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Osteoarthritis, a Degenerative Joint Disorder

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Osteoarthritis, a Degenerative Joint Disorder

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Osteoarthritis is a degenerative joint disorder that mainly affects the geriatric age group leading to immense discomfort in the form of pain with ambulation.

Medically reviewed by

iCliniq medical review team

Published At April 22, 2015
Reviewed AtJanuary 4, 2024

Introduction

Osteoarthritis is the most commonly seen form of arthritis. A few people refer to it as a degenerative joint disease or wear and tear form of arthritis. The most affected body parts are the hands, hips, and knees. In osteoarthritis, the joint cartilage starts breaking down, and the underlying bone begins to change. These changes generally develop at a gradual rate and worsen with time. This disease causes pain, stiffness, and swelling. In a few cases, it also leads to reduced function and disability where they are no longer able to do daily tasks.

Arthritis is defined as a term denoting inflammation of joints leading to pain, swelling, and limitation of joint movement. The bone ends forming the joint are covered with cartilage known as articular cartilage. There is also a fluid present in the joint cavity called synovial fluid which provides good lubrication and thus smooth gliding of bones within joint space. Osteoarthritis symptoms can be managed usually, yet the damage to the joints cannot be reversed. Certain treatments may help in slowing down the advancement of the disease and help in pacifying joint pain and joint function. One should try to stay active and retain a fit body and proper weight benefits too.

What Is Osteoarthritis?

Osteoarthritis happens due to the deteriorating cartilage in the joints that cushion the bone ends in the joints. So, it is also called a degenerative joint disorder. Cartilage is defined as a firm, slippery tissue that makes the joint able for frictionless motion. After some time, if the cartilage wears down completely, the bone will rub against another bone. Osteoarthritis is often referred to as a disorder in which damage occurs after ordinary use. That is why, it is given another name as wear and tear disorder. Osteoarthritis does not only break down the cartilage but affects the entire joint. It causes some changes in the bone and also the deterioration of the connective tissue that is liable for keeping the joint together and attachment of the muscle to the bone.

Inflammation of the joint lining can also be seen in this condition. The biomechanical changes occurring within the bones are called arthritis. Osteoarthritis is the most generally seen type of arthritis. Osteoarthritis develops more likely as people age. The changes in osteoarthritis are observed to be gradual over many years although there can be occasional exceptions. Decomposition of cartilage results in discomfort, swelling, and joint deformity, and deterioration of tendons and ligaments are caused due to inflammation and injury to the joint.

There are two main types of osteoarthritis, mentioned below:

  • Primary Osteoarthritis - This is the most commonly seen type of osteoarthritis. It is generalized and primarily affects the fingers, thumbs, spine, hips, knees, and great toes.

  • Secondary Osteoarthritis - It occurs when a joint abnormality is already present in the body that constitutes an injury or trauma, such as related to recurrent or sports, or inflammatory arthritis, such as psoriatic, rheumatoid, or gout, spreadable arthritis, and genetic joint disorders such as Ehlers-Danlos syndrome.

What Is Cartilage?

A cartilage is defined as a firm, pliable, flexible connective tissue shielding bone ends in normal joints. It is mostly made up of proteins and water whose primary function is reducing the friction in the joints and serving as a shock absorber. The ability of the healthy cartilage to change shape when compressed gives it a shock-absorbing quality. This happens because of its high water content. Even though the cartilage can repair itself to some extent after the damage occurs, the body does not produce new cartilage after any injury. Cartilage has no blood vessels and that is why it is known as avascular. This is the reason the healing is prolonged. Cartilage comprises two elements known as chondrocytes and a gel-like substance known as matrix, composed mostly of water and two types of proteins like collagen and proteoglycans.

  • The precursor form of chondroblasts and chondrocytes are highly complex multifunctional cartilage cells. Its functions include the synthesis of collagen and maintaining the extracellular matrix having collagen and proteoglycans that helps healthy cartilage to grow and heal.

  • Collagen is a variety of proteins that are present in structural form and in many tissues such as tendons, skin, and bone and is an essential structural segment of cartilage. Collagen is accountable for the resilience of the cartilage and the creation of a framework for other components.

  • Proteoglycans are defined as complex molecules that are composed of protein and sugar that are intertwined in the matrix of cartilage. The function of the proteoglycans is to trap large amounts of water in cartilage, which permits it to change shape when squeezed so it acts as a shock absorber. Also, the proteoglycans repel each other allowing the cartilage the ability to preserve its shape and strength.

What Are the Causes of Osteoarthritis?

Primary osteoarthritis is a heterogeneous disease, which means there are many causes of it, and is not only wear and tear arthritis. Some contributing factors to osteoarthritis can be modified and others cannot be modified.

  • Age is one of the contributing factors, but not every older adult develops osteoarthritis and if they do, not all develop associated pain.

  • There are inflammatory and metabolic risks that can advance the risk of osteoarthritis, especially in the setting of diabetes or elevated cholesterol.

  • This disorder and both the types such as primary osteoarthritis and secondary arthritis can be caused due to genetic predisposition. The development of secondary osteoarthritis is due to chronic inflammation and joint destruction.

  • Previous traumas or injuries be they sports-related or repetitive motions can also contribute to osteoarthritis.

Although the accurate explanation of cartilage loss and bone changes is yet to be known, few studies have been put forth in recent years. In those studies, it is suggested that complex signaling processes occur while joint inflammation and defective repair mechanisms in response to injuries slowly degrade the cartilage within the joints. Some other changes lead the joint to lose mobility and function which results in joint pain with activity.

What Is the Treatment or Management of Osteoarthritis?

As of now, there is no cure for osteoarthritis. Management of mild to moderate symptoms is generally done by a combination of pharmacologic and nonpharmacologic treatments. Some of the medical treatments are given below:

  • Medications.

  • Exercise.

  • Intermittent hot and cold packs.

  • Physical or occupational therapy.

  • Weight management.

  • Managing factors like cholesterol and diabetes.

  • Supportive devices like braces, orthotics, or walkers.

  • Injection therapies.

Surgical management may be helpful to relieve symptoms and restore function if other medical treatments fail.

Conclusion

Osteoarthritis cannot be treated completely but can be managed to some extent. The purposes of restorative therapy or medications are to lessen joint pain and immobility, delay further advancement, enhance mobility and function, and lead a better life. Osteoarthritis is caused due to damage to the cartilage that provides cushioning to the ends of the joints. So, it is also called a degenerative joint disorder. Osteoarthritis is the most commonly seen form of arthritis. The mild or moderate symptoms can be managed with medications, exercise, physical or occupational therapies, maintaining weight, and many more. The physician should be contacted regarding the treatment and management of osteoarthritis.

Dr. Akshay Kumar Saxena
Dr. Akshay Kumar Saxena

Orthopedician and Traumatology

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osteoarthritisjoint pain
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