Osteoarthritis, also called degenerative joint disease or wear-and-tear arthritis, typically begins in late adulthood. The joint's smooth covering of cartilage becomes thinned, damaged or worn away entirely. This causes use-related pain and stiffness in the joints, especially the hands, the knee and the hip. It is important to recognize that osteoarthritis is not an inevitable part of aging and occasionally occurs in young people.
What causes osteoarthritis?
There are many potential causes of osteoarthritis, but in most people the cause is not known. Research suggests that cartilage may release abnormal enzymes in osteoarthritis. Or some people may be born with defective cartilage that eventually leads to cartilage breakdown, typical of osteoarthritis. Osteoarthritis caused by other conditions, called secondary osteoarthritis, may be a direct result of trauma, bleeding into the joint, any cause of long-standing joint inflammation (such as rheumatoid arthritis), joint infection or certain metabolic disorders. Osteoarthritis may run in families, so a genetic cause or predisposition may contribute to its development.
There are many drug, surgical and nondrug and nonsurgical treatments to choose from. Most people use some form of pain reliever or anti-inflammatory drug and benefit from regular exercise. Supportive therapies such as canes, shoe inserts and other devices also can be valuable. Surgery, including joint replacement, may be considered as a last resort for severe disease.
Research suggests that obese people are at risk of osteoarthritis and that weight loss
can help prevent or delay osteoarthritis from occurring. This suggests that for anyone who is overweight, one benefit of a weight-loss program may be the prevention of osteoarthritis. There is also an association between low intake of vitamin D and osteoarthritis. However, it is not known whether taking extra vitamin D can prevent this disease. Preventing trauma (for example, by wearing protective gear in athletic activities) also may prevent the development of osteoarthritis.
The vast majority of people with osteoarthritis are able to find some form of treatment that helps to relieve symptoms and improves joint movement. People with severe osteoarthritis can benefit from surgery to rebuild or replace the affected joint. Fortunately, people with osteoarthritis rarely become crippled. When this does occur, it is usually because the person has refused surgery or cannot tolerate surgery because of other medical problems.
Total hip replacement
surgery and total knee replacement surgery are among the most common surgeries performed in the United States. Any major surgery (that is, surgery that requires general anesthesia and takes weeks of recovery time) carries risk, but vast experience with these surgeries has helped to make these procedures safe and effective. Arthroscopy (camera-guided surgery) is another surgical approach to osteoarthritis. Arthroscopy is not considered major surgery; however, recent studies suggest that it is not effective for osteoarthritis (unless torn cartilage or another abnormality amenable to arthroscopic repair is also present).
Research suggests that there may be a genetic component to osteoarthritis, particularly osteoarthritis that involves the hands. This means that your children may be more likely to develop this disease if you have it. However, they are not 100 percent likely to develop it; the disease is not inevitable among children of people with osteoarthritis.
A replaced joint will last an average of 10 to 15 years; many people have replaced joints that last much longer. This time estimate is based on operations performed more than 10 years ago, and current techniques probably offer even better results. If a replaced joint does "fail," (for example, it may become loose, making the joint feel unstable) another replacement (called revision arthroplasty) can be performed, and the results are usually good.
A promising new approach to osteoarthritis is cartilage transplant. One technique removes healthy cartilage from a patient and then grows the healthy cartilage in a laboratory. The cartilage can then be used as a patch to fill the defect in a joint affected by osteoarthritis. This technique is not yet widely available and has been limited primarily to young people with sports-related injuries in whom cartilage damage is limited to one small area. However, this patch may prevent osteoarthritis from developing later. Other drugs, surgical techniques and preventive strategies are under active investigation.
Last updated October 29, 2008