LO: Discuss the basic epidemiology, pathophysiology, presentation, investigation, management and prognosis of osteoarthritis

Osteoarthritis (OA)

• Disease of entire joint: cartilage, synovium, ligaments and bone
• Breakdown of these tissues $\to$ Pain and joint stiffness
• Knees, hips and hands most commonly affected
• Onset is gradual
• Treatment: relieving symptoms and improving function

Causes

• Secondary
  • Trauma
  • Infection
  • Inflammatory - rheumatoid arthritis
  • Perthe's disease
  • Slipped upper femoral epiphysis

Orthopaedic surgery

• Arthrodesis - fusion
• Arthroplasty - replacement
  • Excision
  • Hemi
  • Total joint

Arthodesis

• Sacrifices movement
• Pain relief
• Durable

Arthroplasty

Total joint arthoplasty

• Pain relief
• Keeps movement
• May not be durable

Complications

• Immediate
  • Technical - perioperative fracture
• Early
  • Infection
  • Dislocation
• Late
  • Aseptic loosening
  • Wear

Trapezectomy

• Removal trapezium bone
• Excision arthroplasty
• Non weight-bearing
• Instability
• Long rehabilitation
• Durability - nothing to loosen
• Preserve range of movement

Elbow osteoarthritis

• Rare
• Inflammatory
• Pain flexion/extension
• Pain pronation/supination
• Ulna-humeral
• Radiocapitellar