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Osteoarthritis in the Elderly Population

  • Roy D. AltmanEmail author
Chapter

Abstract

Osteoarthritis, previously known as degenerative joint disease, osteoarthrosis, and hypertrophic osteoarthritis­, is a chronic and sometimes progressive condition of the joint characterized by changes in articular cartilage and associated with adjacent changes in subchondral bone, bone joint ­margins, synovium, ligaments, capsule, and or muscles. Although almost half of the patients with imaging evidence of osteoarthritis are asymptomatic, the remaining half have associated pain, stiffness, swelling, and loss of function. The diagnosis can be confirmed by radiograph, but the radiograph is often not essential to make the diagnosis. Treatment involves non-pharmacologic, pharmacologic, and surgical measures.

Keywords

Osteoarthritis Elderly Treatments Pharmacologic therapy Non-pharmacologic therapy 

References

  1. 1.
    Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. National Arthritis Data Workgroup. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35.PubMedCrossRefGoogle Scholar
  2. 2.
    Bayliss EA, Ellis JL, Steiner JF. Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. Ann Fam Med. 2007;5(5):395–402.PubMedCrossRefGoogle Scholar
  3. 3.
    Altman RD, Asch E, Bloch D, Bole G, Borenstein D, et al. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum. 1986;29:1039–49.PubMedCrossRefGoogle Scholar
  4. 4.
    Quintana JM, Escobar A, Arostegui I, Bilbao A, Armendariz P, Lafuente I, et al. Prevalence of symptoms of knee or hip joints in older adults from the general population. Aging Clin Exp Res. 2008;20(4):329–36.PubMedGoogle Scholar
  5. 5.
    Valdes AM, Spector TD. The contribution of genes to osteoarthritis. Med Clin North Am. 2009;93(1):45–66.PubMedCrossRefGoogle Scholar
  6. 6.
    Messier SP. Obesity and osteoarthritis: disease genesis and nonpharmacologic weight management. Rheum Dis Clin North Am. 2008;34(3):713–29.PubMedCrossRefGoogle Scholar
  7. 7.
    Brandt KD, Dieppe P, Radin EL. Etiopathogenesis of osteoarthritis. Rheum Dis Clin North Am. 2008;34(3):531–59.PubMedCrossRefGoogle Scholar
  8. 8.
    Wong BL, Bae WC, Gratz KR, Sah RL. Shear deformation kinematics during cartilage articulation: effect of lubrication, degeneration, and stress relaxation. Mol Cell Biomech. 2008;5(3):197–206.PubMedGoogle Scholar
  9. 9.
    Pujol JP, Chadjichristos C, Legendre F, Bauge C, Beauchef G, Andriamanalijaona R, et al. Interleukin-1 and transforming growth factor-beta 1 as crucial factors in osteoarthritic cartilage metabolism. Connect Tissue Res. 2008;49(3):293–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Sniekers YH, Intema F, Lafeber FP, van Osch GJ, van Leeuwen JP, Weinans H, et al. A role for subchondral bone changes in the ­process of osteoarthritis; a micro-CT study of two canine models. BMC Musculoskelet Disord. 2008;9:20.PubMedCrossRefGoogle Scholar
  11. 11.
    Sale JE, Gignac M, Hawker G. The relationship between disease symptoms, life events, coping and treatment, and depression among older adults with osteoarthritis. J Rheumatol. 2008;35(2):335–42.PubMedGoogle Scholar
  12. 12.
    Gooberman-Hill R, Woolhead G, Mackichan F, Ayis S, Williams S, Dieppe P. Assessing chronic joint pain: lessons from a focus group study. Arthritis Rheum. 2007;57(4):666–71.PubMedCrossRefGoogle Scholar
  13. 13.
    Amin S, Baker K, Niu J, Clancy M, Goggins J, Guermazi A, et al. Quadriceps strength and the risk of cartilage loss and symptom ­progression in knee osteoarthritis. Arthritis Rheum. 2008;60(1):189–98.CrossRefGoogle Scholar
  14. 14.
    Felson DT, Niu J, McClennan C, Sack B, Aliabadi P, Hunter DJ, et al. Knee buckling: prevalence, risk factors, and associated limitations in function. Ann Intern Med. 2007;147(8):534–40.PubMedGoogle Scholar
  15. 15.
    ACR Subcommittee on Classification Criteria of Osteoarthritis – Altman RD, Chairman. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991;34:505–14.Google Scholar
  16. 16.
    Arnold CM, Faulkner RA. The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis. BMC Geriatr. 2007;7:17.PubMedCrossRefGoogle Scholar
  17. 17.
    Granville L, Musson N, Altman RD, Silverman M. Anterior cervical osteophytes as a cause of pharyngeal stage dysphagia. J Am Geriatr Soc. 1998;46:1003–7.PubMedGoogle Scholar
  18. 18.
    Hernández-Molina G, Guermazi A, Niu J, Gale D, Goggins J, Amin S, et al. Central bone marrow lesions in symptomatic knee osteoarthritis and their relationship to anterior cruciate ligament tears and cartilage loss. Arthritis Rheum. 2008;58(1):130–6.PubMedCrossRefGoogle Scholar
  19. 19.
    Ding C, Martel-Pelletier J, Pelletier JP, Abram F, Raynauld JP, Cicuttini F, et al. Two-year prospective longitudinal study exploring the factors associated with change in femoral cartilage volume in a cohort largely without knee radiographic osteoarthritis. Osteoarthritis Cartilage. 2008;16(4):443–9.PubMedCrossRefGoogle Scholar
  20. 20.
