What is osteoarthritis?

Osteoarthritis (OA) is the most common rheumatic disease that can lead to pain and disability, especially in middle-aged and elderly people.
It is a degenerative disease that mainly affects large weight-bearing joints as well as the joints of the hand and foot.
In addition to damaging the articular cartilage, OA also affects the synovial membrane and subchondral bone, leading to progressive symptoms, such as joint pain, stiffness, limitation of movement and a decrease in the quality of life.

Early osteoarthritis of the knee

What are the risk factors?

There are certain risk factors that have been implicated in the development of osteoarthritis.

  • Age The incidence of osteoarthritis increases with age. The condition mainly affects adults over 45 years of age with an incidence that increases with age.
  • Gender Overall, osteoarthritis is more prevalent in women in men.
  • Heredity Certain forms of the disease exhibit a hereditary pattern.
  • Obesity There is a clear association between obesity and osteoarthritis of the knee. Obesity is one of the most preventable risk factors.
  • Joint shape Abnormalities in joint or bone anatomy may increase the risk of developing osteoarthritis, especially abnormalities in the hip.
  • Joint trauma The risk of developing osteoarthritis appears to increase in cases of severe trauma or joint surgery.

What are the treatment options?

There are many possible approaches to ameliorate the pain, discomfort and disability that the disease causes. Patient education and general reassurance are essential elements in the management of osteoarthritis.
Treatments include:

  • Weight loss to reduce the load on joints and hence minimise pain and lessen disability.
  • Exercise, physiotherapy to improve the muscle strength and tone in order to stabilise the joint.
  • Oral analgesics such as paracetamol
  • Non-steroidal anti-inflammatory drugs (NSAIDs), Cox-2 inhibitors
  • Topical applications (NSAIDs, capsaicin)
  • Opioids analgesics
  • Corticoids injections to temporarily provide relief from pain and inflammation
  • Hyaluronic acid given as intra-articular injections to improve the viscoelastic properties of the synovial fluid and thus reduce the symptoms of osteoarthritis.
  • Symptomatic slow-acting drugs (SYSADOAs) such as diacerein, hyaluronic acid, glucosamine sulphate and chondroitin sulphate. These have a slow onset of efficacy but the effects persist for several months after treatment has stopped.
    Surgery: reserved for patients with severe OA or for patients who have severe pain that cannot adequately be relieved by medicines.
Most treatments will involve a combination of methods. Before beginning any treatment, discuss the options with your doctor to choose what is best for you.