OA Pathophysiology

Progression of osteoarthritis involves of three stages. Stage 1 start from cartilage matrix breakdown follow by cartilage fibrillation and erosion. Disease continues to progress to stage three where synovial inflammation started. With inflamed synovial, synovial membrane produced cytokines, particularly inflammatory cytokines and growth factors which both able to diffuse through synovial fluid and enter the cartilage. This will activates pro-inflammatory cytokines (Pelletier et al, 1999).In short, cartilage breakdown or degrade will lead erosion and release pro-inflammatory cytokine which in turn contribute to joint destruction. In an osteoarthritis knee, Examples of pro-inflammatory cytokines are interleukin-1, IL-1 and tumour necrosis factor alpha, TNF-α.

Rheumatoid arthritis is one of the incurable diseases and turns chronic with progressive inflammatory of the synovial lining of peripheral joins. It is characterized by symmetric, chronic, and deforming polyatrhitis that causes long term joint disability when not controlled early. Considering there is no cure for this disease, management focuses on pain and inflammation reduction in order to prevent destruction of joints while at the same time preserving and improving on the functionality of the patient (Varatharajan et al, 2009).

Osteoarthritis, the most common type of arthritis, is most prevalent in older patients. Osteoarthritis is a degenerative bone disease due to the gradual loss of cartilage. A primary type of osteoarthritis is hip arthritis where it is caused by joint injury, increasing age, and being overweight (“Hip Osteoarthritis,” n.d.). However, osteoarthritis can also be caused by immature joints, inherited defects in cartilage, and extra stress on a patient’s joints (Hip Osteoarthritis,” n.d.). As a result, hip arthritis becomes a huge detriment in patient’s social, emotional, physical lifestyles. In order to treat hip arthritis, doctors choose from a variety of non-drug treatments, medications, and surgeries. Uniquely, I was inspired to research about the treatments of hip arthritis because my very own brother was pronounced with hip arthritis a few years back. Therefore, his determination to battle this disease encouraged me to investigate about the treatment of hip arthritis.

The fifth article critiqued is the first update of a clinical practice guideline (CPG) authored by the American Academy of Orthopedic Surgeons (AAOS). The purpose of this systematic review is to evaluate the best available evidence associated with nonsurgical treatment of knee OA. To be included in this study, the subjects must be original research treating knee OA with pain, function, and disability status as the primary outcome measures. Studies were excluded based on design and if they were of very limited strength of evidence. The authors searched the databases PubMed, EMBASE, CINAHL, and Cochrane Register of Controlled Trials. The recommendations in this CPG are based upon the evidence found in these studies. When critiquing the articles, the authors analyzed the quality and applicability of the studies using the Grade Evidence Appraisal System and the PRECIS Instrument. The authors made the following recommendations for braces and insoles.

The knee has the highest prevalence of OA of all of the joints in the human body. Knee OA regularly causes people to experience troubling pain and/or loss of physical function to varying degrees,5 and often results in total knee arthroplasty8 after years of distress and economic burden to the patient and society.9 During 2005 in Ontario, Canada, knee OA costs for an individual averaged $12,200 annually, including personal expenses as well as lost wages.10 It is estimated that as the world’s population ages and as the obesity epidemic grows, the burden of OA on the healthcare system, and therefore the economy, will continue to increase, barring improvements in knee OA management.8

Osteoarthritis (OA) is a chronic degenerative and progressive condition affecting synovial joints, which mainly causes degeneration of hyaline cartilage; Although OA can affect any joint containing hyaline cartilage; Its effects take place most often in the weight bearing joints of lower extremities and the most common large joints involved are knee joints [1].

Osteoarthritis is a type of arthritis in the knee that is most common to receive. This is a joint disease that mostly affects the cartilage. This arthritis only affects the joints. The cartilage is a slippery tissue that cover the ends of the bones in a joint. It is known as a wear and tear type of arthritis that occurs in people over the age of 50. However, it can occur to people younger than the age of 50 too. For this type of arthritis the top layer of the cartilage breaks down, which causes the slippery tissue to wear away. What happens then is that the bones of the joints rub closely against each other with less of the cartilage.