    Kraus VB, McDaniel G, Worrell TW, Feng S, Vail TP, Varju G, et al. Association of bone scintigraphic abnormalities with knee malalignment and pain. Ann Rheum Dis. 2009;68(11):1673–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Chao J, Kalunian K. Ultrasonography in osteoarthritis: recent advances and prospects for the future. Curr Opin Rheumatol. 2008;20(5):560–4.PubMedCrossRefGoogle Scholar
  22. 22.
    Chen HC, Shah S, Stabler TV, Li YJ, Kraus VB. Biomarkers associated with clinical phenotypes of hand osteoarthritis in a large multigenerational family: the CARRIAGE family study. Osteoarthritis Cartilage. 2008;16(9):1054–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Pritzker KP. Crystal deposition in joints: prevalence and relevance for arthritis. J Rheumatol. 2008;35(6):958–9.PubMedGoogle Scholar
  24. 24.
    Altman RD, Hochberg MC, Moskowitz RW, Schnitzer TJ, American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis fo the hip and knee: 2000 update. Arthritis Rheum. 2000;43:1905–15.CrossRefGoogle Scholar
  25. 25.
    Zhang W, Doherty M, Leeb BF, Alekseeva L, Arden NK, Bijlsma JW, et al. EULAR evidence based recommendations for the management of hand osteoarthritis: report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2007;66(3):377–88.PubMedCrossRefGoogle Scholar
  26. 26.
    Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16:137–62.PubMedCrossRefGoogle Scholar
  27. 27.
    Hart LE, Haaland DA, Baribeau DA, Mukovozov IM, Sabljic TF. The relationship between exercise and osteoarthritis in the elderly. Clin J Sport Med. 2008;18(6):508–21.PubMedCrossRefGoogle Scholar
  28. 28.
    Laine L, White WB, Rostom A, Hochberg M. COX-2 selective inhibitors in the treatment of osteoarthritis. Semin Arthritis Rheum. 2008;38(3):165–87.PubMedCrossRefGoogle Scholar
  29. 29.
    Zacher J, Altman R, Bellamy N, Bruhlmann P, Da Silva J, Huskisson E, et al. Topical diclofenac and its role in pain and inflammation: an evidence-based review. Curr Med Res Opinion. 2008;24:925–50.CrossRefGoogle Scholar
  30. 30.
    Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;(2):CD005328.Google Scholar
  31. 31.
    Raynauld JP, Buckland-Wright C, Ward R, Choquette D, Haraoui B, Martel-Pelletier J, et al. Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2003;48(2):370–7.PubMedCrossRefGoogle Scholar
  32. 32.
    Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;(2):CD005321.Google Scholar
  33. 33.
    Towheed TE, Maxwell L, Anastassiades TP, Shea B, Houpt J, Robinson V, Hochberg MC, Wells G. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. 2005;(2):CD002946.Google Scholar
  34. 34.
    Reichenbach S, Sterchi R, Scherer M, Trelle S, Bürgi E, Bürgi U, et al. Meta-analysis: chondroitin for osteoarthritis of the knee or hip. Ann Intern Med. 2007;146(8):580–90.PubMedGoogle Scholar
  35. 35.
    Morgan SL, Baggott JE, Morland L, Desmond R, Kendrach AC. The safety of flavoxid, a medical food, in the dietary management of knee osteoarthritis. J Med Food. 2009;12:1–6.CrossRefGoogle Scholar
  36. 36.
    Mattia C, Coluzzi F, Sarzi Puttini P, Viganó R. Paracetamol/Tramadol association: the easy solution for mild-moderate pain. Minerva Med. 2008;99(4):369–90.PubMedGoogle Scholar
  37. 37.
    Choquette D, McCarthy TG, Rodrigues JF, Kelly AJ, Camacho F, Horbay GL, et al. Transdermal fentanyl improves pain control and functionality in patients with osteoarthritis: an open-label Canadian trial. Clin Rheumatol. 2008;27(5):587–95.PubMedCrossRefGoogle Scholar
  38. 38.
    Hale M, Tudor IC, Khanna S, Thipphawong J. Efficacy and tolerability of once-daily OROS hydromorphone and twice-daily extended-release oxycodone in patients with chronic, moderate to severe osteoarthritis pain: results of a 6-week, randomized, open-label, noninferiority analysis. Clin Ther. 2007;29(5):874–88.PubMedCrossRefGoogle Scholar
  39. 39.
    Fusco BM, Giacovazzo M. Peppers and pain. The promise of capsaicin. Drugs. 1997;53(6):909–14.PubMedCrossRefGoogle Scholar
  40. 40.
    Chappell AS, Ossanna MJ, Hong L-S, Iyengar S, Skljarevski V, Li LC, et al. Duloxetine, a centrally acting analgesic, in the treatment of patients with osteoarthritis knee pain: a 13-week, randomized, placebo-controlled trial. Pain. 2009;146:253–60.PubMedCrossRefGoogle Scholar
  41. 41.
    Santaguida PL, Hawker GA, Hudak PL, Glazier R, Mahomed NN, Kreder HJ, et al. Patient characteristics affecting the prognosis of total hip and knee joint arthroplasty: a systematic review. Can J Surg. 2008;51(6):428–36.PubMedGoogle Scholar
  42. 42.
    Alford JW, Cole BJ. Cartilage restoration, part 1: basic science, historical perspective, patient evaluation, and treatment options. Am J Sports Med. 2005;33(2):295–306.PubMedCrossRefGoogle Scholar
  43. 43.
    Alford JW, Cole BJ. Cartilage restoration, part 2: techniques, ­outcomes, and future directions. Am J Sports Med. 2005;33(3):443–60.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Division of RheumatologyUCLALos AngelesUSA

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