Inflammatory Degenerative Arthritis
Pathophysiology and Etiology
The most common joint disease is osteoarthritis (degenerative arthritis) where the most common site is the knee. Changes can be seen mainly in the articular cartilage, then in the subchondral bone. The etiology is multifactorial and not completely understood.
The beginning and development of knee osteoarthritis include mechanical, structural, genetic, and environmental factors. Since knee cartilage becomes thicker in the areas with the most loads, the local development of the articular cartilage in the knee is considerably influenced by the tibiofemoral mechanics and loading patterns when walking. Trauma, acute injury, ligamentous laxity, weight gain, and improper footwear can alter normal gait mechanics by placing load in areas of the cartilage where it is not used to accepting that amount of stress.
The beginning and development of knee osteoarthritis include mechanical, structural, genetic, and environmental factors. Since knee cartilage becomes thicker in the areas with the most loads, the local development of the articular cartilage in the knee is considerably influenced by the tibiofemoral mechanics and loading patterns when walking. Trauma, acute injury, ligamentous laxity, weight gain, and improper footwear can alter normal gait mechanics by placing load in areas of the cartilage where it is not used to accepting that amount of stress.
Diagnositic Tools
- Radiograph
- MRI
Signs and Symptoms
- Deep ache aggravated by weight-bearing activity
- Pain lessons with rest
- Crepitus
- Joint stiffness usually follows inactivity, especially if knee is bent for a long period of time
- Difficulty with squatting or kneeling
- Periodic buckling
- Knee malalignment and laxity
- Gait abnormalities
Prognosis
The prognosis of knee osteoarthritis (degenerative arthritis) depends on the severity of the patient’s condition. It is a chronic disease and it is not curable, but can be treated with medications, injections, by altering one’s activities and total knee replacement if the previous treatments do not work. The prognosis is also good for those who have had a total knee replacement.
References
Deyle, G.D., Gill, N.W., Allison, S.C., Hando, B.R., & Rochino, D.A. Knee OA: Which patients are unlikely to benefit from manual PT and exercise? Journal of Family Practice. 2012; 61:E1-E8.
Chapple, C.M., Nicholson, H., Baxter, G.D., & Abbott, J.H. Patient Characteristics That Predict Progression of Knee Osteoarthritis: A Systematic Review of Prognositc Studies. Arthritis Care & Research. 2011;63:8:1115-1125.
Guccione AA, Minor MA. Arthritis. In O’Sullivan SB, Schmitz TJ, eds. Physical Rehabilitation. 5th ed. Philadelphia, PA: F.A. Davis Company; 2007:1066- 1069.
Heijink, A., Gomoll, A.H., Madry, H., Drobnic, M., Filardo, G., Espregueira, J., & Van Dijk, C.N. Biomechanical consideration in the pathogensis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthosc. 2012; 20:423-435.
Wilkins AN, Phillips EM. Knee osteoarthritis. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2008:345-352.
Vincent, K.R., Conrad, B.P., Fregly, B.J., & Vincent, H.K. The Pathophysiology of Osteoarthritis: A Mechanical Perspective on the Knee Joint. Physical Medicine & Rehabilitation. 2012;4:S3-S9.
Chapple, C.M., Nicholson, H., Baxter, G.D., & Abbott, J.H. Patient Characteristics That Predict Progression of Knee Osteoarthritis: A Systematic Review of Prognositc Studies. Arthritis Care & Research. 2011;63:8:1115-1125.
Guccione AA, Minor MA. Arthritis. In O’Sullivan SB, Schmitz TJ, eds. Physical Rehabilitation. 5th ed. Philadelphia, PA: F.A. Davis Company; 2007:1066- 1069.
Heijink, A., Gomoll, A.H., Madry, H., Drobnic, M., Filardo, G., Espregueira, J., & Van Dijk, C.N. Biomechanical consideration in the pathogensis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthosc. 2012; 20:423-435.
Wilkins AN, Phillips EM. Knee osteoarthritis. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2008:345-352.
Vincent, K.R., Conrad, B.P., Fregly, B.J., & Vincent, H.K. The Pathophysiology of Osteoarthritis: A Mechanical Perspective on the Knee Joint. Physical Medicine & Rehabilitation. 2012;4:S3-S9.