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1-55. OSTEOARTHRITIS
a. Osteoarthritis is the most common of all joint diseases. It is also known as degenerative joint disease. It is a slow, progressive thinning of the joint cartilage that exposes underlying bone to pressure, abrasion and erosion. Unlike rheumatoid arthritis, degenerative joint disease has no remissions and no systemic symptoms such as malaise and fever. Although the exact cause is not known, there appears to be an underlying metabolic abnormality of cartilage. The following predisposing factors are known:
(1) Aging (usually, late middle life and older).
(2) Joint injury.
(3) Obesity or excessive joint use.
(4) Genetic influences.
(5) Systemic diseases (hemophilia or due to organ transplantation.
(6) Poor posture.
b. Pathological changes include thinning cartilage, which exposes bone to articulating surfaces, and thickened synovial membrane. The fibrous tissue around the joint ossifies. Ankylosis does not occur. Signs and symptoms of osteoarthritis are:
(1) Pain in one or more joints, particularly after exercise and long periods of inactivity.
(2) Stiffness in the morning or at night.
(3) Joint enlargement.
(4) Limitation of joint motion.
c. The goal of patient care is relief of pain and discomfort. Rest of the affected joints and short periods of moderate exercise are helpful. Heat to the affected part may afford some relief of pain. Obese patients should lose weight. Analgesics are given for pain control. Anti-inflammatory agents are prescribed when synovial inflammation is present. Assistive devices such as splints, braces, cervical collars, or corsets are provided as necessary. Surgical procedures are used to repair or replace painful, nonfunctioning joints.
d. Nursing care implications include administering medications as prescribed, application of heat as ordered, assessing and reporting the postoperative patient's status, and educating the patient regarding the disease.
