General Overview of Osteoarthritis for Rehabilitation Professionals: Difference between revisions
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Introduction | == Introduction == | ||
Osteoarthritis (OA) is a common chronic health condition. It can cause pain, decreased function, poor sleep, decreased mental health and reduced quality of life.<ref name=":0">Allen KD, Thoma LM, Golightly YM. [https://www.oarsijournal.com/article/S1063-4584(21)00886-4/fulltext Epidemiology of osteoarthritis]. Osteoarthritis Cartilage. 2022 Feb;30(2):184-95. </ref><ref>Osteoarthritis Research Society International (OARSI). Improving care for osteoarthritis: the forgotten chronic disease infographic. Available from: https://oarsi.org/sites/oarsi/files/docs/2022/oarsi_infographic_for_policymakers_2022_final.pdf (last accessed 13 May 2024). </ref> It is also associated with an increased risk of cardiovascular disease, diabetes, hypertension and mortality.<ref>Constantino de Campos G, Mundi R, Whittington C, Toutounji MJ, Ngai W, Sheehan B. [https://journals.sagepub.com/doi/full/10.1177/1759720X20981219 Osteoarthritis, mobility-related comorbidities and mortality: an overview of meta-analyses]. Ther Adv Musculoskelet Dis. 2020 Dec 25;12:1759720X20981219. </ref><ref>Osteoarthritis Research Society International (OARSI). Is osteoarthritis a series disease infographic. Available from: https://oarsi.org/sites/oarsi/files/images/2020/oarsi-20-final-oa-infographic-_revised_copyright.pdf (last accessed 13 May 2024).</ref> General rehabilitation strategies for osteoarthritis include education, exercise and weight loss. This page provides a general overview of osteoarthritis, including epidemiology, risk factors and pathology, before considering diagnosis and management trends. | |||
== Definition == | |||
<blockquote>The Osteoarthritis Research Society International (OARSI) defines osteoarthritis as: “a disorder involving movable joints characterized by cell stress and extracellular matrix degradation initiated by micro- and macro-injury that activates maladaptive repair responses including pro-inflammatory pathways of innate immunity. The disease manifests first as a molecular derangement (abnormal joint tissue metabolism) followed by anatomic, and/or physiologic derangements (characterized by cartilage degradation, bone remodeling, osteophyte formation, joint inflammation and loss of normal joint function), that can culminate in illness.”<ref>Osteoarthritis Research Society International (OARSI). Standardization of osteoarthritis definitions. Available from: https://oarsi.org/research/standardization-osteoarthritis-definitions (last accessed 13 May 2024).</ref></blockquote>'''Key points:'''<ref>Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. [https://www.mdpi.com/2077-0383/11/20/6013 Osteoarthritis: new insight on its pathophysiology]. J Clin Med. 2022 Oct 12;11(20):6013. </ref> | |||
* osteoarthritis has traditionally been described as a degenerative cartilage disease, but our understanding has evolved and we know that there is a breakdown of the cartilage, as well as structural changes across the whole joint | |||
* subchondral bone lesions precede cartilage degeneration | |||
== Epidemiology == | |||
It is estimated that 240 million individuals have symptomatic osteoarthritis,<ref name=":0" /> with a current prevalence rate of around 15%. This figure is expected to increase to 35% by 2030. This would make osteoarthritis the “single greatest cause of disability globally”.<ref name=":1">He Y, Li Z, Alexander PG, Ocasio-Nieves BD, Yocum L, Lin H, Tuan RS. [https://www.mdpi.com/2079-7737/9/8/194 Pathogenesis of osteoarthritis: risk factors, regulatory pathways in chondrocytes, and experimental models]. Biology (Basel). 2020 Jul 29;9(8):194. </ref> Increased prevalence has been linked to our ageing populations and an increase in obesity and joint injuries.<ref name=":1" /><ref>van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, Peter WF. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care. 2020 Dec;18(4):575-95. </ref> | |||
