Osteoarthritis

Osteoarthritis (OA) is a common and frequently debilitating joint disorder; prevalence increases with age.

The most commonly affected joints are the knee, hip, hands, feet, and lumbar and cervical spine.

Presents with joint pain and stiffness that is typically worse with activity.

Radiographs show loss of joint space, subchondral sclerosis, and osteophytes.

Treatments are nonpharmacologic and pharmacologic.

Joint replacement surgery is effective for controlling the pain of OA in advanced disease.

OA is the result of mechanical and biologic events that destabilize the normal process of degradation and synthesis of articular cartilage chondrocytes, extracellular matrix, and subchondral bone. It involves the entire joint, including the articular cartilage, subchondral bone, pericapsular muscles, capsule, and synovium. The condition leads to loss of cartilage, sclerosis and eburnation of the subchondral bone, osteophytes, and subchondral cysts. It is clinically characterized by joint pain, stiffness, and functional limitation.[1]Sharma L, Kapoor D, Issa S. Epidemiology of osteoarthritis: an update. Curr Opin Rheumatol. 2006;18:147-156. http://www.ncbi.nlm.nih.gov/pubmed/16462520?tool=bestpractice.com [2]Hunter DJ, Felson DT. Osteoarthritis. BMJ. 2006;332:639-642. http://www.ncbi.nlm.nih.gov/pubmed/16543327?tool=bestpractice.com