Osteoarthritis is a major cause of disability of the musculoskeletal system and progressively and chronically causes pain and loss of joint function, reduce, sometimes dramatically, the quality of life of patients and their ability to work.
Definition and symptoms of osteoarthritis
Osteoarthritis is basically a syndrome of joint pain and dysfunction caused by joint degeneration, and globally affects more patients than any other joint disease. Primarily characterized by degeneration of articular cartilage, the presence of intraarticular inflammation with synovitis and changes in subchondral bone and periarticular tissues.
Articular cartilage acts like a cushion, absorbing mechanical loads and facilitating movement of friction in the joints, allowing bones to glide over others, giving rise to joint movement. The articular cartilage injury causes loss of natural lubrication, causing the friction of the articular surfaces of bones and formation of bone spurs or osteophytes. In some cases, fragments of cartilage may break off and remain floating inside the joint, causing irritation joint inflammation and further structural damage.
From the pathological point of view of osteoarthritis is characterized by degeneration of articular cartilage, with loss of extracellular matrix, fibrillation and fissure formation, up to the complete loss of the articular surface. Also affect other tissues of the joint, including subchondral bone, ligaments, joint capsule, synovial membrane and periarticular muscles.
In the beginning, osteoarthritis may arise after a history of trauma in the joint, or joint infection secondary to a chronic inflammatory joint disease or simply a primary osteoarthritis as a result of age and degeneration associated with the use of the joints for a long number of years, often associated with overweight and / or the presence of angular deformities, especially at the knee joint.
The main symptoms of osteoarthritis are pain, stiffness and swelling of the joints. The affected joint usually has limited mobility, and sensitivity may also exist in the area, and associated skeletal deformities (often these deformities are the initial cause of osteoarthritis). Sometimes the joint can cause cracking, which is called crepitus. In turn, when the joint is badly affected, there may be secondary and progressive deformities.
Epidemiology of Osteoarthritis
Osteoarthritis is rare in people under 40 years but becomes more common with age. In particular most people over 65 years show radiographic signs of osteoarthritis in at least one or more joints. Overall, it is the most common cause of disability in older adults. Although the level of degradation is very different for each individual, causes symptoms in 60% of men and 70% of women aged over 65. The estimates calculate that more than 8 million people in the UK and some 20 million Americans have osteoarthritis clinically symptomatic, and they have pain intensity greater than 2.5 on a visual analog scale (VAS) from 0 to 10, and / or loss of function of the knee. The forecasts estimate that by 2030 20% of the adult population in Western Europe and North America have developed osteoarthritis, with an assessment on the scale of Kellgren-Lawrence greater than or equal to 2, since it has been found patients with this assessment (≥ 2) have an increased risk of disease progression. Despite being rare below 40 years its incidence in young people is increasing. In the United States, osteoarthritis and rheumatoid arthritis, together, affect 46 million people. The health costs generated by this disease amounted to 128,000 million in 2003, rivaling even the health costs of ischemic heart disease, which emphasizes the urgent need for new and more effective treatments for joint injury.
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