OSTEOARTHRITIS

Osteoarthritis

Osteoarthritis

Introduction

Osteoarthritis (OA) is the most common type of arthritis. It can affect any joint in the body, but the hips, knees, hands, and spine are frequently involved. Among adults over 60 years of age, 17 percent of men and 30 percent of women suffer from the debilitating effects of the disease. It results from degeneration of the joint cartilage and changes in the surrounding bones, muscles, and soft tissue.

Obesity and osteoarthritis coexist in a large segment of the population. Obesity plays an important role in the etiology and progress of osteoarthritis because of the impact on weight-bearing joints. Management of obesity significantly improves symptoms of osteoarthritis and is a key element in the treatment plan.

Types of Osteoarthritis

Primary osteoarthritis is the result of age-related degeneration in the joint. This type is seen in the elderly and involves multiple joints.

What makes the joint cartilage susceptible to faster breakdown is the progressive loss of water content along with changes in the protein composition. Secondary OA is seen in younger individuals who have previously had a trauma or surgery. This type may affect just one or two joints. Younger individuals with congenital or developmental disorders of the bone or joint can develop symptoms of OA before the age of 40.

Risk Factors

Several factors predispose to osteoarthritis. Genetic factors have been noted to be important in hip osteoarthritis and hand joint arthritis in women. Being obese or overweight is strongly related to the risk of having knee arthritis. Some studies have also linked obesity to hip and hand arthritis, although the association is not as strong.

Having a higher body mass index (BMI greater than 25) before the age of 30 increases one's chance of developing arthritis of the knee by age 60. In fact, the risk is threefold higher among overweight and obese young men and nine times among women as compared to their normal weight peers. Other risk factors for developing OA are previous joint surgery, injury to a joint, diabetes, and excessive strain as a result of work.

Etiology

Osteoarthritis (OA) is the most prevalent form of arthritis. Moderate to severe OA affects more than 12% of the adults between the ages of 25 and 74 years. Symptomatic OA affects roughly 6% of the adult population, 10% of people older than 65 years. Age, female gender, and obesity are key risk factors for OA. Clinically, people with OA display increased joint pain, stiffness, decreased function, joint instability, muscle weakness, and fatigue. Pain worsens with use of the affected joint and is alleviated with rest. Morning stiffness lasting less than 30 minutes is common. In advanced stages of arthritis, most patients show profound structural articular changes. These structural changes, accompanied by comorbidities and age-related regression in physical conditioning often leads to further impairment and disability, making OA a major source of disability among older adults.

The goals for managing arthritis are reduction of pain, reduction of disability, and improvement of quality of life. Analgesics and nonsteroid anti-inflammatory medications (NSAIDs) are the most commonly used medications, yet ...