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Osteoarthritis (Degenerative Joint Disease) - An Update
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Osteoarthritis (OA), (previously known as degenerative joint disease) is a disease predominantly, but not solely, affecting the diarthrodial joints and results from an interaction of a number of complex mechanical and biological processes. The major characteristic of OA is progressive degradation and destruction of the articular cartilage. Knowledge of the etiopathogenesis has progressed significantly in recent years. The loss of articular cartilage represents a culmination of failure of the articular cartilage to withstand the cyclic trauma of athletic activity and this may be complicated by aging changes. Traumatic arthritis includes a number of conditions, but these can generally be divided into 1. synovitis and capsulitis and 2. instability causing injury such as intra-articular and collateral ligament injury, intra-articular fracture, subchondral bone disease and meniscal injury (stifle) and 3. osteoarthritis.
Pathways by which trauma can cause can an effect
The joint is an organ. There are a number of ways in which traumatic damage occurs. The possible pathways can be divided into abnormal forces on normal cartilage or normal forces on abnormal (diseased) cartilage as illustrated in Figure 1.
Abnormal stresses on normal cartilage can be created by heavy athletic activity, as well as loss of stability due to fractures or ligamentous tears with abnormal loading, as well as joint congruency changes. On the other hand, abnormal cartilage can be created within normal stresses when synovitis and capsulitis causes degradation of articular cartilage or there is pathologic change in the underlying subchondral bone.
Principles of Therapy
The aims of all therapeutic procedures are to prevent the progressive loss of articular cartilage. Many instances of early joint disease mainly manifest as synovitis and capsulitis and their appropriate treatment will delay or prevent the cartilage loss of OA (discussed below). On the other hand, timely and appropriate surgery for intra-articular fractures, osteochondritis dissecans (OCD) and other traumatic injuries to joints is also a necessary part of preventing OA. [...]
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