1. Osteoarthritis
osteoarthroses

2.  Chronic degenerative disorder of synoveal joints with
progressive softening, disintegration of articular cartilage,
osteophyte formation.
Etiology:
Age (50%>60 year).
♂=♀ (♀-polyarticular).
Genetics (type II collagen).
Inflammation (Arthritis).
Asymmetric loading (Deformity, Instability, Fractures,
Dysplasia).

3. Pathogeneses
– Collagen failure.
– Proteoglycan loss.
– Cartilage deformation.
– Chondrocyte damage, enzyme release.
Collagen
failure
Proteolytic enzyme Proteoglycan matrix loss Cartilage deformation
release
Chondrocyte
damage

4. Pathology
 Progressive cartilage destruction (Fraying, Fibrillation).
 Ivory like bone (Eburination).
 Subchondral cyst.
 Subchondral Scleroses.
 Marginal Osteophytes.
 Capsular fibroses.
 Subchondral venous congestion.

5. Clinical features
Above middle age.
 ♀ usually polyarticular.
 Knee& hip,
interphalangeal joints (♀).
 Previous joint problem
(Fracture, Deformity, Infection, Dysplasia).
 Symptoms intermittent.

6. Clinical features
 Pain (Diffuse, Gradual, ↑Exertion, Night Pain) {cause}.
 Stiffness (After rest).
 Swelling (Intermittent, Constant).
 Deformity.
 Loss of function (Limping).
 Crepitus.
 Baker cyst.
 Muscle wasting.

7. Imaging
Plain X-ray: Four Cardinal Signs
Narrow joint space (Asymmetric).
Subchondral scleroses.
Marginal Osteophytes.
Subchondral cysts.
• Subluxation.
• Features of the cause.

8. Imaging
• MRI:
Concomitent meniscal tear, bone cavities before
surgery,assesing popliteal cyst.
• CT scan: previous fracture, incongruity

9. Management
Early stage:
• Physiotherapy (Movement, Muscle Power).
• Load reduction (Wt. Reduction, stick,
activities).
• Analgesic medication {NSAID}, hyaluronic acid
injections.

10. Management
Intermediate stage:
• Arthroscopic debridement (Mechanical,
Chemical).
• Osteotomy (Mechanical, Decompression).

11. Management
Late stage:
• Arthroplasty( standard treatment for late
stages).
• Arthrodeses(limited indications).