Osteoarthritis is the most common form of arthritis. It occurs when the protective cartilage on the ends of your bones wears down over time. Osteoarthritis often gradually worsens, and no cure exists. But staying active, maintaining a healthy weight and other treatments may slow progression of the disease and help improve pain and joint function. Osteoarthritis occurs when the cartilage that cushions the ends of bones in your joints gradually deteriorates. Cartilage is a firm, slippery tissue that permits nearly frictionless joint motion. In osteoarthritis, the slick surface of the cartilage becomes rough. Eventually, if the cartilage wears down completely, you may be left with bone rubbing on bone. These symptoms can develop slowly and worsen

Osteoarthritis is the most common joint disorder, and more than half of all Americans who are older than 65 have been diagnosed with osteoarthritis. However, recent US data has revealed knee osteoarthritis does not discriminate age, and there is growing evidence that osteoarthritis affects individuals at a young age. The annual cost of osteoarthritis due to treatment and loss of productivity in the US is estimated to be more than 65 billion dollars.1 With no cure currently available for osteoarthritis, current treatments focus on management of symptoms. The primary goals of therapy include improved joint function, pain relief, and increased joint stability. Although the exact cause of osteoarthritis is unknown, many risk factors have been identified including increased age, female gender, obesity, and trauma.2 Within these risk factors, the etiology of osteoarthritis has been divided into anatomy, body mass, and gender.

Cartilage damage in RA is result of several processes: 1. CD4 T helper cells and other cells in the synovial fluid become activated, promoting cytokine release and activating B lymphocytes. 2. Recruitment and retention of inflammatory cells in the joint sub lining region. 3. Vicious cycle of altered cytokine and signal transduction pathways. 4. Possible immune complex deposition and resultant inflammatory molecule release 5. RANKL release and osteoclast activation 6. Angiogenesis or growth of new blood vessels in the synovium. Several leukocytes are attracted out of circulation and into synovial membrane. The phagocytes of inflammation (neutrophils and macrophages) ingest the immune complexes and release powerful enzymes that degrade synovial tissue and articular cartilage. Overall, the immune system’s B and T lymphocytes are also activated. The B lymphocytes are stimulated to produce more RFs and T lymphocytes release enzymes that amplify the inflammatory response.

OA is a musculoskeletal disease that causes chronic joint pain and reduced physical functioning (Laba, brien, Fransen, & jan, 2013). Osteoarthritis (OA) is a non-inflammatory disorder of synovial joints that results in loss of hyaline cartilage and remodeling of surrounding bone. OA is the single most common joint disease, with an estimated prevalence of 60% in men and 70% in women later in life after the age of 65 years, affecting an estimated 40 million people in the United States (Goodman & Fuller, 2009). Women are more commonly affected after the age of 55, almost everyone has some symptoms by the age of 70 (Tan, Zahara, Colburn & Hawkins, 2013, p.78). Osteoarthritis can be described radiological, clinical, or subjective.

According to Petterson and Jacobsson (2002), degenerative joint disease (DJD) or osteoarthritis is the most common joint disorder seen in humans, affecting 60% of adults 60 years of age and older. Many studies have attempted to treat patients with DJD in a number of different ways including the use of the drug glucosamine, glucosamine and alendronate. Hamid Reza Arti and Mohammad Ebrahim Azemi undertook their own research in 2012 by comparing the effect of glucosamine and glucosamine with alendronate in symptomatic relieve of degenerative knee joint disease. They believed that due to the high prevalence of osteoarthritis especially knee osteoarthritis identification of effective treatment methods was an important factor in medical treatment of knee osteoarthritis. According to Arti and Azemi (2012) no previous study had addressed these issues.

Current understanding of OA and treatment OA is a noninflammatory degenerative joint disease and the leading cause of physical disability [1]. Approximately 27 million people suffer from OA in the USA alone [2]. OA represents an enormous societal burden that increases greatly as the population ages. Clinically, OA is described by joint pain and functional impairment including tenderness

Arthritis is a joint disorder, which affects one or several joints in the body. The condition has more than one hundred types of diseases with osteoarthritis being the most common. Osteoarthritis results from joint infection, or age. Patients that suffer from arthritis complain about pain in the joints. In most cases, the pain remains constant in the affected joint. It is worth noting, “The pain from arthritis is due to inflammation that occurs around the joint, damage to the joint from disease, daily wear and tear of joint, muscle strains caused by forceful movements against stiff painful joints and fatigue” (Reid, Shengelia & Parker, 2012, p. 40). However, joint pain could result from various diseases, and in such

In this study there were several selection criteria which may have ruled out a certain population from participating. The inclusion criteria stated that the participant must have at least moderate pain on movement, additionally if NSAIDs or analgesic treatments were previously undertaken additional criteria needed to be met. The study also ruled out subjects with severe OA requiring surgery, subjects with skin affections on the treated knee, and subjects with additional joint diseases. The external validity of the study may be reduced, due to the selection criteria being exclusive to a significant number of the population of interest.