Treatment Options for Osteoarthritis Adam Bastin Prof Powdrill

Treatment Options for Osteoarthritis Adam Bastin Prof. Powdrill March 27, 2008

Arthritis • Rheumatoid Arthritis – Autoimmune – Symmetrical – Joint pain, swelling, stiffness, fatigue – Better once joint is used • Osteoarthritis – – – Asymmetrical Joint pain, stiffness Pain is worse with use Boney enlargement Weight bearing joints Joint space narrowing

Osteoarthritis • Most common joint disorder worldwide • Diagnosed on clinical presentation and supported by radiography. • Risk Factors – Older age, female sex, obesity, trauma, quadriceps weakness, and nutritional deficiencies

Osteoarthritis

Osteoarthritis Measurement Scales • Western Ontario and Mc. Master Osteoarthritis Index (WOMAC) – Questionnaire with twenty four questions about pain, function, and stiffness • Visual Analogue Scale – 100 mm long line with descriptive words (no pain / worst pain ever felt) on either side • Lequesne Index – Questionnaire 11 questions that ask about the patient’s symptoms and functional ability

Review of Literature • Exercise Related Therapy • Pharmaceutical therapy • Various procedures performed to relieve symptoms

Exercise Therapy • Indicated for mild to moderate osteoarthritis • Water therapy – Very effective – Good for elderly patients • Exercise training – Effective – Improvements in both knee and hip patients • Weight loss – Effective – Weight loss groups improved over weight stable group (All studies had statistically significant results on the scales discussed earlier)

Pharmaceutical therapy • Indicated for mild, moderate, and severe • NSAIDS – Very common • Transdermal Fentanyl – Indicated when NSAIDS, weak opiods don’t work • Glucosamine – Improves repair process and formation of cartilage (All studies had statistically significant results on the scales discussed earlier)

Various Procedures • Hyaluronic acids – Injected into the joint capsule to reduce friction and improves articulation (act as synovial fluid)

Various Procedures • Joint Replacement Surgery – Improved pain and overall patient well being

Various Procedures • Acupuncture – No difference seen in patients who exercised and advice when compared to patients who exercised, had advice, and acupuncture.

Treatment Overview

Conclusion • Treatment is different with every individual • Think about severity of osteoarthritis symptoms when considering treatment options • Consider patients goal for treatment (pain free vs. being able to perform activities)

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