Osteoarthritis

Osteoarthritis is a disease distinguished by degeneration of cartilage and its underlying skeletal part within a joint as well as bony overgrowth.

The breakdown of these tissues finally directs to pain and joint stiffness. The joints most commonly influenced are the knees, hips, and those in the hands and spine. The exact determinants of osteoarthritis are unidentified, but are accepted to be a outcome of both mechanical and molecular events in the influenced junction.

Disease onset is stepwise and generally begins after the age of 40. There is actually no cure for OA. Treatment for OA focuses on reassuring symptoms and advancing function, and can encompass a blend of persevering education, personal treatment, heaviness command, and use of medications.

Etiology of Osteoarthritis
OA can be classified as: Idiopathic (localized or generalized) or Secondary (traumatic, congenital, metabolic/endocrine/neuropathic and other medical causes).
 * OA is a degenerative joint disease.
 * Most widespread type of arthritis.

Characterized by focal and progressive decrease of the hyaline cartilage of junctions, underlying bony changes.

Usually characterized by symptoms, pathology or combination Pathology = radiographic alterations (joint space narrowing, osteophytes and bony sclerosis)

Symptoms = agony, enlarging, stiffness

The American school of Rheumatoloty (ACR) has released clinical classification guidelines for OA of the hand Adobe PDF document [PDF - 1.31MB]External world wide web location Icon, hip Adobe PDF document [PDF - 1.31MB]External Web location Icon, and kneeExternal world wide web location Icon.

Prevalence of Osteoarthritis
General OA affects 13.9% of adults elderly 25 and older and 33.6% (12.4 million) of those 65+; an approximated 26.9 million US mature persons in 2005 up from 21 million in 1990 (believed to be conservative approximate).

Radiographic OA (moderate to severe)—prevalence per 100 (knee and hip may be underestimated)


 * Hand = 7.3 (9.5 female; 4.8 male)
 * Feet = 2.3 (2.7 feminine; 1.5 male)
 * Knee = 0.9 (1.2 feminine; 0.4 male)
 * Hip = 1.5 (1.4 feminine; 1.4 male)

Symptomatic OA—prevalence per 100

 * Hand = 8% (8.9% feminine; 6.7% male) 2.9 million mature persons elderly 60+ years
 * Feet = 2.0% (3.6 feminine; 1.6 male) elderly 15–74 years
 * Knee = 12.1% (13.6% feminine; 10.0% male) 4.3 million mature persons elderly 60+ years
 * Knee = 16% (18.7% feminine; 13.5% male) adults elderly 45+ years
 * Data from Framingham OA Study accounts similar rates:
 * Knee = 6.1% all mature persons > age 30
 * Knee = 9.5% (11.4 feminine; 6.8 male) ages 63-93
 * Hip = 4.4% (3.6% feminine; 5.5% male) adults ≥55 years of age

Age and sex-standardized incidence rates of symptomatic OA

 * Hand OA = 100 per 100,000 person years
 * Hip OA = 88 per 100,000 person years
 * Knee OA = 240 per 100,000 individual years

Osteoarthritis Among women

 * occurrence radiographic knee OA 2% per year
 * occurrence symptomatic knee OA 1% per year
 * Progressive knee OA 4% per year
 * Incidence rates bigger with age, and grade off round age 80.
 * Women had higher rates than men, particularly after age 50.
 * Men have 45% smaller occurrence risk of knee OA and 36% decreased risk of hip OA than women.
 * Prevalent knee OA, but not hip or hand OA, is significantly more critical in women contrasted to men.

Mortality and Morbidity of Osteoarthritis
About 0.2 to 0.3 killings per 100,000 community due to OA (1979–1988). OA anecdotes for ~6% of all arthritis-related killings. ~ 500 killings per year attributed to OA; numbers bigger throughout the past 10 years.

OA killings are expected highly underestimated. For demonstration, gastrointestinal bleeding due to remedy with NSAIDs is not counted.

Osteoarthritis and Hospitalizations

 * OA accounts for 55% of all arthritis-related hospitalizations; 409,000 hospitalizations for OA as principal diagnosis in 1997.
 * Knee and hip joint replacement procedures accounted for 35% of total arthritis-related methods throughout hospitalization.
 * From 1990 to 2000 the age-adjusted rate of total knee replacements in Wisconsin bigger 81.5% (162 to 294 per 100,000).
 * Rates increased most amidst least old age group (45–49 years).
 * charges bigger from 69.4 million to 148 million dollars.
 * Blacks and individuals with reduced earnings have reduced rates of total knee replacement but higher complications and death than whites.

Ambulatory care visits and Osteoarthritis
OA accounted for 7.1 million (19.5%) of all arthritis-related ambulatory health care visits in 1997.


 * 7.1 million total ambulatory care visits for OA as prime diagnosis.
 * SEX: Males = 2.2 million; Females = 4.9 million.
 * AGE: 0–18 = 35,000; 19–44 = 355,000; 45–64 = 2.5 million; 65+ = 4.1 million.
 * About 39% of persons with OA report inability to access needed health care rehabilitative services.

Cost of Osteoarthritis

 * $7.9 billion approximated charges of knee and hip replacements in 1997.
 * Average direct charges of OA ~$2,600 per year out-of-pocket expenses.
 * Total annual disease charges = $5700 (US dollars FY2000).
 * Job-related OA costs $3.4 to $13.2 billion per year.

Osteoathritis Impact on health-related quality of life

 * OA of the knee is 1 of 5 premier causes of disability amidst non-institutionalized mature persons.
 * About 80% of patients with OA have some degree of action limitation
 * and 25% will not perform foremost activities of every day dwelling (ADL’s), 11% of adults with knee OA need help with personal care and 14% require help with usual needs.
 * About 40% of adults with knee OA described their wellbeing “poor” or “fair”.
 * In 1999, mature persons with knee OA described more than 13 days of lost work due to wellbeing difficulties.
 * Hip/knee OA ranked high in disability modified life years (DALYs) (20) and years dwelled with disability (YLDs).

Features of Osteoathritis
Disease in weight bearing joints has larger clinical influence. About 20–35% of knee OA and ~50% of hip and hand OA may be genetically very resolute. Established modifiable and nonmodifiable risk components:

Modifiable risk factors for osteoathritis
Obesity overweight or high body mass index (especially knee OA).

Joint injury (sports, work, trauma). Occupation (due to unwarranted mechanical stress: hard work, heavy lifting, knee angling, repetitive motion). Men — Often due work that includes construction/mechanics, agriculture, azure collar laborers, and engineers.

Women — Often due work that encompasses cleaning, building, agriculture, and little business/retail.

Non-modifiable risk factors for osteoathritis

 * Gender (women higher risk).
 * Age (increases with age and levels round age 75).
 * Race (some Asian populations have lower risk).

Genetic predisposition and Osteoarthritis
NOTE: present fuming has been shown to be shielding for osteoarthritis whereas it is unknown if this is due to the physiological consequences of smoking on collagen, skeletal part and cartilage tissue or if it is due to some unmeasured surrogate factor.

Other likely risk factors for Osteoarthritis

 * Estrogen deficiency (ERT may reduce risk of knee/hip OA).
 * Osteoporosis (inversely related to OA).
 * Vitamins C, E and D – equivocal reports.
 * C-reactive protein (increased risk with higher levels).