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Predisposing Conditions
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Pathology and Histology
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Clinical Features
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Laboratory Aspects
- Osteoarthritis of the Knee:
- Alternatives to Total Knee Replacement:
Autologous Hamstring Resurfacing Arthroplasty
- Hip:
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clinical features:
- pain on wt-bearing felt in the groin, buttock, or medial thigh;
- trendelenburg gait will decrease mechanical stress on joint and thereby lessen pain (see
forces acting on hip joint);
- pain during sleep results from loss of protective function of muscular splinting;
- in some cases, a patient w/ OA of the hip will experience acute hip pain which often correlates
w/ rupture of subcondral cyst into the joint;
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treatment options:
-
arthrodesis
-
total hip replacement
- valgus extension osteotomy:
- may be indicated in younger patients with DJD w/ flattened or mushroom shaped head, an osteophyte on the medial side of femoral head, and an
osteophyte partially covering the true acetabular floor;
- technique is less useful for patients with primary hip disease or reduced range of motion;
- technique considerations:
- abductor lever arm is maintained by elevation of greater trochanter through the insertion of a portion of wedge taken from osteotomy, as
a graft under the greater trochanter;
- osteotomy shifts the center of the stress medially which improves joint mechanics;
- extension of the femoral head, recenters the head, and prevents anterior subluxation;
- anterior capsule is opened using the lateral approach;
- guide wires are inserted to help determine the proper bone cuts;
- proximal osteotomy is made 2 cm distal to the entry side for the blade plate;
- Proximal femoral osteotomy as the primary operation for young adults who have OA of the hip. SR D'souza et al. JBJS. Vol 80-A. No 10. Oct 1998. p 1428.
- Shoulder:
-
arthrodesis
-
shoulder arthroplasty
- Fingers and Hand: (see
CMC arthritis)
- occurs most often in fifth or sixth decade of life;
- gradual onset of pain in the distal interphalangeal (DIP) joints;
- aggravating nocturnal fingertip pain and paresthesias may develop;
- Heberden's nodes:
- cystic swellings containing gelatinous hyaluronic acid appear on the dorsolateral aspects of DIP joints (see
mucous cyst);
- metacarpophalangeal (MCP) joints are typically spared;
Intertrochanteric osteotomy for osteoarthritis. A long term follow up. H. Weisl. JBJS Vol 62-B (1): 1980. p 37-42.
An Aggrecanase and Osteoarthritis.
Osteoarthritis Slide Show
Neurovascular invasion at the osteochondral junction and in osteophytes in osteoarthritis
Migratory Chondrogenic Progenitor Cells from Repair Tissue during the Later Stages of Human Osteoarthritis
