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Osteoarthritis

A. WHAT IS OSTEOARTHRITIS?

  • Osteoarthritis is also known as degenerative arthritis.
  •  Osteoarthritis is a type of arthritis caused by the breakdown and eventual loss of the cartilage of one or more joints.
  • Among the over 100 different types of arthritis conditions, osteoarthritis is the most common.
  •  Osteoarthritis occurs more frequently as we age but there are also genetic factors or external factors like traumas, unbalanced weight and posture … Before age 45, osteoarthritis occurs more frequently in males. After 55 years of age, it occurs more frequently in females.
  • A higher incidence of osteoarthritis exists in the Japanese population, while South-African blacks, East Indians, and Southern Chinese have lower rates.
  • Osteoarthritis commonly affects the hands, feet, spine, and large weight-bearing joints, such as the hips and knees (the most treated with NaHA as the biggest joint ~ 90%).
  • Most cases of osteoarthritis have no known cause and are referred to as primary osteoarthri- tis. When the cause of the osteoarthritis is known, the condition is referred to as secondary osteoarthritis.
  • ·       Osteoarthritis is sometimes abbreviated OA.

B. WHAT CAUSES OSTEOARTHRITIS?

  • Primary osteoarthritis is mostly related to aging. With aging, the water content of the cartilage increases, and the cartilage degenerates.
  • Eventually, cartilage begins to degenerate by flaking or forming tiny crevasses.
  • In advanced cases, there is a total loss of cartilage cushion between the bones of the joints. Repetitive use of the worn joints over the years can irritate and inflame the cartilage, causing joint pain and swelling.
  • Loss of the cartilage cushion causes friction between the bones, leading to pain and limitation of joint mobility. Inflammation of the cartilage can also stimulate new bone outgrowths (spurs, also referred to as osteophytes) to form around the joints.
  • Osteoarthritis occasionally can develop in multiple members of the same family, implying a hereditary (genetic) basis for this condition.
  • Secondary osteoarthritis is caused by another disease or condition.
  • Conditions that can lead to secondary osteoarthritis include obesity, repeated trauma or surgery to the joint structures, abnormal joints at birth (congenital abnormalities), gout, diabetes, and other hormone disorders.
  • Image of the vicious circle
  • Once solicited by a high or long mechanical stress, the cartilage will be under pressure, then pressure will create inflammation and this inflammation will worsen the synovial fluid quality.
  • The synovial fluid will not protect cartilage and it will be under pressure …
  • … This is the osteoarthritis vicious circle.
  • In fact, next to aging, obesity is the most powerful risk factor for osteoarthritis of the knees.
  • The early development of osteoarthritis of the knees among weight lifters is believed to be in part due to their high body weight.
  • Repeated trauma to joint tissues (ligaments, bones, and cartilage) is believed to lead to early osteoarthritis of the knees in soccer players for example.
  • But interestingly, studies have not found an increased risk of osteoarthritis in long-distance runners.

c. WHAT ARE OSTEOARTHRITIS SYMPTOMS?

  • Osteoarthritis is a disease of the joints.
  • Unlike many other forms of arthritis that are systemic illnesses, such as rheumatoid arthritis, osteoarthritis does not affect other organs of the body.
  • The most common symptom of osteoarthritis is pain and stiffness in the affected joint(s) after repetitive use.
  •  Joint pain is usually worse later in the day. There can be swelling, warmth, and creaking of the affected joints.
  • Pain and stiffness of the joints can also occur after long periods of inactivity.
  • In severe osteoarthritis, complete loss of the cartilage cushion causes friction between bones, causing pain at rest or pain with limited motion.
  • Symptoms of osteoarthritis vary greatly from patient to patient.
  • Some patients can be debilitated by their symptoms.
  • On the other hand, others may have remarkably few symptoms in spite of dramatic degeneration of the joints apparent on X-rays.
  • Symptoms also can be intermittent.
  • It is not unusual for patients with osteoarthritis of the finger joints of the hands and knees to have years of pain-free intervals between symptoms.
  • Osteoarthritis of the knees is often associated with excess upper body weight, with obesity, or a history of repeated in jury and/or joint surgery.
  • Progressive cartilage degeneration of the knee joints can lead to deformity and outward curvature of the knees, which is referred to as being “bowlegged:’
  • People with osteoarthritis of the weight-bearing joints (like the knees) can develop a limp.
  • The limping can worsen as more cartilage degenerates. In some patients, the pain, limping, and joint dysfunction may not respond to medications or other conservative measures.
  • Therefore, severe osteoarthritis of the knees is one of the most common reasons for total knee replacement surgical procedures.