Osteoarthritis

Osteoarthritis (OA) (Greek: osteon, "bone"; Greek: arthron, "joint"; Greek: itis, "inflammation") is a common joint disorder and involves degeneration of cartilage and potential joint destruction. Also commonly known as osteoarthrosis, hypertrophic osteoarthritis, and degenerative joint disease. As cartilage within the afflicted joint breaks down and wears away, the bones rub together; causing pain, swelling, and stiffness. When progression is most active, osteophytes form, the joint capsule thickens, subchondral bone changes and there is cartilage loss.

Causes & Risk Factors
Factors that can lead to OA:
 * Aging
 * Normal "wear & tear"
 * Hereditary factors
 * Obesity
 * Fractures
 * Injuries to cartilage or ligaments
 * Occupations involving physical labor, such as repetitive kneeling, squatting, walking, or heavy lifting
 * Playing sports that involve direct impact to the joints, twisting, or throwing
 * Bleeding disorders that cause bleeding in the joint
 * Disorders that block blood supply near the joint
 * Other types of arthritis, such as chronic gout, pseudogout, or rheumatoid arthritis

Incidence

 * Osteoarthritis affects about 26.9 million persons in the United States, or about 1 in 11 people.
 * Symptoms usually appear in middle age.
 * Before age 55, OA occurs equally in men and women. After age 55, it is more common in women.
 * By age 70, almost everyone has some symptoms indicative of osteoarthritis.
 * Trauma to the joint or surrounding tissues may hasten the onset of osteoarthritis.

Symptoms
Pain and stiffness are most noticeable the first 30 minutes of the day, or following weight-bearing activities.
 * Pain in the joint
 * Stiffness in the joint
 * Weakness surrounding the joint

Signs & Tests
Physical exam may show: Other diagnostic tests:
 * Crepitus
 * Swelling in and around the joint
 * Limited range of motion
 * Tenderness when the joint is pressed
 * In OA of the hand, bony nodules may be visible along the fingers due to ossification
 * An x-ray image may show loss of joint space
 * An x-ray image may show wearing down of involved bones
 * An x-ray image may show bone spurs

Knee

 * A knee orthosis can help stabilize the knee, correct alignment of the leg and shift weight away from the affected part of the joint. There are different types of orthoses, but all are made from some combination of metal, foam, plastic, elastic material, and straps.
 * A wedged foot orthosis may change the alignment of the foot and redirect weight away from the affected compartment, thereby reducing pain.

Ankle/Foot

 * In many cases, a simple ankle brace may be used to add support, stability, and to provide compression to reduce swelling.
 * In more severe cases, it may be necessary to completely immobilize the joint with the use of a solid ankle AFO.

Hand

 * A simple hand splint may be used as support and to immobilize afflicted joints, thereby reducing pain.

Other Treatment Options

 * Losing weight - To reduce amount of stress on affected area.
 * Oral medications - Anti-inflammatory medications can help reduce irritation and pain.
 * Physical therapy - May strengthen muscle groups around the affected joint and stretch the ligaments. In many cases, appropriate exercise has been shown to alleviate pain from OA.
 * Steroid injection - In more severe cases, anti-inflammatory medication may be injected directly into the joint.
 * Applying heat/cold - May temporarily relieve pain.
 * Surgery - In the most severe cases, surgery may repair, replace, or realign afflicted joints or even fuse a joint (arthrodesis).

Prognosis
Prognosis depends on the joints involved and/or severity of the condition. OA will usually either progress in perpetuity or stabilize at some point and rarely regresses. Orthotic intervention is directed only at symptom relief and cannot regress the condition. Patients who undergo joint replacement surgeries have over a 90% success rate.