartilage loss
Progressive cartilage destruction
Result from stress to articular cartilages, the
ability of cartilage to withstand stress, & poor
subchondral bone.

Cause ...
Normally : loading forces are widely
distributed over the articular surfaces &
stress is minimal instability, subluxation,
deformity decrease the area of contact
the force is concentrated over a smaller
area the stress is greatly increased
surface may break down
Pathology
Articular Cartilage & Bone
- Increase water content of cartilage
disruption of the large chondromucoprotein
molecules loss of proteoglycans
cartilage becomes oedematous & soft the
clefts more pronounced chondrocyte
clusters in the matrix depleted cartilage
Articular Cartilage & Bone ...
Proteoglycan increases subarticular
thickens cracks in the subchondral plate
pressure transmission to the cancellous
bone cysts formation progressive
cartilage disintegration lead to surface
abration instability increase the intact
cartilage in peripheral unstressed areas
proliferates & ossifies (osteophytes)
Synovial Membrane & Capsule
Deposition of cartilage&bone detritus onto
the synovium inflammation particles
penetrate to subsynovial layers results
fibrosis fibrosis extend to the capsules
thickens and inelastic limiting movement
Symptoms
A history of previous disorder or injury of
the joint
Intermittent with periods of symptomatic
remission lasting for months or years
Pain
Stiffness
Swelling
Deformity
Signs
Swelling & deformity
Muscle wasting
Tell-tale scars
Local tenderness
Synovial thickening or osteophytes felt
Movement restricted
Abduction & internal rotation limited
Joint instability

X-Ray
Narrowing of the joint space
Subarticular sclerosis
Bone cysts
osteophytes

Differential Diagnosis
Monoarticular synovitis
Crystal Deposition Disease
Aseptic Necrosis
Treatment
Early :
pain relief
Mobilization
Load reduction
Intermediate
- realignment osteotomy
Late
- surgery : arthrodesis, arthroplasty