== Risk Factors == | |||
<blockquote>"Most cases of OA have a clear predisposing condition, such as genetics, trauma, aging, or obesity, leading to the idea that OA describes a common endpoint with different etiologies."<ref name=":1" /></blockquote>Known risk factors for osteoarthritis, include ageing, obesity, acute trauma, chronic overload, gender and hormone profile, metabolic syndrome and genetic predisposition. However, osteoarthritis is not "the inevitable consequence of these factors [...and…] different risk factors may act together in the pathogenesis of osteoarthritis".<ref name=":1" /> | |||
'''Ageing''' is characterised by progressive tissue loss and decreased organ function, and it "represents the single greatest risk factor for OA"<ref name=":1" /> | |||
'''Obesity''' is considered "the most prevalent '''preventable''' risk factor for developing osteoarthritis"<ref name=":2">Batushansky A, Zhu S, Komaravolu RK, South S, Mehta-D'souza P, Griffin TM. [https://www.sciencedirect.com/science/article/pii/S1063458421008803 Fundamentals of OA. An initiative of osteoarthritis and cartilage. Obesity and metabolic factors in OA]. Osteoarthritis Cartilage. 2022 Apr;30(4):501-15. </ref>: | |||
* previously obesity was considered a primary risk factor in knee osteoarthritis because of its impact on biomechanics, but it is now understood that it increases risk by altering metabolism and inflammation<ref name=":2" /> | |||
* obesity increases the risk of osteoarthritis in various joints, including the hand,<ref>Plotz B, Bomfim F, Sohail MA, Samuels J. Current epidemiology and risk factors for the development of hand osteoarthritis. Curr Rheumatol Rep. 2021 Jul 3;23(8):61. </ref> hip, knee, ankle and spine<ref name=":2" /> | |||
* obesity increases the risk of osteoarthritis in both males and females, but the effect size is greater in females<ref name=":2" /> | |||
'''Acute trauma / joint injury''' are considered "potent' risk factors for osteoarthritis.<ref name=":0" /> | |||
'''Chronic overload''': | |||
* various occupational ergonomic risk factors for osteoarthritis have been proposed, including force exertion, demanding posture, repetitive movements, hand-arm vibration, kneeling / squatting, lifting and climbing<ref>Hulshof CTJ, Pega F, Neupane S, Colosio C, Daams JG, Kc P, et al. [https://www.sciencedirect.com/science/article/pii/S0160412020323047 The effect of occupational exposure to ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury]. Environ Int. 2021 May;150:106349. </ref> | |||
** these risk factors can increase the risk of developing knee or hip osteoarthritis compared to no exposure | |||
** however, because the quality of evidence is currently low, there is "limited evidence of harmfulness" | |||
* another systematic review found that physically demanding jobs (e.g. construction work, floor and bricklaying, fishing, farming, etc) are associated with increased risk of knee and hip osteoarthritis, and there may be a dose-response relationship<ref name=":0" /> | |||
== References == | |||
[[Category:Course Pages]] | |||
[[Category:Plus Content]] | |||
[[Category:Osteoarthritis]] | |||
Revision as of 00:29, 13 May 2024
Original Editor - Shala Cunningham Top Contributors - Jess Bell
This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (13/05/2024)
Introduction[edit | edit source]
Osteoarthritis (OA) is a common chronic health condition. It can cause pain, decreased function, poor sleep, decreased mental health and reduced quality of life.[1][2] It is also associated with an increased risk of cardiovascular disease, diabetes, hypertension and mortality.[3][4] General rehabilitation strategies for osteoarthritis include education, exercise and weight loss. This page provides a general overview of osteoarthritis, including epidemiology, risk factors and pathology, before considering diagnosis and management trends.
