Osteoarthritis, or degenerative joint disease, is the most common form of arthritis and results in the loss of the articular joint cartilage (the cartilage coating the ends of bones). The loss of articular joint cartilage or cartilage cells is most commonly due to ones genetic make up. Old trauma or injury is another cause of degenerative joint disease and along with genetics contributes to early development of disabling arthritis.
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Articular cartilage cushions the joint during activities and provides smooth, pain free motion of the joint. The loss of the cartilage (via the death of cartilage cells) leaves areas of the bone uncovered leading to bone on bone contact. This contact and pressure changes results in inflammation, which leads to pain, swelling, and stiffness. We are currently working on ways to prevent cartilage cell death and ways to restore articular cartilage through stem cell and genetic research. Unfortunately, we are many decades away from effective treatments and hip replacement or resurfacing reamains the treatment of choice for end stage arthritis.
Other causes of articular cartilage or joint disease include avascular necrosis (loss of the blood supply of the underlying bone), post traumatic degenerative joint disease, and inflammatory conditions (including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis).
The initial treatment of arthritis is though medications designed to decrease pain and inflammation. These medications include acetaminophen (tylenol), aspirin, ibuprophen (motrin), Naproxen (Naprosyn), Diclofenac (Voltaren), and cox 2 inhibitors (Celebrex). Other early treatments include injections such as corticosteroids and viscosupplamentation injections such as synvisc. Once these treatments are exhausted and the patient has significant activity limiting pain, surgical treatments can be considered.