The Management of Osteoarthritis: An Overview and Call to Appropriate Conservative Treatment
Section snippets
Diagnosis of osteoarthritis
In clinical practice the diagnosis of OA should be made on the basis of history and physical examination. The role of radiography is to confirm this clinical suspicion and rule out other conditions [12]. The cardinal features that suggest a diagnosis of OA include pain, stiffness, reduced movement, swelling, and crepitus in typically involved joints (eg, the distal and proximal interphalangeal joints in the hand, hips, knees, and metatarsophalangeal joints), older age (OA incidence is unusual
Investigation of osteoarthritis
Imaging can assist in making a diagnosis that is made predominantly by assessing the constellation of presenting clinical features. When disease is advanced, it is visible on plain radiographs that show narrowing of joint space caused by the loss of hyaline articular cartilage in most of the affected joints (and also, in the knee, by damage to the meniscus [21]), osteophytes, and, sometimes, changes in the subchondral bone. Given the current lack of therapy that can modify the disease course
Treatment
The aims in managing patients who have OA are
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Patient education about both the disease and its management
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Pain control
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Improving function and decrease disability
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Altering the disease process and its consequences
The management of OA should be individualized and probably will consist of a combination of treatment options. Unfortunately, the overwhelming preponderance of treatments tested and used for OA presently are drugs and/or surgery. For example, in a recent meta-analysis of trials in OA, 60%
Summary
Despite the increasing prevalence of OA, many uncertainties exist pertaining to its management. Many putative risk factors are characterized by excessive loading of vulnerable joint structures. Clinical examination should include an assessment of joint function and the influence of modifiable risks such as malalignment, muscle strength, and obesity. Braces, footwear, exercises, and dieting are prescribed to improve the distribution of loads on the joints and to reduce the likelihood that OA and
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Cited by (57)
Inhibition of fibrotic changes in infrapatellar fat pad alleviates persistent pain and articular cartilage degeneration in monoiodoacetic acid-induced rat arthritis model
2021, Osteoarthritis and CartilageCitation Excerpt :Persistent pain is a major complaint for patients suffering from OA1. Therefore, most of the current conservative treatment strategies are based on symptom management by anti-inflammatory analgesics2–4. However, these treatments are not intended to prevent cartilage degeneration, there are patients who cannot control joint pain as disease progresses.
Challenges toward musculoskeletal injuries and diseases
2020, Nanoengineering in Musculoskeletal RegenerationApproach to Osteoarthritis Management for the Primary Care Provider
2018, Primary Care - Clinics in Office PracticeCitation Excerpt :On examination, an involved joint may show range of motion loss, cracking, or crepitus. The joint is typically cool to touch but an effusion, particularly in the knee, may be present.54 Associated muscle atrophy, such as in the quadriceps, may be noted.55,56
The Effect of Therapeutic Ultrasound on Pain and Physical Function in Patients with Knee Osteoarthritis
2017, Ultrasound in Medicine and BiologyEffect of hydrocortisone ultrasonic phonophoresis in the treatment of knee osteoarthritis
2023, Balneo and PRM Research JournalTherapeutic effect of C-type natriuretic peptide on persistent pain in a rat knee arthritis model
2023, Journal of Orthopaedic Surgery
Dr. Hunter receives research or institutional support from AstraZeneca, Donjoy, Lilly, Merck, Pfizer, Stryker, and Wyeth.