Osteoarthritis - Dr. S. Sriram

What is Osteoarthritis?
Broadly speaking, arthritis means any joint pain associated with signs of inflammation (swelling, redness, warmth etc). Osteoarthritis (OA) is one of the most commonest arthritis seen in general population. It is a painful condition can that can involve one or more of the joints in the body. It is commonly a disease which occurs with increasing age.

Osteoarthritis - Dr. S. Sriram
What actually happens in Osteoarthritis?
Often you would hear that there is no or decreased “lubricant” or oil in the joint! Major joints in the body are formed by two end of bones coming together. This end of bones are covered by a cushion, which is known as cartilage. These bone ends along with the cartilage in between forms the joint. This cushion of cartilage is very important in normal functioning of the joint. However in osteoarthritis,there is degeneration and wearing out of the out of this cushion or cartilage. In OA the cartilage thins out along with some other changes in the surrounding bone of the joint and this leads to various problems of osteoarthritis.

What causes osteoarthritis in the joints?
We are not exactly sure what causes osteoarthritis. However, it is strongly associated with increasing age. Hence age related degeneration of the joint plays a major role. But it is not as simple as that. Many people can develop osteoarthritis at an early age. Many people with osteoarthritis do not have much pain. Many people have osteoarthritis which is much more advanced at an unexpected age. Different patients have variable levels of pain even with same amount of osteoarthritis. Family history is important as well. We arestill trying to understand many of these factors.
What are the risk factors associated with osteoarthritis?
As mentioned above, we don't totally understand what causes osteoarthritis. However we do know that certain factors play a role in increasing risk of having osteoarthritis.
Age : Advancing age is one of the most commonest risk factors for osteoarthritis. Ingeneral public above 60 years of age, at least 80% have some evidence of osteoarthritis, in at least one of their joints. This may be just seen on X rays and patient may or may not have pain. However as mentioned above, not everyone with the same degree of osteoarthritis will have the same amount of pain.
Gender : For some unknown reasons, females have more chances of osteoarthritis than males. Females also tend to have more pain compared with same degree of osteoarthritis in men.
Obesity and weight : Osteoarthritis occurs more frequently in people who are obese (weight is well above required for that age and height). There is also some evidence that people who reduceweight can decrease the risk of developing osteoarthritis in the future.
Sports and rigorous physical activity : There is evidence that playing excessive injury sports like football, wrestling or repeated kneeling and squatting jobs can increase the risk of osteoarthritis. Having any injury in the ligament in the knee or any other joint can also crease the risk of osteoarthritis in the future . There is good evidence to suggest that routine, non-competitive running or exercises done for personal fitness does not increase the risk of osteoarthritis.
Previous ligament or meniscus injury : Any person who has had a history of injury to their supporting structures in joints like ligaments, meniscus etc at a young age, have higher chances of osteoarthritis in future. This is commonly seen in knee joint ligament and meniscus injuries. Even if one undergoes surgery to repair same, they are still at higher risk for developing osteoarthritis of respective joint in the future.
Family history: Osteoarthritis, particularly, nodal OA, can have remarkable familial predisposition.
Do all patients with age get Osteoarthritis?
No, not all patient get OA and it depends on multiple other factors, some of them have been outlined as above. We don’t have exact figures from India, but OA is more common in women and increases after an age of 50 years and plateaus at 70 years. Western literature shows increasing prevalence over time due to longer life expectancy, obesity and sedentary life style. It is estimated that 10% and 18% men and women are affected respectively.
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