Osteoarthritis

Overview

Disease involving the breakdown of a joint
Causes pain and joint stiffness
No cure, symptoms can only be managed

What Happens in the Body

Osteoarthritis affects the entire joint
A combination of risk factors, mechanical stress, and abnormal joint mechanics leads to inflammation that gradually progresses to joint destruction
- Common risk factors include increasing age, female gender, obesity, joint injury, muscle weakness, and anatomical factors
Articular cartilage usually gets affected first
- The smooth, white tissue that covers the ends of bones where they meet to form a joint, allowing bones to glide over each other smoothly
- Surface becomes rough and damaged over time
The destruction then progresses onward to the bone, continually expanding and affecting more of the joint surface

American Academy of Orthopaedic Surgeons. (n.d.). Osteoarthritis. OrthoInfo. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/osteoarthritis/

Types

Primary osteoarthritis
- Acquired from no predisposing trauma or disease
- Associated with the risk factors of higher age, female gender, obesity, muscle weakness, and anatomical factors
- Is most common type
Secondary osteoarthritis
- Acquired as a result of a preexisting joint injury or abnormality

Symptoms

Joint pain
- Usually during activity, not at rest
Joint stiffness
Muscle weakness in some cases
Crepitus
- Grinding sensation with movement
Edema/swelling
Tenderness
Joint malalignment

Who Gets It?

Affects 3.3-3.6% of global population
Can occur at any age but is more common as people age
60% of older adults in the United States has symptomatic osteoarthritis
More common in women, especially after menopause
Commonly affected joints:
- Carpometacarpal joint of the thumb
- Trapeziometacarpal joint of the thumb
- Proximal and distal interphalangeal joints
- Glenohumeral joint

Treatment Ideas

Patient education on adaptive equipment and activity modification

Gradual strengthening

Tennis ball exercises

Prognosis/Timeline

Prognosis varies greatly among individuals
There is no cure for osteoarthritis
- Progression of disease can be managed and slowed down, but not reversed
Some may experience mild symptoms and live relatively unaffected by the condition
Some may experience severe symptoms and require surgery
Common surgeries include:
- Arthroscopy: Small camera and instruments are used to remove debris from the joint to restore function
- Osteotomy: Instruments are used to cut and reshape affected bones to better align the joint and distribute forces in the joint
- Arthroplasty: Artificial components are inserted to replace damaged portions of the joint
- Joint fusion: Bones are fused together to eliminate pain and improve stability in the joint
- Ligament reconstruction and tendon interposition: Trapezium bone is removed and part of a tendon (usually the flexor carpi radialis) is used to stabilize the joint (used for carpometacarpal arthritis)

Quiz Questions

1. What is typically the first joint structure affected by osteoarthritis?

A. Synovial membrane

B. Articular cartilage

C. Subchondral bone

D. Joint capsule

2. What type of osteoarthritis is associated with no prior injury or disease?

A. Secondary osteoarthritis

B. Idiopathic arthritis

C. Primary osteoarthritis

D. Inflammatory osteoarthritis

3. What is the most common type of osteoarthritis?

A. Inflammatory osteoarthritis

B. Secondary osteoarthritis

C. Post-traumatic arthritis

D. Primary osteoarthritis

4. Which risk factor is MOST strongly associated with developing primary osteoarthritis?

A. Recent infection

B. Previous tendon repair

C. Increasing age

D. Low calcium levels

5. What is the goal of an arthroplasty surgery for osteoarthritis?

A. Fuse bones together

B. Remove bone spurs

C. Replace damaged joint components

D. Realign tendons

6. What type of osteoarthritis results from a preexisting joint injury or abnormality?

A. Idiopathic

B. Primary

C. Degenerative

D. Secondary

Quiz Answers

References

Cucchiarini, M., de Girolamo, L., Filardo, G., Oliveira, J. M., Orth, P., Pape, D., & Reboul, P. (2016). Basic science of osteoarthritis. Journal of Experimental Orthopaedics, 3(1), 22. https://doi.org/10.1186/s40634-016-0060-6

Osteoarthritis of the Hands. (2021). Arthritis Foundation. https://www.arthritis.org/diseases/more-about/osteoarthritis-of-the-hands

Sen, R., & Hurley, J. A. (2025). Osteoarthritis. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK482326/

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