osteoarthritis

1. Osteoarthritis
Dr. Ashish P
Asst. Professor
Dept. Musculoskeletal Sciences
DVVPF’s College of Physiotherapy,
Ahmednagar

2. Introduction
• OA (degenerative joint disease) is
characterized by progressive destruction
of hyaline cartilage followed by remodeling
of affected joint.
• The term osteoarthrosis is preferred as
primary pathological process is more
degenerative than inflammatory.
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3. • OA is separated in to primary and
secondary forms.
• Primary- when there is no obvious
underlying cause.
• Secondary – when there is an identifiable
etiological factor such as inflammatory
arthropathy (R.A), infection, fracture with
disruption of articulating surfaces, LLD etc
• Families with early onset OA due to rare,
inherited mutations of collagen have been
described.
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4. Epidemiology
• OA is the most common form of arthritis.
• Its prevalence steadily increases with age,
radiological changes of OA are seen in the
knee of more than 50 % of the population
older than the age of 60 yrs.
• At of after 75 yrs virtually every one has
evidence of OA in at least one joint.
• Men and women are equally affected
before age of 45, but after age 45 the
prevalence is higher in women.
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5. Etiology
• Aging
• Trauma
• Faulty posture
• Occupation involving repeated knee
bending
• obesity
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6. Classification
• Grade 0
• Grade 1
• Grade 2
• Grade 3
• Grade 4
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7. Pathology
water content
Loss of PG in cartilage
Loss of stiffness and elasticity of cartilage
Fibrillation
Destruction of cartilage
Jt space reduction
Compressive forces on bone
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8. Clinical presentations
Osteoarthritis
Etiology Aging, overuse, obesity
Onset gradual
Dominance M = F
Occurance >40
C/F Pain, swelling, stiffness, felling of
instability of joint, locking.
Heberden's node
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10. X- Rays
OA
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11. Management
• Pharmacological
o NSAIDS
o DMARD
o Corticosteroids
o Anthrocentesis technique and
intrasynovial therapy
o Somatic gene therapy
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12. • Surgical procedures
o Debridement
o Synovectomy
o Bursectomy
o Joint replacement
o Osteotomy
o Arthrodesis
o For wrist and hand – procedures using
silastic posthesis.
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13. PT management
• Osteoarthritis
o Electrotherapy- SWD, cryo, therapeutic US,
TENS
o Ultrasound - controversial use
o Coldtherapy- to be applied for 15 to 20 min.
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14. o TENS-Applied for a period of 30 to 45 min,
leads to approximately three hours of pain
relief, improves sleep, and reduces intake
of pain relieving med.
o Mobilization- to improve joint mobility and
decrease pain by using selected grading,
gentle distraction and stretching the
capsule tissue can be useful to increase
mobility.
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15. o Exercise- dynamic preferred over
isometric.
o Walking- at least 3 times a week for 30
minutes, provided lower extremity will
tolerate walking or same can be done in a
swimming pool.
o Knee bracing- the use of knee bracing for
pain relief.
o Assistive devices- canes and crutches.
o Taping
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16. Lifestyle modification
• Assistive modification
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18. Allied therapy
• Yoga
• Acupuncture
• Tai chi
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19. Thank You
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