Consensus Definition of Osteoarthritis

1
Consensus Definition of Osteoarthritis

• OA diseases are a result of both mechanical and
  biologic events that destabilize the normal
  coupling of degradation and synthesis of
  articular cartilage chondrocytes and
  extracellular matrix, and subchondral bone.
  Although they may be initiated by multiple
  factors, OA diseases involve all of the tissues
  of diarthrodial joint. Ultimately, OA diseases
  are manifested by morphologic, biochemical,
  molecular, and biomechanical changes of both
  cells and matrix which lead to a softening,
  fibrillation, ulceration, loss of articular
  cartilage, sclerosis and eburnation of
  subchondral bone, osteophytes, and subchondral
  cysts. When clinically evident, OA diseases are
  characterized by joint pain, tenderness,
  limitation of movement, crepitus, occasional
  effusion, and variable degrees of inflammation
  without systemic effects

From Kuettner Goldberg. Introduction. In
Kuettner, Goldberg, editors. Osteoarthritis
disorders. 1995
Provided by S Chubinskaya
2
Risk Factors for Incident Osteoarthritis
Meniscectomy
Age
Infection
Body Weight
Gender
Biomechanics
Occupational triggers
Osteoarthritis
Metabolic Disorders
Nonoccupational Physical Activity
Congenital Abnormalities
Bone Mineral Density
Injury
Other Factors
Postmenopausal Hormone Replacement Therapy
Genetics
Adapted from Sharma Kapoor Epidemiology of
Osteoarthritis In Osteoarthritis, 4th Ed. 2007
Provided by S Chubinskaya
3
Risk Factors for Incident Osteoarthritis

• Systemic factors
• Sex Hormones
• Genetic Susceptibility
• Racial Differences
• Gender
• Metabolic/Endocrine disorders

• Local Factors
• Weight
• Injury
• Occupation
• Developmental Abnormalities
• Other local factors
• Strength of the lesser quadriceps
• Knee laxity
• Damage to other local cartilage

Osteoarthritis
Adapted from www.arthritis.org
Provided by S Chubinskaya
4
Classification of OA

• Primary (Idiopathic)
• Peripheral Joints
• Spine
• Subsets
• Hereditary

• Secondary
• Trauma
• Underlying Joint disorders
• Systemic Metabolic disorders
• Crystal deposition disease
• Neuropathic disorders (Charcot joints)
• Miscellaneous

Adapted from Sharma Kapoor Epidemiology of
Osteoarthritis In Osteoarthritis, 4th Ed. 2007
Provided by S Chubinskaya
5
Occupations Associated with OA

• Knee
• Miners
• Dockers
• Physical Education Teachers
• Male Athletes
• Concrete Workers
• Painters
• Shipyard Workers
• Nuns

• Ankle
• Ballet Dancers
• Soccer Players

From slide collection of Drs. Kuettner and
Cole Rush University Medical Center
Provided by S Chubinskaya
6
Definition of OA for Epidemiologic Study(Rely
upon radiographic definitions of OA)

• Symptomatic, radiographic OA has been defined by
  a radiographic criterion coupled with a positive
  response to a questions, e.g., pain, in that
  joint, on most days of a month within the
  preceding year

Adapted from Sharma Kapoor Epidemiology of
Osteoarthritis In Osteoarthritis, 4th Ed. 2007
7
Prevalence of OA among joints

• High
• Hand
• DIP joint
• PIP joint
• CMC joint of the thumb
• Cervical Spine
• Lumbosacral spine
• Hip
• Knees
• First MTP joint

• Low
• Ankle
• Wrist
• Elbow
• Shoulder

Adapted from Felson Epidemiology of
Osteoarthritis prevalence and risk factors In
Osteoarthritic Disorders, Kuettner Goldberg,
Eds.1995.
8
From slide collection of Drs. Kuettner and
Cole Rush University Medical Center
Provided by S Chubinskaya
9
Prevalence of OA vs RA
From slide collection of Drs. Kuettner and
Cole Rush University Medical Center
Provided by S Chubinskaya
10
Provided by S Chubinskaya
11
Adapted from Felson Epidemiology of
Osteoarthritis prevalence and risk factors In
Osteoarthritic Disorders, Kuettner Goldberg,
Eds.1995.
Provided by S Chubinskaya