Medical Clinics of North America Vol 93 Issue 01 2009 Osteoarthritis

Current definitions of osteoarthritis......Page 1
A current view of the etiopathogenesis of osteoarthritis......Page 3
Articular cartilage healing and remodeling: mechanobiology of the chondrocyte......Page 5
Why does any of this matter? Lack of relevance of chondroprotective drugs to the underlying process......Page 6
Periarticular Muscle as a Shock Absorber for the Joint......Page 8
The Quadriceps Muscle: Implications for Knee Osteoarthritis......Page 9
The normal joint......Page 10
The osteoarthritic joint......Page 11
Etiopathogenesis of osteoarthritis pain......Page 12
Synovitis......Page 13
Subchondral Bone......Page 14
Relief of osteoarthritis pain by physiologic interventions: further reason to consider a mechanical etiopathogenesis of osteoarthritis......Page 16
References......Page 18
Periarticular bone structure and mechanisms of adaptation in osteoarthritis......Page 25
Periarticular bone changes associated with osteoarthritis......Page 28
Subchondral cortical and trabecular bone changes in osteoarthritis......Page 29
Bone marrow edema and bone cysts......Page 30
Osteophytes......Page 31
References......Page 32
Different types of meniscal lesions......Page 36
Past, present, and future treatment strategies of a torn meniscus......Page 37
Meniscal tear-a cause or result of osteoarthritis?......Page 38
References......Page 39
The Contribution of Genes to Osteoarthritis......Page 43
Familial aggregation......Page 44
Familial Aggregation of Generalized Osteoarthritis and Progression of Osteoarthritis......Page 45
Classic twin studies......Page 46
Genetic Contribution to Disease Progression......Page 47
Linkage analyses......Page 50
Wnt Signaling, FRZB Variants, and Gender-Specific Associations......Page 55
Bone Morphogenetic Proteins......Page 56
What can we expect in the years to come in genetic research in osteoarthritis?......Page 57
References......Page 58
The Measurement of Joint Mechanics and Their Role in Osteoarthritis Genesis and Progression......Page 65
Mechanical hypotheses about osteoarthritis......Page 66
What Would We Like To Measure and Why Can’t We Do It?......Page 67
Gait Analysis......Page 68
MRI Measurements of Kinematics......Page 69
The Future......Page 70
Alignment......Page 71
Injury......Page 72
The role of mechanics in osteoarthritis treatment......Page 73
References......Page 74
The Symptoms of Osteoarthritis and the Genesis of Pain......Page 81
What are the characteristic symptoms of osteoarthritis?......Page 82
The diagnosis of osteoarthritis......Page 83
Local tissue pathology......Page 84
Innervation in the joint......Page 87
Processing the Perception of Pain......Page 88
Central sensitization......Page 89
The Concept of Wind-Up......Page 90
Constitutional factors......Page 91
Footwear......Page 92
References......Page 93
Osteoarthritis: Current Role of Imaging......Page 99
Conventional radiography......Page 100
Ultrasound......Page 101
Nuclear medicine......Page 104
CT......Page 105
MRI......Page 107
References......Page 116
The Management of Osteoarthritis: An Overview and Call to Appropriate Conservative Treatment......Page 125
Diagnosis of osteoarthritis......Page 126
Investigation of osteoarthritis......Page 127
Treatment......Page 128
Education......Page 130
Exercise......Page 131
Pharmacologic Approaches......Page 137
References......Page 138
Acknowledgments......Page 142
Impact of obesity on function and gait......Page 143
Inflammation and osteoarthritis......Page 146
Managing body weight......Page 147
Exercise interventions......Page 148
Conceptual basis and delivery of the lifestyle intervention......Page 149
Translating trial results to clinical practice......Page 150
References......Page 151
Muscle and Exercise in the Prevention and Management of Knee Osteoarthritis: an Internal Medicine Specialist’s Guide......Page 157
Influence of muscle activity on knee-joint loading......Page 158
Strength......Page 159
Muscle Activation Patterns......Page 160
Evidence for the role of muscle in osteoarthritis development and progression......Page 161
Muscle Strength......Page 162
Do improvements in muscle function lead to improved symptoms and joint structure in knee osteoarthritis?......Page 163
Exercise prescription for muscle rehabilitation......Page 164
Mode of Delivery......Page 165
Type of Program......Page 166
Enhancing Uptake of Exercise and Patient Compliance......Page 167
References......Page 168
Knee Osteoarthritis: Primary Care Using Noninvasive Devices and Biomechanical Principles......Page 174
Canes, walkers, and ground reaction forces......Page 175
Tibiofemoral malalignment and the unloader brace......Page 178
Joint contact area and patellar taping or bracing......Page 182
Transient shock and viscoelastic insoles......Page 186
Laterally wedged insoles......Page 187
Medially wedged insoles......Page 189
A final word of caution......Page 190
References......Page 192
The Role of Analgesics and Intra-Articular Injections in Disease Management......Page 196
Analgesics......Page 197
Non-steroidal anti-inflammatory drugs......Page 198
Topical agents......Page 199
Hyaluronic acid......Page 200
Nutritional supplementation......Page 201
References......Page 202
Surgery for Osteoarthritis of the Knee......Page 207
Arthroscopy......Page 208
The Varus Knee with Medial Compartment Arthrosis......Page 209
The Valgus Knee with Lateral Compartment Arthrosis......Page 210
Unicompartmental arthroplasty......Page 211
Emerging technology for total knee replacement......Page 213
References......Page 214
How Close are We to Having Structure-Modifying Drugs Available?......Page 217
Is the marriage of symptoms and structure rational?......Page 218
Is there evidence that suggests we can modify disease?......Page 220
What promising targets are being explored?......Page 221
Obstacles to drug development......Page 223
References......Page 224
B......Page 229
E......Page 230
H......Page 231
K......Page 232
M......Page 233
O......Page 234
P......Page 235
S......Page 236
W......Page 237