17a. MSK - OA Flashcards
(42 cards)
What is OA?
Degenerative arthritis of the cartilage
Effects weight bearing joints
Over 45 yrs
Signs and symptoms of OA
Joint pain (worsened by activity/relieved by rest)
Joint stiffness
Swelling
Deformity (due to osteocytes)
Heberden’s nodes
What is the composition of the articular cartilage?
Extracellular matrix (water, collagen, proteoglycans)
Chondrocytes
What are proteoglycans made up of?
Glycosaminoglycan (GAG) chains
What are GAG chains bound to?
Hyaluronic acid
What is the first stage of OA pathophysiology?
Proteolytic breakdown of cartilage matrix
What happens during the proteolytic breakdown of cartilage matrix in OA?
Matrix metalloproteases (MMP) such as collagenase degrade the ECM, releasing fragments into synovial fluid
Triggers the release of inflammatory cytokines
What happens in OA as the level of proteoglycans starts to drop?
Cartilage softens and losing elasticity
Compromises joint surface integrity
What develops on the articular cartilage as the cartilage softens and loses its elasticity?
Fibrillations
What does the loss of cartilage result in?
Loss of joint space
Erosion of damaged cartilage, exposing underlying bone
What happens to the exposed bone once the cartilage has worn away?
Bone thickening
Osteocyte formation (bone spurs)
Causes and risk factors for OA
Age
Previous joint trauma
Overweight/obesity
T2D
Genetics
Nutritional deficiencies
Other joint diseases
Drivers of chronic inflammation
Why is increasing age a risk factor for OA?
Erosion of chondrocyte telomere length
Mitochondrial dysfunction
Inflammaging
Why is a previous joint trauma a risk factor for OA?
Associated with joint inflammation
Cartilage degradation
Why is being overweight/obese a risk factor for OA?
Mechanical load on cartilage
Why is T2D a risk factor for OA?
Insulin stimulates chondrocytes to make proteoglycans
(chondocytes can’t keep up)
Example of a chronic inflammatory driver that’s a risk factor for OA
Metabolic endotoxaemia
Other joint diseases that are a risk factor for OA
Gout
RA
Example of a nutrient deficiency that’s a risk factor for OA, and why
Vit D
Prevents articular cartilage erosion by regulating collagen turnover and bone metabolism
Example of conventional medication for OA
NSAIDs
(to suppress symptoms)
Why aren’t NSAIDs really ideal for OA?
Inhibit collagen matrix synthesis
Accelerate cartilage breakdown
Nutritional approach to support OA
Naturopathic diet with focus on anti-inflammatory
Reduce arachidonic acid
Increase O3s
Hydration
Glucosamine sulphate
Chondroitin sulphate
MSM
C
D
E
K2
Tart cherry
Turmeric
Boswellia
Ginger
Devil’s Claw
Why is glucosamine sulphate good for OA?
Proteoglycan synthesis
Inhibits MMPs
Dosage of glucosamine sulphate to support OA
500mg 3/day
