4Strategies for the prevention and management of osteoarthritis of the hip and knee
Introduction
Osteoarthritis (OA) is the most common joint disorder and accounts for more disability among the elderly than any other disease. The prevalence of OA increases indefinitely with age, because the condition is not reversible. The impact of OA on the individual relates to pain and loss of motion of affected joints, which limits activities such as manual dexterity and mobility. It is the major contributor to lower limb disability. It affects independence and psychosocial functioning and, in addition, leads to financial loss.
When considering preventative possibilities, an evaluation of risk factors for the incidence and progression of OA is of relevance. At risk are those aged over 50 years and those with obesity, abnormal biomechanics or previous joint damage. Interventions recommended for those at risk include lifestyle, pharmacological interventions, surgical interventions and rehabilitative measures.
The aim of this paper is to give different preventative and treatment options, strategies for patients at risk and for those with different stages of OA in order to reduce the enormous impact of OA on the population. These have been largely developed as part of the European Bone and Joint Health Strategies Project.33
Section snippets
Size of the problem?
OA is a slowly progressive musculoskeletal disorder that can occur in any joint, but is most common in selected joints of the hand, spine and the lower limb weight-bearing joints: the hip, knee and feet. It is the most common joint disorder and accounts for more disability among the elderly than any other disease. OA is characterised by changes to the structure of the entire joint. There are focal areas of fibrillation, fissures, ulceration and full thickness loss of articular cartilage,
Consequences for the near future
It has become clear from the data given above that effective treatment of OA by reducing pain and improving function will have a major impact on the individual as well as on society. How realistic is this goal in the near future?
OA increases in prevalence and also progresses with age. The aging of the population will significantly increase the burden due to OA. Obesity is increasing and is associated with the development and progression of OA. This is bad news at the level of both the
Prevention
When considering preventative possibilities, an evaluation of the risk factors for the incidence and progression of OA is of relevance. Age is the strongest predictor of the development and progression of radiographic OA. Some types are hereditary – in particular of the finger joints. Congenital abnormalities such as congenital dislocation of the hip or hip dysplasia are also risk factors for the development of OA. Obesity (high body mass index) is a risk factor for the development of OA of the
References (33)
- et al.
Osteoarthritis of the peripheral joints
Best Practice and Research. Clinical Rheumatology
(2002) - et al.
Substantial work disability and earnings losses in individuals less than age 65 with osteoarthritis: comparisons with rheumatoid arthritis
Journal of Clinical Epidemiology
(1989) - et al.
Economics of osteoarthritis: a global perspective
Baillières Clinical Rheumatology
(1997) - et al.
Homeopathic remedies for the treatment of osteoarthritis: a systematic review
British Homeopathic Journal
(2001) - et al.
Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association
Arthritis and Rheumatism
(1986) - et al.
The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand
Arthritis and Rheumatism
(1990) - et al.
The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip
Arthritis and Rheumatism
(1991) - et al.
Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: proof of concept in an open prospective study and in a randomized controlled study
Arthritis and Rheumatism
(2002) - et al.
Molecular markers for osteoarthritis: the road ahead
Current Opinion in Rheumatology
(2002) Rheumatism in Populations
(1977)
Nationaal Kompas Volksgezondheid
The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020
World Health Report 2001. Mental Health: New Understanding, New Hope
The economic impact of the rheumatic diseases in the United States
The Journal of Rheumatology
A template for diagnosis and management of musculoskeletal diseases
The Medical Journal of Australia
Indirect and nonmedical costs among people with rheumatoid arthritis and osteoarthritis compared with nonarthritic controls
The Journal of Rheumatology
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