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» Home » CAD » Orthopedics » Orthopedic Disorders » Osteoarthritis
Background
The most prevalent type of arthritis globally is osteoarthritis. Osteoarthritis can be classified as primary and secondary osteoarthritis. However, osteoarthritis is clinically quite varied and can be just an asymptomatic accidental discovery to an irreversibly disabling condition. Osteoarthritis typically manifests with joint discomfort and loss of function.
Epidemiology
About 3.6% of people worldwide suffer from osteoarthritis. It ranks as the 11th most disabling disease globally, causing moderate to severe disability in 43 million individuals. Although only 60% of the population over 65 in the United States experiences symptoms, it is believed that 80% of this subgroup has radiographic evidence.
It is because radiographic osteoarthritis occurs at least twice as frequently as symptomatic osteoarthritis. Therefore, radiographic alterations do not demonstrate that the patient’s joint pain is due to osteoarthritis. Osteoarthritis was the second most expensive condition in the United States in 2011, accounting for about 1 million hospital admissions at a total cost of almost $15 billion.
Anatomy
Pathophysiology
The entire joint is affected by osteoarthritis; mechanical stress and aberrant joint mechanics interact to develop osteoarthritis. Pro-inflammatory markers and proteases are produced due to the combination, which ultimately causes joint degeneration. The articular cartilage typically experiences the first osteoarthritis alterations at surface fibrillation, irregularity, and isolated erosions. These erosions eventually penetrate the bone and keep growing to cover additional joint areas.
After a cartilage injury, the collagen matrix is microscopically degraded, which prompts chondrocytes to multiply and organize into clusters. As a result of a phenotypic transition to hypertrophic chondrocytes, cartilage outgrowths ossify and develop into osteophytes. More collagen matrix injury causes chondrocytes to apoptose. Bone cysts are uncommon in advanced disease; subchondral bone thickening is caused by improperly mineralized collagen.
Although this is not the primary cause, as in inflammatory arthritis, there is also some degree of synovial inflammation and enlargement. Menisci, joint capsules, and other soft-tissue structures are also impacted. Both calcium phosphate and pyrophosphate dihydrate crystals can be found in end-stage osteoarthritis. Although their exact function is unknown, they are believed to contribute to synovial inflammation.
Etiology
Age, obesity, female gender, anatomical abnormalities, weak muscles, and joint damage are the risk factors for developing osteoarthritis. The most prevalent subgroup of the disease, primary osteoarthritis, is diagnosed without a preceding event or illness but is linked to the risk factors mentioned above.
When a joint problem already exists, secondary osteoarthritis develops. Trauma or injury, infectious arthritis, congenital joint problems, Paget disease, avascular necrosis, osteopetrosis, metabolic disorders, Ehlers-Danlos syndrome, osteochondritis dissecans, hemoglobinopathy, or Marfan syndrome are some examples of predisposing circumstances.
Genetics
Prognostic Factors
The severity of symptoms, functional impairment, and damaged joints affect an osteoarthritis patient’s prognosis. While some patients with osteoarthritis experience minimal effects, others may be severely disabled. Joint replacement surgery occasionally provides the best long-term result.
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
10
mg
Tablet
Oral
once a day
12.5
mg
Orally
once a day
Increase to 25 mg orally once a day
30
mg
Tablet
Oral
once a day
200
mg
Orally
once a day
400 mg immediate release 2 times daily
Or
300 mg immediate release 2 to 3 times a day
Or
500 mg immediate release 2 times a day
Or
400 mg to 1 g extended release once a day
3
g
Orally
in divided doses as needed
300 - 600
mg
Tablet
Orally
every 8 hrs
300 - 600
mg
Tablet
Orally
every 8 hrs
1000
mg
Tablet
Orally
once a day
Can be treated with a dosage of 200-400 mg orally, two to three times daily, or a daily dose of 1000-1200 mg
It is sometimes prescribed in combination with glucosamine
600
mg
Tablet
Orally
every day
May be increased to 1200mg Orally Tablet every day in severe cases
Do not exceed 1,800 mg daily
Take one tablet orally (PO) two times a day, ensuring a minimum interval of 30 minutes before each meal
choline magnesium trisalicylate
1000-3000 mg orally 2-3 times a day
suggested dosing
For knee osteoarthritis
Dehydrated aqueous extract: take 100 mg orally daily
3 ounces (90ml) of noni juice per day
Extract: take 333 mg orally three times a day
diclofenac potassium- 50 mg orally 2-3 times daily
diclofenac sodium- 50 mg orally thrice daily or 75 mg orally every 12 hours
Extended-release- 100 mg orally once a day; may increase the dose to 100 mg twice daily
Zorvolex- 35 mg orally thrice a day
50mg/200mcg as 1 tablet orally thrice daily
