Osteoarthritis Peer response

• Length: A minimum of 150 words per post, not including references
• Citations: At least one high-level scholarly reference in APA per post from within the last 5 years

A 65-year-old male presents with a painful left finger unable to bend and is significantly swollen.  He has a history of osteoarthritis.

1. OA is a disease of articular cartilage and subchondral bone in diarthrodial joints.  Explain this.
2. What is the role osteophytes in OA?
3. How do NASAIDS affect   OA?
4. How does weight loss affect OA?

Articular cartilage is the smooth white tissue covering the ends of bones, where diarthrodial (synovial) joints are located, making them easier to move by gliding smoothly over each other.  This allows for friction-free movement and minimizes pressure on the underlying subchondral bone (Science Direct, 2020).  Osteoarthritis (OA), also known as wear and tear arthritis or degenerative joint disease, is an inflammation of the joint where the degeneration of articular cartilage and its underlying bone becomes rough and worn, thus interfering with joint movement. As a result, the movement is no longer smooth and gliding. This degeneration of cartilage results in joint pain, stiffness, limited joint range of motion, and joint deformities, to name a few.  Additionally, secondary effects of the disease, such as bony overgrowths, may be seen (Dlugasch & Story, 2021). 

Osteophytes, also called bone spurs, are small outgrowths of bone that appear on joints where OA is present.  As the body attempts to repair the deteriorated cartilage, as seen in OA, new bone material is created near the damaged area as a result (Mayo Clinic, 2019).

Non-Steroidal Anti-Inflammatory drugs (NSAIDS) are commonly used to decrease the pain associated with OA, however, as with any pharmacological intervention, it is very important to examine to long term side effects and use to treat the pain, not to prevent it (Dlugasch & Story (2021). These assist in the pain because of the anti-inflammatory pain as well as the analgesic effect of this class of medication. Often, providers will prescribe a Proton pump inhibitor (PPI), with this medication as well to protect the patient from the GI symptoms that can occur with long-term therapy. Patients also need to know the importance of taking medications with food.

Osteoarthritis can be affected by the weight of a patient. For example, obesity can contribute to OA development resulting from metabolic derangement, not just mechanical stress (Dlugasch & Story (2021).  Interestingly, this tends to occur in the non-weight bearing joints such as the hands, the mechanism behind this is still somewhat unknown even though there are theories. There are benefits, according to the Arthritis foundation (2021), losing one pound take about four pounds of pressure off the knees. Fat also contains pro-inflammatory enzymes which may increase pain. Therefore, losing weight in the right fashion will improve patient outcomes. Obviously, maintaining proper nutrition is key for bone health, so losing weight in a healthy manner is important.

References

Bjordal, J. (2006). NSAIDs in osteoarthritis: irreplaceable or troublesome guidelines? * Commentary. British Journal of Sports Medicine, 40(4), 285286. https://doi.org/10.1136/bjsm.2005.021691

Mayo Clinic. (2019, October 17). Bone spurs. 

Science Direct. (2020). Articular cartilage. 

Weight Loss Benefits for Arthritis: Arthritis Foundation. Weight Loss Benefits for Arthritis | Arthritis Foundation. (2021). https://www.arthritis.org/health-wellness/healthy-living/nutrition/weight-loss/weight-loss-benefits-for-arthritis.