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Osteoarthritis is the most common type of arthritis. The greatest risk factor for developing Osteoarthritis is age. Women are twice as likely as men to develop knee Osteoarthritis. Obesity is another a risk factor for Osteoarthritis of the knees. Another risk factor is doing the same activity, repeating the same movement.
. Osteoarthritis is often described as the “wear-and-tear” type of arthritis, because of its association with joint injury and old age. Certainly both injury and repetitive strain are major contributors to Osteoarthritis. Injury to or severing of the knee’s ligament can lead to Osteoarthritis within a few years because the joint is worn and no longer fits together perfectly. Compared to repetitive work-related joint degeneration, athletes have a relatively low frequency of arthritis. Whether people can actually wear out their joints through a lifetime of normal use, however, has yet been proven. Nor is it clear whether the pitting, fissuring and drying out of joint cartilage seen in Osteoarthritis is determined by age alone. Genes clearly play a role in the development of some Osteoarthritis. Multi-generational studies in Iceland indicate that some families are genetically predisposed to develop Osteoarthritis of the hip. On the other hand, people of Asian, African and Indian descent are less likely to develop hip Osteoarthritis. A single gene defect leads to an uncommon sub-type of Osteoarthritis, called primary generalized osteoarthritis.
The earliest symptom patients report to their doctors is persistent joint pain and stiffness. At first, the pain occurs during activity and goes away with rest; later minimal activity is enough to cause pain even at rest or during the night. The source of the pain isn’t the cartilage, it’s the surrounding joint structure: membranes, ligaments, tendons and muscles.
Cartilage has no nerve or blood supply, since its function is to absorb and shield against the physical shocks and jolts of normal movement. Primarily muscles, tendons and ligaments contracting in spasm to protect the joint and prevent painful movement cause the pain of Osteoarthritis. Inflammation-with its heat, redness, swelling and soreness-can arise when grains of eroded cartilage float in the joint’s fluid and irritate the membrane, which causes the surrounding muscles to contract even more.
Although diagnosis is usually straightforward, it involves a physical examination of the affected joint’s range of motion and X-rays, which remain the standard for definitive diagnosis. Typically, over time, a series of X-rays will reveal gradual narrowing of the joint space indicating loss of cartilage, thickening bone underneath the cartilage, osteophytes forming on the joint margins and bone cyst formation. Laboratory tests are only necessary if the doctor feels other types of arthritis, such as rheumatoid, septic or psoriatic arthritis, need to be excluded from the diagnosis.
Since there is no known treatment that can reverse the process of cartilage degradation, treatment focuses on pain management using medication and other means. Analgesics and non-steroidal anti-inflammatories. NSAIDs are most commonly prescribed to relieve pain. Occasionally, for a badly inflamed joint, the doctor will inject cortisone to bring the pain and swelling under control.
Just as important as medication are physiotherapy and exercise, which help control pain by keeping a joint’s muscles fit and thus preserving its range of motion. Physiotherapy targets specific muscle groups, whereas exercise preserves general fitness.
When pain compromises quality of life or cartilage damage cripples a joint, surgery can often be the best treatment option. Hip and knee surgery are now extremely commonplace and successful at restoring joint function and relieving pain.
Arthritis Foundation. Arthritis Today: Osteoarthritis Fact Sheet [Online database]. http://www.arthritis.org. [Copyright 1998].
Empatheon, Inc. Arthritis Website.com [Online database]. http://www.arthritiswebsite.com. [Copyright 1999-2000].
Gotlieb, David Dr. Arthritis Pages of drdoc on-line [Online database]. http://www.arthritis.co.za.
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