5. Joint Disorders: Osteoarthritis (OA)

Osteoarthritis

Degenerative, non-inflammatory joint disease.

Pathophysiology

Cartilage degeneration → bone on bone contact → osteophytes → stiffness and pain.

Signs and Symptoms

• Pain worsens with use

• Stiffness <30 mins after rest

• Crepitus

• Heberden’s and Bouchard’s nodes

Risk Factors

• Age >50

• Obesity

• Joint overuse

• Previous joint injury

Diagnostics

1. X-ray - Joint space narrowing, bone spurs

2. MRI - Early cartilages changes

3. Blood tests - Normal (RF Negative)

Nursing Management

• Encourage low-impact exercise

• weight loss

• use braces or supportive shoes

• apply heat for stiffness

Pharmacologic Treatment

1. Acetaminophen - First line for mild-moderate pain

2. NSAIDs - Reduce pain and inflammation

3. Topical NSAIDs - Local pain control

4. Intra-articular steroids - Short term inflammation relief.

Surgical Interventions

🔧 Total Joint Replacement (TJR / Arthroplasty)

• Indication: Severe OA unresponsive to conservative treatment (hip, knee most common)

• Purpose: Replaces damaged joint surfaces with artificial components

• Post-op:

  • Early ambulation (usually day 1 post-op)

  • Prevent dislocation (especially in hip replacement: avoid flexing >90°, adduction, internal rotation)

  • Physical therapy for strength and mobility

🔩 Osteotomy

• Indication: Younger patients with unilateral OA (especially knee)

• Purpose: Realigns bone to shift weight off damaged area

• Post-op: Long recovery, often used to delay joint replacement