Definition[edit | edit source]
The Osteoarthritis Research Society International (OARSI) defines osteoarthritis as: “a disorder involving movable joints characterized by cell stress and extracellular matrix degradation initiated by micro- and macro-injury that activates maladaptive repair responses including pro-inflammatory pathways of innate immunity. The disease manifests first as a molecular derangement (abnormal joint tissue metabolism) followed by anatomic, and/or physiologic derangements (characterized by cartilage degradation, bone remodeling, osteophyte formation, joint inflammation and loss of normal joint function), that can culminate in illness.”[5]
Key points:[6]
- osteoarthritis has traditionally been described as a degenerative cartilage disease, but our understanding has evolved and we know that there is a breakdown of the cartilage, as well as structural changes across the whole joint
- subchondral bone lesions precede cartilage degeneration
Epidemiology[edit | edit source]
It is estimated that 240 million individuals have symptomatic osteoarthritis,[1] with a current prevalence rate of around 15%. This figure is expected to increase to 35% by 2030. This would make osteoarthritis the “single greatest cause of disability globally”.[7] Increased prevalence has been linked to our ageing populations and an increase in obesity and joint injuries.[7][8]
Risk Factors[edit | edit source]
"Most cases of OA have a clear predisposing condition, such as genetics, trauma, aging, or obesity, leading to the idea that OA describes a common endpoint with different etiologies."[7]
Known risk factors for osteoarthritis, include ageing, obesity, acute trauma, chronic overload, gender and hormone profile, metabolic syndrome and genetic predisposition. However, osteoarthritis is not "the inevitable consequence of these factors [...and…] different risk factors may act together in the pathogenesis of osteoarthritis".[7]
Ageing is characterised by progressive tissue loss and decreased organ function, and it "represents the single greatest risk factor for OA"[7]
Obesity is considered "the most prevalent preventable risk factor for developing osteoarthritis"[9]:
- previously obesity was considered a primary risk factor in knee osteoarthritis because of its impact on biomechanics, but it is now understood that it increases risk by altering metabolism and inflammation[9]
- obesity increases the risk of osteoarthritis in various joints, including the hand,[10] hip, knee, ankle and spine[9]
- obesity increases the risk of osteoarthritis in both males and females, but the effect size is greater in females[9]
Acute trauma / joint injury are considered "potent' risk factors for osteoarthritis.[1]
Chronic overload:
- various occupational ergonomic risk factors for osteoarthritis have been proposed, including force exertion, demanding posture, repetitive movements, hand-arm vibration, kneeling / squatting, lifting and climbing[11]
- these risk factors can increase the risk of developing knee or hip osteoarthritis compared to no exposure
- however, because the quality of evidence is currently low, there is "limited evidence of harmfulness"
- another systematic review found that physically demanding jobs (e.g. construction work, floor and bricklaying, fishing, farming, etc) are associated with increased risk of knee and hip osteoarthritis, and there may be a dose-response relationship[1]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthritis Cartilage. 2022 Feb;30(2):184-95.
- ↑ Osteoarthritis Research Society International (OARSI). Improving care for osteoarthritis: the forgotten chronic disease infographic. Available from: https://oarsi.org/sites/oarsi/files/docs/2022/oarsi_infographic_for_policymakers_2022_final.pdf (last accessed 13 May 2024).
- ↑ Constantino de Campos G, Mundi R, Whittington C, Toutounji MJ, Ngai W, Sheehan B. Osteoarthritis, mobility-related comorbidities and mortality: an overview of meta-analyses. Ther Adv Musculoskelet Dis. 2020 Dec 25;12:1759720X20981219.
- ↑ Osteoarthritis Research Society International (OARSI). Is osteoarthritis a series disease infographic. Available from: https://oarsi.org/sites/oarsi/files/images/2020/oarsi-20-final-oa-infographic-_revised_copyright.pdf (last accessed 13 May 2024).
- ↑ Osteoarthritis Research Society International (OARSI). Standardization of osteoarthritis definitions. Available from: https://oarsi.org/research/standardization-osteoarthritis-definitions (last accessed 13 May 2024).
- ↑ Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: new insight on its pathophysiology. J Clin Med. 2022 Oct 12;11(20):6013.
- ↑ 7.0 7.1 7.2 7.3 7.4 He Y, Li Z, Alexander PG, Ocasio-Nieves BD, Yocum L, Lin H, Tuan RS. Pathogenesis of osteoarthritis: risk factors, regulatory pathways in chondrocytes, and experimental models. Biology (Basel). 2020 Jul 29;9(8):194.
- ↑ van Doormaal MCM, Meerhoff GA, Vliet Vlieland TPM, Peter WF. A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care. 2020 Dec;18(4):575-95.
- ↑ 9.0 9.1 9.2 9.3 Batushansky A, Zhu S, Komaravolu RK, South S, Mehta-D'souza P, Griffin TM. Fundamentals of OA. An initiative of osteoarthritis and cartilage. Obesity and metabolic factors in OA. Osteoarthritis Cartilage. 2022 Apr;30(4):501-15.
- ↑ Plotz B, Bomfim F, Sohail MA, Samuels J. Current epidemiology and risk factors for the development of hand osteoarthritis. Curr Rheumatol Rep. 2021 Jul 3;23(8):61.
- ↑ Hulshof CTJ, Pega F, Neupane S, Colosio C, Daams JG, Kc P, et al. The effect of occupational exposure to ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int. 2021 May;150:106349.
