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Osteoarthritis
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Osteoarthritis is one of the most common types of arthritis, currently affecting over 20 million Americans. Also known as degenerative joint disease, osteoarthritis is an illness that affects the condition of the cartilage in your joints. Cartilage is located between your joints to help facilitate movement. Without it, your joints will rub together, causing pain, stiffness, and impaired range of motion. Osteoarthritis occurs when your joint cartilage begins to break down, causing pain and suffering.
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Osteoarthritis (OA) is the most common adult joint disease, increasing in frequency and severity in all aging populations. The estimated U.S. prevalence is 20-40 million patients or 5 times that of rheumatoid arthritis. OA involvement of the hand, knee, hip and spine is common, with total knee replacements numbering over 250,000/yr and total hip replacements numbering over 150,000 per year in the U.S. alone. OA may involve a single joint or multiple joints in the same individual, with current therapy focused on pain relief as there is no FDA-approved therapy that arrests or reverses the joint deterioration. The etiology of OA is multifactorial involving both mechanical and biochemical factors. OA progression is associated with accelerated cartilage degradation leading to joint space narrowing, painful joint disruption, and functional compromise.
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Osteoarthritis in all its various forms appears to have a strong genetic connection. Gene mutations may be a factor in predisposing individuals to develop osteoarthritis. For example, scientists have identified a mutation (a gene defect) affecting collagen, an important part of cartilage, in patients with an inherited kind of osteoarthritis that starts at an early age. The mutation weakens collagen protein, which may break or tear more easily under stress. Scientists are looking for other gene mutations in osteoarthritis. Researchers have ... found that the daughters of women who have knee osteoarthritis have a significant increase in cartilage breakdown, thus making them more susceptible to disease.
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Osteoarthritis is often very mild and does not always have many symptoms even though xrays may show joint changes. Most older people will experience some twinges of joint pain which will soon go away or which are fully eased by rest and a little warmth. Sometimes... the symptoms are more pronounced and may include any one, or all of the following:
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Osteoarthritis results from deterioration or loss of the cartilage that acts as a protective cushion between bones, particularly in weight-bearing joints such as the knees and hips. As the cartilage is worn away, the bone rubbing against bone forms spurs, areas of abnormal hardening, and fluid-filled pockets in the marrow known as subchondral cysts. As the disorder progresses, pain results from deformation of the bones and fluid accumulation in the joints. The pain is relieved by rest and made worse by moving the joint or placing weight on it. In early OA, the pain is minor and may take the form of mild stiffness in the morning. In the later stages of OA, chronic inflammation develops. The patient may experience pain even when the joint is not being used; and he or she may suffer permanent loss of the normal range of motion in that joint.
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Osteoarthritis (... known as degenerative or hypertrophic arthritis, or age-related arthritis) implies an inflamed joint by its very name, but for a long time the role of inflammation in osteoarthritis has been somewhat controversial. The pathology reflects the result of joint disease, with loss and erosion of articular cartilage, subchondral sclerosis, and bone overgrowth (osteophytes). Rather than one uniform disease, osteoarthritis may be either a primary or idiopathic phenomenon or secondary to some other disorder. Osteoarthritis is also commonly seen as a secondary form of arthritis in patients with other inflammatory arthritides, such as rheumatoid arthritis. Mechanical and genetic factors play a role in the development of this disease as well. Histologic evidence clearly shows that there is ongoing inflammation and cartilage destruction in osteoarthritis, although not to the same degree as in other arthritides, such as rheumatoid arthritis.145
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