Abstract
Osteoarthritis is a slowly progressive musculoskeletal disorder that can occur in any joint and is characterised by symptoms of pain, stiffness or loss of function. Studies showed that the work related disability rate with osteoarthritis varied from 30 to 50%, it is also a frequent cause of early retirement.
Age is the strongest predictor of the development and progression of radiographic osteoarthritis. Further risk factors are physical activity, injuries, high bone mass index and intensive sport activities.
Targets that are most important in the prevention or management of osteoarthritis are to reduce pain, disability and to prevent radiological progression.
There are various life style factors that increase the risk of developing osteoarthritis, increase its rate of progression and may increase pain and functional limitation. Preventable or modifyable risk factors are obesity and mechanical aspects of the joint f.e. joint laxity or malalignment. Tears of menisci or ligaments may lead to at normal loading of articular cartilage and result in the increased deveopment of osteoarthritis. Further risk factors are certain occupations (f.e. farmers for hip- and knee osteoarthritis), intensive sport participation, muscle weakness and nutritional factors.
Pharmacological interventions are mainly to treat the symptom of pain and have nearly no effect on tissue damage. Nevertheless activity and participation is improved as well as using simple analgesics, antiinflammatory drugs, disease modifying therapies, hyaluronic acid and intraarticular steroids. There is no evidence that pharmacological interventions can prevent osteoarthritis as defined by radiological changes.
Biomechanic deficiencies may lead to joint damage and result in pain and disability. Therefore surgical correction of these abnormalities can relief pain and improve function. Further surgical interventions to reduce the impact of osteoarthritis include cartilage repair and joint preserving surgeries. For severely damaged joints, partial or total replacement of the joint is now possible for all those joints that are commonly affected by osteoarthritis.
Osteoarthritis is commonly associated with limited function that can be improved with a wide variety of rehabilitative interventions. Symptoms of pain may be reduced by joint specific exercises, transient immobilisation, heat or cold packings and braces or other devices. Further attention can be put on modifiying the environment as adaptions at home and at work, support services or other social interventions. Eduction and self managements play an important role as well in early as in late stages of the disease.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
