Osteoarthritis
Overview
Osteoarthritis (OA) is the most common form of arthritis, affecting over 500 million people globally. It involves progressive degradation of joint cartilage and underlying bone, leading to pain, stiffness, and functional limitation.
Pathophysiology
- Cartilage breakdown — Loss of proteoglycans and collagen
- Subchondral bone changes — Sclerosis and osteophyte formation
- Synovial inflammation — Low-grade inflammatory response
- Joint space narrowing — Progressive structural change
Most Affected Joints
| Joint | Prevalence | Impact |
|---|---|---|
| Knee | 35-40% | Mobility limitation |
| Hip | 10-15% | Gait disturbance |
| Hand (DIP/PIP) | 25-30% | Fine motor tasks |
| Spine | 40-85% | Back pain, radiculopathy |
Risk Factors
- Age >50 years
- Obesity — BMI >30 (strongest modifiable risk)
- Joint injury — Prior trauma or surgery
- Genetics — 40-65% heritability
- Female sex — Higher risk after menopause
Management Approach
- Non-pharmacologic: Weight loss, exercise, physical therapy
- Pharmacologic: NSAIDs, acetaminophen, intra-articular injections
- Surgical: Joint replacement when conservative measures fail
Weight loss of just 5-10% significantly reduces knee pain and improves function in overweight patients with knee OA.
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