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Name :
Andri Reza Rahmadi, MD, Internist & Rheumatologist , M.Med
Education :
Medical Doctor graduated 1997 F.Med UNPAD Bandung
Master of Medicine graduated 2003 UGM Yogyakarta
Internal Medicine specialist graduated 2008 F.Med UNPAD
Bandung
Rheumatology consultant graduated 2013 F.Med UNPAD/RSHS
Bandung
Fellow :
IDI, PAPDI, IRA
PATHOPHYSIOLOGY OF OSTEOARTHRITIS
Past :
Non Inflamation
Wear and Tear
New :
Mediator inflamation
Multifactorial etiology
Epidemiology
Hasan Sadikin Hospital
Bandung
A pro-inflammatory
A degenerative disease disease
Avascular
Low Oxigen
Metabolism : glycolysis anaerob, lactic acid
Ph : 7,1 7,2
Nutrition and Water : from Synovium and
Subchondran bone
Difusion process
Cartilage Component
Chondrocyte, produce :
Collagen
Proteoglycan
Matrix exracellular :
Water 65%
Colagen type II, IV, IX, XVI and Proteoglycan 15-
25%
Proteoglycan = Agrecan
Glucosaminoglycan
Chondroitin sulfate
Ceratan sulfate
Hyaluronic acid
Turnover :
PRIMARY
Unknown etiology
Degenerative
Genetic
SECONDARY
Known etiology
Trauma
Overuse
Genetic
Obese
Over use
Weight forcess
Stairs
Climb
Sport
Accident
Trauma
Mechanical Aspect
Pathophysiology OA
Interaction
Serine proteinase
Cystein proteinase
Aspartat proteinase.
Metaloproteinase :
Collagenase
Gelatinase
Stromeolysine