Do not increase the dose of misoprostol to more than 200 mcg/dose or 800 mcg each day
75mg/200mcg as 1 tablet orally thrice daily
Do not increase the dose of misoprostol to more than 200 mcg/dose or 800 mcg each day
If the dose is not tolerated, reduce the frequency to twice daily
Voltaren gel
Administer 2 g for upper limbs or 4 g for lower limbs every 6 hours
Maximum dose of 8 g/day for each joint in the upper limbs and 16 g/day for each joint in the lower limbs
Pennsaid topical solution
For 1.5%: apply 40 drops on each aching knee four times a day and provide 10 drops per application by directly placing them on the knee
Carry out this process until 40 drops have been administered
For 2%: apply 40 mg to each aching knee twice a day; put 40 mg into the palm of the hand and apply uniformly to the anterior, lateral and posterior of the knee
hyaluronic acid and derivatives
Indicated for Osteoarthritis (Knee)
Visco-3: Administer a single weekly injection of 25 mg (equivalent to 2.5 mL) for a duration of three weeks, a total of three injections
Hymovis: Administer a dosage of 24 mg (equivalent to 3 mL) one time weekly for a duration of 2 weeks, total of 2 injections
Supartz FX, GenVisc 850: Administer 25 mg (equivalent to 2.5 mL) once a week for a duration of 5 weeks, a total of 5 injections
certain individuals may find it advantageous to receive a total of 3 injections
Monovisc: Administer a single injection of 88 mg (equivalent to 4 mL) into the affected knee through intra-articular means
Orthovisc: Administer 30 mg (equivalent to 2 mL) of medication directly into the affected knee every week for a total of three weeks
Synvisc-One: Administer a single injection of 48 mg (equivalent to 6 mL) into the affected knee via intra-articular route
Synvisc: Administer 16 mg (equivalent to 2 mL) of medication directly into the affected knee every week for a total duration of three weeks
Not more than 1800 mg each day
200 to 600 mg orally every eight hours
triamcinolone acetonide extended-release injectable suspension
Indicated for Osteoarthritis
A single intra-articular injection of 32 mg was administered in the knee
Administer 80mg daily thrice
For osteoarthritis, a combination of 32mg/gm camphor, 30mg/gm glucosamine sulfate, and 50mg/gm chondroitin sulfate for 8 weeks as required
Administer 50 to 100mg orally in one to two divided doses daily.
The usual recommended dose for dogs is 2 mg/lb of body weight daily orally
The total daily dose is 2 mg/lb of body weight once a day or in divided doses as 1 mg/lb twice a day
100 mg Orally administered thrice a day after the meals
300 to 500 mg immediate release twice a day
Or
300 mg immediate release 3 times a day (Do not exceed 1000 mg/day)
Or
400 to 1000 mg extended release once a day
Safety and efficacy are not seen in pediatrics
Future Trends
References
https://www.ncbi.nlm.nih.gov/books/NBK482326/
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» Home » CAD » Orthopedics » Orthopedic Disorders » Osteoarthritis
The most prevalent type of arthritis globally is osteoarthritis. Osteoarthritis can be classified as primary and secondary osteoarthritis. However, osteoarthritis is clinically quite varied and can be just an asymptomatic accidental discovery to an irreversibly disabling condition. Osteoarthritis typically manifests with joint discomfort and loss of function.
About 3.6% of people worldwide suffer from osteoarthritis. It ranks as the 11th most disabling disease globally, causing moderate to severe disability in 43 million individuals. Although only 60% of the population over 65 in the United States experiences symptoms, it is believed that 80% of this subgroup has radiographic evidence.
It is because radiographic osteoarthritis occurs at least twice as frequently as symptomatic osteoarthritis. Therefore, radiographic alterations do not demonstrate that the patient’s joint pain is due to osteoarthritis. Osteoarthritis was the second most expensive condition in the United States in 2011, accounting for about 1 million hospital admissions at a total cost of almost $15 billion.
The entire joint is affected by osteoarthritis; mechanical stress and aberrant joint mechanics interact to develop osteoarthritis. Pro-inflammatory markers and proteases are produced due to the combination, which ultimately causes joint degeneration. The articular cartilage typically experiences the first osteoarthritis alterations at surface fibrillation, irregularity, and isolated erosions. These erosions eventually penetrate the bone and keep growing to cover additional joint areas.
After a cartilage injury, the collagen matrix is microscopically degraded, which prompts chondrocytes to multiply and organize into clusters. As a result of a phenotypic transition to hypertrophic chondrocytes, cartilage outgrowths ossify and develop into osteophytes. More collagen matrix injury causes chondrocytes to apoptose. Bone cysts are uncommon in advanced disease; subchondral bone thickening is caused by improperly mineralized collagen.
