Osteoarthrosis

Osteoarthrosis

Dr. Wahby Ghalib CABO, FJMC, MRCS

Articular cartilage

↑ joint stabilityDistributes load

Structure

Ground substance : proteoglycan + hyaluronic acid Collagen fibres Chondrocytes

Compressive strength : PG Tensile strength : collagen

OA = degeneration of the articular cartilage

Pathology

Depletion of the PG 


↓ H2O ↓ imbibition pressure  ↓ nutritionDamage to chondrocytes  lytic enzymeDamage to collagen

Pathologic featurs

Progressive cartilage destruction Subchondral sclerosis Osteophyte formation Subchondral cyst formation Capsular fibrosis

Risk factors

Aging TraumaObesityJoint diseases : RA, SA ….Family HxOccupation

C / F

Joints : knee, hip, spine, DIP♂ = ♀Pain : relapse & remissionStiffnessSwellingDeformity

Hand OA

DIPJ : Heberden nodes 1st CMCJ> in ♀


Cx
Capsular herniation : knee : Baker`s cyst Loose bodies Spine : spinal canal stenosis & spondylolisthesis

Nonoperative Rx

Analgesia Physiotherapy Load reduction Intraarticular injection

Operative Rx

Joint debridement Realignment osteotomy Arthrodesis Arthroplasty

Objectives :

Stressing the importance of studying osteoarthrosis as being the most common type of joint disease. Clarification of general predisposing factors. General outlines of management.

Objectives :

Training the students to be familiar with the XR features of osteoarthrosis. Clarifying the general outlines of the surgical aspects of management specially arthroplasty.