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Feature Article

Osteoarthritis: moving beyond ageing

JULIAN D. SEGAN, ANITA E. WLUKA, FLAVIA M. CICUTTINI

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Abstract

Osteoarthritis is a heterogeneous group of diseases characterised by pain and loss of function, and is a leading cause of disability worldwide. Although risk factors vary across joints, common factors include obesity and advancing age. A largely clinical diagnosis, management for symptomatic disease is centred on nonpharmacological and nonsurgical measures.

Key Points

  • Osteoarthritis (OA) is the most common form of arthritis, and a leading cause of disability worldwide.
  • OA is a heterogeneous disease with risk factors varying across different joints affected, although there are some shared risk factors (e.g. age, obesity).
  • A clinical diagnosis can be made in the absence of red-flag features (e.g. prolonged early-morning stiffness).
  • Nonpharmacological therapies are the mainstay of OA management and include exercise and weight loss; comprehensive assessment and regular review are also important features of therapy.
  • Pharmacotherapy is ideally limited to the treatment of acute flares of pain; opiates are rarely indicated given an unfavourable risk-benefit profile.
  • Joint replacement is reserved for advanced symptomatic disease; arthroscopy rarely provides clinical benefit.

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