Although this is not the primary cause, as in inflammatory arthritis, there is also some degree of synovial inflammation and enlargement. Menisci, joint capsules, and other soft-tissue structures are also impacted. Both calcium phosphate and pyrophosphate dihydrate crystals can be found in end-stage osteoarthritis. Although their exact function is unknown, they are believed to contribute to synovial inflammation.
Age, obesity, female gender, anatomical abnormalities, weak muscles, and joint damage are the risk factors for developing osteoarthritis. The most prevalent subgroup of the disease, primary osteoarthritis, is diagnosed without a preceding event or illness but is linked to the risk factors mentioned above.
When a joint problem already exists, secondary osteoarthritis develops. Trauma or injury, infectious arthritis, congenital joint problems, Paget disease, avascular necrosis, osteopetrosis, metabolic disorders, Ehlers-Danlos syndrome, osteochondritis dissecans, hemoglobinopathy, or Marfan syndrome are some examples of predisposing circumstances.
The severity of symptoms, functional impairment, and damaged joints affect an osteoarthritis patient’s prognosis. While some patients with osteoarthritis experience minimal effects, others may be severely disabled. Joint replacement surgery occasionally provides the best long-term result.
10
mg
Tablet
Oral
once a day
12.5
mg
Orally
once a day
Increase to 25 mg orally once a day
30
mg
Tablet
Oral
once a day
200
mg
Orally
once a day
400 mg immediate release 2 times daily
Or
300 mg immediate release 2 to 3 times a day
Or
500 mg immediate release 2 times a day
Or
400 mg to 1 g extended release once a day
3
g
Orally
in divided doses as needed
300 - 600
mg
Tablet
Orally
every 8 hrs
300 - 600
mg
Tablet
Orally
every 8 hrs
1000
mg
Tablet
Orally
once a day
Can be treated with a dosage of 200-400 mg orally, two to three times daily, or a daily dose of 1000-1200 mg
It is sometimes prescribed in combination with glucosamine
600
mg
Tablet
Orally
every day
May be increased to 1200mg Orally Tablet every day in severe cases
Do not exceed 1,800 mg daily
Take one tablet orally (PO) two times a day, ensuring a minimum interval of 30 minutes before each meal
choline magnesium trisalicylate
1000-3000 mg orally 2-3 times a day
suggested dosing
For knee osteoarthritis
Dehydrated aqueous extract: take 100 mg orally daily
3 ounces (90ml) of noni juice per day
Extract: take 333 mg orally three times a day
diclofenac potassium- 50 mg orally 2-3 times daily
diclofenac sodium- 50 mg orally thrice daily or 75 mg orally every 12 hours
Extended-release- 100 mg orally once a day; may increase the dose to 100 mg twice daily
Zorvolex- 35 mg orally thrice a day
50mg/200mcg as 1 tablet orally thrice daily
Do not increase the dose of misoprostol to more than 200 mcg/dose or 800 mcg each day
75mg/200mcg as 1 tablet orally thrice daily
Do not increase the dose of misoprostol to more than 200 mcg/dose or 800 mcg each day
If the dose is not tolerated, reduce the frequency to twice daily
Voltaren gel
Administer 2 g for upper limbs or 4 g for lower limbs every 6 hours
Maximum dose of 8 g/day for each joint in the upper limbs and 16 g/day for each joint in the lower limbs
Pennsaid topical solution
For 1.5%: apply 40 drops on each aching knee four times a day and provide 10 drops per application by directly placing them on the knee
Carry out this process until 40 drops have been administered
For 2%: apply 40 mg to each aching knee twice a day; put 40 mg into the palm of the hand and apply uniformly to the anterior, lateral and posterior of the knee
hyaluronic acid and derivatives
Indicated for Osteoarthritis (Knee)
Visco-3: Administer a single weekly injection of 25 mg (equivalent to 2.5 mL) for a duration of three weeks, a total of three injections
Hymovis: Administer a dosage of 24 mg (equivalent to 3 mL) one time weekly for a duration of 2 weeks, total of 2 injections
Supartz FX, GenVisc 850: Administer 25 mg (equivalent to 2.5 mL) once a week for a duration of 5 weeks, a total of 5 injections
certain individuals may find it advantageous to receive a total of 3 injections
Monovisc: Administer a single injection of 88 mg (equivalent to 4 mL) into the affected knee through intra-articular means
Orthovisc: Administer 30 mg (equivalent to 2 mL) of medication directly into the affected knee every week for a total of three weeks
Synvisc-One: Administer a single injection of 48 mg (equivalent to 6 mL) into the affected knee via intra-articular route
Synvisc: Administer 16 mg (equivalent to 2 mL) of medication directly into the affected knee every week for a total duration of three weeks
Not more than 1800 mg each day
200 to 600 mg orally every eight hours
triamcinolone acetonide extended-release injectable suspension
Indicated for Osteoarthritis
A single intra-articular injection of 32 mg was administered in the knee
Administer 80mg daily thrice
For osteoarthritis, a combination of 32mg/gm camphor, 30mg/gm glucosamine sulfate, and 50mg/gm chondroitin sulfate for 8 weeks as required
Administer 50 to 100mg orally in one to two divided doses daily.
