REFERAT

OSTEOARTHRITIS

Pembimbing : Oleh :
Letkol CKM dr. Maksum Pandelima, Sp.OT Faridatul Afifah (17710042)

SMF ILMU BEDAH

Rumah Sakit Tentara Tk. II dr. Soepraoen Malang
Fakultas Kedokteran Universitas Wijaya Kusuma Surabaya
2018
 INTRODUCTION

 Osteoarthritis is a syndrome
affecting a variety of patient
profiles.
 A European Society for Clinical
and Economic Aspects of
Osteoporosis and Osteoarthritis
(ESCEO) and the European
Union Geriatric Medicine Society
(EUGMS) working meeting
explored the possibility of
identifying different patient
profiles in osteoarthritis.
 DEFINITION

 Osteoarthritis is progressive chronic disease potentially affecting every articular

tissue, and may potentially lead to joint failure.
 Indeed, osteoarthritis may present differently in men and women, in patients
with or without trauma, in athletes, or in obese patients.
 EPIDEMIOLOGY
 Osteoarthritis(OA) is the most common joint
disease
 OA of the knee joint is found in 70% of the
population over 60 years of age
 Radiological evidence of OA can be found in over
90 % of the population
 PATHOGENESIS OF OA

Cytokines IL -1, IL -6, TNF -

Cell destruction

Membrane phospholipids

Arachidonic acid

Cox -1, cox -2

 IL-1 and metalloproteases have been found to
play an important role in cartilage destruction.

 Local growth factors, especially transforming

growth factor (TGF) are involved in the formation
of osteophytes
CLASSIFICATION OF OSTEOARTHRITIS

PRIMARY OA SECONDARY OA

ETIOLOGY IS UNKNOWN ETIOLOGY IS KNOWN

 Risk Factors

PRIMARY OA SECONDARY OA
 Female  Mechanical forces: scoliosis,

 Caucasian
congenital deformity
 Metabolic, endocrine disorders
 Obesity
 Prior trauma
 Genetics
 Prior RA and JIA or other
inflammatory processes
 ETIOLOGY

Cartilage Biomechanical
Properties Problems
Morphology of
Primary OA Primary Generalized OA
 STRUCTURE OF JOINT
CARTILAGE

 Collagen (type 2)
 Proteoglycan
-Hyaluronic acid
-Glycoseaminoglycan
 Water
 Condrocyte
 Regeneration and Degeneration
 Eburnation Osteophytes

Subcondral
Fibrillation
cysts
PATHOLOGY
OF
OSTEOARTH
RITIS
 LABORATORY RADIOLOGIC
FINDINGS OF OA FINDINGS OF OA

 There are no pathognomonic  Narrowing of joint space

l a b o r a t o r y f i n d i ng s f o r O A (due to loss of cartilage)
 Laboratory analysis is  Osteophytes
p e r f o r m e d f o r d i f f e r e n t i al  Subchondral (paraarticular)
diagnosis sclerosis
 Bone cysts
 RADIOLOGIC GRADE OF OA

 G1 normal
 G2 mild
 G3 moderate
 G4 severe

K e l l g r e n l a w r e n c e c l a s s i f ic a t i o n
 DIAGNOSIS

CLINICAL RADIOLOGIC
FINDINGS FINDINGS

JOINT PAIN OSTEOPHYTES

 CLINIC OF OSTEOARTHRITIS
SIGNS AND SYMPTOMS

 Joint pain - degenerative

 S t i f f n e ss f o l l o w i n g i n a c t i v i t y – 3 0 m i n
 Limitation of ROM – later stages
 Deformity – restricition of ADL
Radiologic finding grade 1 - 4
 TREATMENT

Symptomatic Surgical

Structure
modifying

Hyaluronic Acid Glycose Amino

injection (HA) Glycans (GAG)