Degenertive Joint disease

Osteoarthriris

-          Normal articular cartilage

  • Chondrocyte
  • Extracellular matrix

-          Pathophysiology

-          Cause of Osteoarthriris

  • Primary OA
  • Secondary OA
    • Trauma
    • infection
    • repetitive overload

-          Pathology

  • Progressive cartilage destruction
  • Sclerosis of the surrounding bone
  • subarticular cyst formation
  • Capsular fibrosis

-          Clinical presentation

  • Natural history
  • Symptoms : Pain Swelling, Deformity, Loss of motion
  • Sign: Joint swelling ,Joint deformity, Local tenderness, Crepitation, Limited movement, Muscle wasting, Instability

Investigation

-          Plain film

  • joint space narrowing
  • subchrondal sclerosis
  • subchondral cyst

-          MRI

Differential Diagnosis

-          Joint infection

-          Crystal induced arthritis

-          Lesion from remote areas

-          Inflammatory arthropathy

-          Neuropathic arthropathy

Treatment

-          Supportive treatment

  • Relieve pain
  • Maintain joint mobility
  • Muscle strengthening
  • Modify daily activities
  • Viscosupplementation

Surgical treatment

-          Cartilage repair

-          Joint debridement

-          Corrective osteotomy

-          Joint replacement (arthroplasty)

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