The usual recommended dose for dogs is 2 mg/lb of body weight daily orally
The total daily dose is 2 mg/lb of body weight once a day or in divided doses as 1 mg/lb twice a day
100 mg Orally administered thrice a day after the meals
300 to 500 mg immediate release twice a day
Or
300 mg immediate release 3 times a day (Do not exceed 1000 mg/day)
Or
400 to 1000 mg extended release once a day
Safety and efficacy are not seen in pediatrics
choline magnesium trisalicylate
750 milligrams orally 2-3 times a day
https://www.ncbi.nlm.nih.gov/books/NBK482326/
The most prevalent type of arthritis globally is osteoarthritis. Osteoarthritis can be classified as primary and secondary osteoarthritis. However, osteoarthritis is clinically quite varied and can be just an asymptomatic accidental discovery to an irreversibly disabling condition. Osteoarthritis typically manifests with joint discomfort and loss of function.
About 3.6% of people worldwide suffer from osteoarthritis. It ranks as the 11th most disabling disease globally, causing moderate to severe disability in 43 million individuals. Although only 60% of the population over 65 in the United States experiences symptoms, it is believed that 80% of this subgroup has radiographic evidence.
It is because radiographic osteoarthritis occurs at least twice as frequently as symptomatic osteoarthritis. Therefore, radiographic alterations do not demonstrate that the patient’s joint pain is due to osteoarthritis. Osteoarthritis was the second most expensive condition in the United States in 2011, accounting for about 1 million hospital admissions at a total cost of almost $15 billion.
The entire joint is affected by osteoarthritis; mechanical stress and aberrant joint mechanics interact to develop osteoarthritis. Pro-inflammatory markers and proteases are produced due to the combination, which ultimately causes joint degeneration. The articular cartilage typically experiences the first osteoarthritis alterations at surface fibrillation, irregularity, and isolated erosions. These erosions eventually penetrate the bone and keep growing to cover additional joint areas.
After a cartilage injury, the collagen matrix is microscopically degraded, which prompts chondrocytes to multiply and organize into clusters. As a result of a phenotypic transition to hypertrophic chondrocytes, cartilage outgrowths ossify and develop into osteophytes. More collagen matrix injury causes chondrocytes to apoptose. Bone cysts are uncommon in advanced disease; subchondral bone thickening is caused by improperly mineralized collagen.
Although this is not the primary cause, as in inflammatory arthritis, there is also some degree of synovial inflammation and enlargement. Menisci, joint capsules, and other soft-tissue structures are also impacted. Both calcium phosphate and pyrophosphate dihydrate crystals can be found in end-stage osteoarthritis. Although their exact function is unknown, they are believed to contribute to synovial inflammation.
Age, obesity, female gender, anatomical abnormalities, weak muscles, and joint damage are the risk factors for developing osteoarthritis. The most prevalent subgroup of the disease, primary osteoarthritis, is diagnosed without a preceding event or illness but is linked to the risk factors mentioned above.
When a joint problem already exists, secondary osteoarthritis develops. Trauma or injury, infectious arthritis, congenital joint problems, Paget disease, avascular necrosis, osteopetrosis, metabolic disorders, Ehlers-Danlos syndrome, osteochondritis dissecans, hemoglobinopathy, or Marfan syndrome are some examples of predisposing circumstances.
The severity of symptoms, functional impairment, and damaged joints affect an osteoarthritis patient’s prognosis. While some patients with osteoarthritis experience minimal effects, others may be severely disabled. Joint replacement surgery occasionally provides the best long-term result.
https://www.ncbi.nlm.nih.gov/books/NBK482326/
Founded in 2014, medtigo is committed to providing high-quality, friendly physicians, transparent pricing, and a focus on building relationships and a lifestyle brand for medical professionals nationwide.
USA – BOSTON
60 Roberts Drive, Suite 313
North Adams, MA 01247
INDIA – PUNE
7, Shree Krishna, 2nd Floor, Opp Kiosk Koffee, Shirole Lane, Off FC Road, Pune 411004, Maharashtra
Founded in 2014, medtigo is committed to providing high-quality, friendly physicians, transparent pricing, and a focus on building relationships and a lifestyle brand for medical professionals nationwide.
MASSACHUSETTS – USA
60 Roberts Drive, Suite 313,
North Adams, MA 01247
MAHARASHTRA – INDIA
7, Shree Krishna, 2nd Floor,
Opp Kiosk Koffee,
Shirole Lane, Off FC Road,
Pune 411004, Maharashtra
