Osteoarthritis (OA) is also known as degenerative joint disease (DJD). Though the etiology is generally unknown, OA is associated with “wear and tear” correlated with the aging process characterized by degeneration of articular cartilage with secondary bony effects. However, it is clear that OA is a disease of the whole synovial joint organ.





Leading cause of disability in the US


One in thirteen people suffer from some level OA


Effects women more than men


Most common in people over 65 years old


Not uncommon in people in their 40’s


Also present in younger people often related to injury or increased activity (e.g. athletics)


Risk Factors


Excessive wear or joint injury


Family history


Female


Obesity


Increased age




Pathophysiology


Breakdown of articular cartilage


Sometimes triggered by mechanical injuries


May be triggered by inflammatory mediators from the synovium


Tissue damage may spur chondrocytic activity that may ultimately stimulate enzymatic activity that may actually damage cartilage


Ultimately damage may lead to the narrowing of the bone just beneath the cartilage (subchondral stenosis) with osteophyte formation, synovial inflammation, secondary muscle weakness, loss of range of motion, and pain.



Management





Pharmaceutical


Nonsteroidal anti inflammatory drugs (NSAID)


Corticosteroids

These medications, often administered as injections, can quickly reduce inflammation in the joint.


Creams or gels containing ingredients like capsaicin, menthol, or lidocaine can help relieve pain and inflammation when applied directly to the affected joint.


Hyaluronic Acid Injections

These injections can help lubricate and cushion the joint, potentially providing pain relief.


Opioids

In some cases, stronger pain relievers, such as tramadol or oxycodone, may be prescribed to manage severe pain, but they carry a risk of addiction and should be used with caution.





Surgical Management





Arthroscopy

Arthroscopy is a surgical procedure for the examination of the joint using a thin viewing tool called an arthroscope, or scope.


Osteotomy

An osteotomy is a surgical procedure that involves cutting bone (and sometimes adding bone tissue) to reshape or realign your bones.


Reconstructive Procedures

Arthroplasty is an orthopedic surgery where the articular surface of a musculoskeletal joint is replaced, remodeled, or realigned by osteotomy or some other procedure. It is an elective procedure that is done to relieve pain and restore function to the joint after damage by arthritis or some other type of trauma. Total joint replacement is a common arthroplasty procedure.



Physical Therapy