Osteoarthritis / edited by Kenneth D. Brandt, Michael Doherty and L. Stefan Lohmander.

Format:

Book

Contributor:

Brandt, Kenneth D.

Doherty, Michael, 1951-

Lohmander, L. Stefan.

Series:

Oxford medical publications

Language:

English

Subjects (All):

Osteoarthritis.

Medical Subjects:

Osteoarthritis.

Physical Description:

xii, 511 pages : illustrations (some color) ; 29 cm.

Edition:

Second edition.

Place of Publication:

Oxford ; New York : Oxford University Press, 2003.

Summary:

At a time when prevalence of osteoarthritis (failure of the joint) is increasing with an ageing population it is timely to review the latest evidence and management strategies for optimal treatment of patients with this, the most common joint disease of mankind. A number of exciting new developments related to etiopathogenesis and management make it highly desirable at this time to publish a fully comprehensive authoritative discussion of the risk factors, mechanisms of joint damage, clinical aspects, differential diagnosis, and treatment of osteoarthritis. A review of the current understanding of the management of this disorder and of the basic mechanisms involved provides the rationale for publication of this new fully updated edition.

Osteoarthritis 2/e looks at the mechanisms of joint failure and how this may be due to abnormal cartilage or disease in underlying tissue. Significant coverage is given to exciting new research on disease-modifying drugs and methodologies for their outcome evaluation. It is becoming increasingly recognised that optimal management of osteoarthritis requires a comprehensive program involving drugs and non-medicinal components and, in some cases, surgery. Chapters on both non-surgical and surgical therapy are contained in the management section. The full coverage given in this book allows the physician to consider and choose the right blend of treatment for each patient from the range available whether physical, pharmacological, surgical or supportive. This book is sympathetic to the significant differences that often exist between the perception of the patient and that of the physician regarding what is important in treatment, and coverage is therefore given to the outcome measures needed for optimal evaluation of both.

Highly illustrated and in full colour throughout, this definitive text is written principally for clinical rheumatologists, although primary care physicians, orthopaedic surgeons, allied health professionals, basic researchers, members of the pharmaceutical industry who are involved in drug research and development, and regulatory staff also should find it useful.

Contents:

1 Definition and classification of osteoarthritis 1

2 Epidemiology of osteoarthritis 9

3 The economics of osteoarthritis 17

4 Genetic aspects of osteoarthritis 23

4.1 Evidence for the inheritance of osteoarthritis 25

4.2 Specific gene defects associated with osteoarthritis 33

4.3 Laboratory approaches to the identification of genetic association in osteoarthritis 41

5 Pathology of osteoarthritis 49

6 Paleopathology of osteoarthritis 59

7 Pathogenesis of osteoarthritis 67

7.1 Introduction: the concept of osteoarthritis as failure of the diarthrodial joint 69

7.2 Pathogenesis of structural changes in the osteoarthritic joint 73

7.2.1 Articular cartilage 73

7.2.1.1 Biochemistry and metabolism of normal and osteoarthritic cartilage 73

7.2.1.2 Proteolytic degradation of normal and osteoarthritic cartilage matrix 82

7.2.1.3 Articular cartilage repair 93

7.2.1.4 Mechanical properties of normal and osteoarthritic articular cartilage, and the mechanobiology of chondrocytes 102

7.2.1.5 Response of the chondrocyte to mechanical stimuli 112

7.2.1.6 Crystals and osteoarthritis 120

7.2.2 Bone 125

7.2.2.1 Subchondral bone in the pathogenesis of osteoarthritis. Mechanical aspects 125

7.2.2.2 Subchondral bone in the pathogenesis of osteoarthritis. Biological effects 133

7.2.2.3 Systemic changes in bone in osteoarthritis 142

7.2.3 Synovium 147

7.2.3.1 Synovial mediators of cartilage damage and repair in osteoarthritis 147

7.2.3.2 Synovial physiology in the context of osteoarthritis 155

7.2.4 Neuromuscular system 161

7.2.4.1 Innervation of the joint and its role in osteoarthritis 161

7.2.4.2 Neuromuscular protective mechanisms 167

7.2.4.3 Proprioception in osteoarthritis 172

7.2.5 Local mechanical factors in the natural history of knee osteoarthritis. Malalignment and joint laxity 177

7.3 Pathogenesis of joint pain in osteoarthritis 185

7.3.1 Peripheral and central pain mechanisms in osteoarthritis 185

7.3.2 Why does the patient with osteoarthritis hurt? 189

8 Clinical features of osteoarthritis and standard approaches to the diagnosis 195

8.1 Signs, symptoms, and laboratory tests 197

8.2 Plain radiographic features of osteoarthritis 211

8.3 The natural history and prognosis of osteoarthritis 227

9 Management of osteoarthritis 235

9.1 Introduction: the comprehensive approach 237

9.2 Systemic analgesics 243

9.3 The role of NSAIDs in the treatment of osteoarthritis 251

9.4 Economic considerations in pharmacologic management of osteoarthritis 259

9.5 Topical NSAIDs 267

9.6 Topical Capsaicin Cream 273

9.7 Intra-articular glucocorticoids and other injection therapies 277

9.8 Intra-artiuclar hyaluronan injection 283

9.9 Nutritional therapies 289

9.10 Mechanisms by which micronutrients may influence osteoarthritis 293

9.11 Physical therapy 299

9.11.1 Exercise for the patient with osteoarthritis 299

9.11.2 Other physical therapies 305

9.12 Occupational therapy for the patient with osteoarthritis 311

9.13 Patient education 321

9.14 Social support 327

9.15 Depression in osteoarthritis 333

9.16 Coping strategies for the patient with osteoarthritis 339

9.17 Irrigation of the osteoarthritic joint 347

9.18 Surgical approaches to preserving and restoring articular cartilage 353

9.19 Arthroplasty and its complications 361

9.20 Weight loss and osteoarthritis 371

9.21 Patient adherence 375

10 Outcome assessment in osteoarthritis: a guide for research and clinical practice 381

11 Prospects for pharmacological modification of joint breakdown in osteoarthritis 391

11.1 Pharmacological modification of joint breakdown in OA: Do we need it, can we do it, can we prove it, is it good? 393

11.2 Disease modifying osteoarthritis drugs (DMOADs) 395

11.2.1 The biological perspective 395

11.2.2 The clinical perspective 401

11.3 Advantages and limitations of animal models in the discovery and evaluation of novel disease-modifying osteoarthritis drugs (DMOADs) 411

11.4 Assessment of changes in joint tissues in patients treated with disease modifying osteoarthritis drugs (DMOADs): monitoring outcomes 417

11.4.1 Radiographic grading systems 417

11.4.2 Quantitation of radiographic changes 426

11.4.3 Magnetic resonance imaging 433

11.4.4 Arthroscopic evaluation of knee articular cartilage 451

11.4.5 Bone scintigraphy 456

11.4.6 Ultrasonography 462

11.4.7 Defining and validating the clinical role of molecular markers in osteoarthritis 468

12 Design of clinical trials for evaluation of structure modifying drugs and new agents for symptomatic treatment of osteoarthritis 479

A1 The American College of Rheumatology (ACR) criteria for the classification and reporting of osteoarthritis 491

A2 Lequesne's algofunctional lower limb indices 493

A3 WOMAC osteoarthritis Index 495

A4 Protocols for radiography 497.

Notes:

Previous ed.: 1998.

Includes bibliographical references and index.

ISBN:

0198509677

OCLC:

53369805