Osteoarthritis

=Degenerativejointdisease/degenerativearthritisDefinition

- Wearandtearofjointsurfacecartilage- Eventualinvolvementofbonystructuresandsofttissues- Maybeagerelatedoroccuraftertrauma/injurytoajoint- Commonlyaffectsknees,hips,handsandspine

Diagnosis

- History- Jointexamination- X-ray- NoMRIrequired

TypicalSymptoms

- Painwithactivitiesthatinvolveweight-bearing(walking,running,jumping,squatting)

- Jointswelling- Decreasedrangeofmotion- Stiffnesswithinactivity- Catchingandclickingofjoint(‘crepitus’)- Oftensymptomscomeandgo

Years

Resource:TheArthritisSocietywww.arthritis.ca

Dr.StephanieMullin Updated2017

2000SouthlandDriveSW Tel:403.251.9535Calgary,ABT2V4S4 Fax:403.251.9595

Treatment

1. Achieveormaintainahealthyweight

2. Activitymodificationa. Avoidexcessweightbearingactivitiesb. Chooselowimpactexercisesmoreoften

(swimming,cycling,deepwaterfitness,walking,elliptical,rowing)

3. Physicaltherapya. Rangeofmotionb. Strengtheningc. Stretching

4. FunctionalAidsa. Properfootwear–supportiveshoesb. Orthoticsc. Kneesleeveorpatellarstabilizingbraced. Unloaderkneebrace-medialorlaterale. Walkingsticks,cane,walker

5. Supplements–littlebenefita. Glucosamine

i. 500mg3timesperdayOR1500mg/daytotal

+/-Chondroitinb. Other–MSM,Bioflex,Vitamins,

JointEase…noevidence,$$$

SelfManagementProgramwww.arthritis.ca/asmp

6. Analgesicmedication-MAINTENECEa. Acetaminophen(Tylenol)

i. 2tabletsextrastrength=1000mgtwiceadayMAXupto3timesperday

ii. TylenolArthritis650mg1to2tabletsupto3timesaday

b. Prescriptioni. Opioids(i.e.codeine,oxycodone)ii. Non-opioidanalgesics(Tramadol)

7. Anti-inflammatorymedication-FLARESa. Ibuprofen(Advil,Motrin)b. Alevec. Prescription

i. i.e.Voltaren,Naproxen,Arthrotec,Celebrex

8. Topicalmedicationsa. Anti-inflammatorygel(Diclofenacx%)

ordrops(Pennsaid)b. Capsaicincream

9. Injectionsa. Steroid/Cortisone–forswellingb. Viscosupplement-hyaluronicacidderivative

i. Lubricationforthejointii. i.e.Synvisc,Monovisc,Durolane

10. Surgerya. Arthroscopyb. Correctivealignmentsurgeryc. Totalorpartialjointreplacement(Arthroplasty)