Understanding Osteoarthritis- Pathophysiology, Osteophyte Formation, and NSAID Treatment Osteoarthritis (OA) is a Disease of Articular Cartilage and Subchondral Bone
Osteoarthritis is a degenerative joint disease characterized by the progressive breakdown of articular cartilage and changes in the underlying subchondral bone in diarthrodial (freely movable) joints. Articular cartilage, a smooth and elastic tissue that covers the ends of bones in joints, provides a low-friction surface for joint movement. This cartilage undergoes gradual wear and tear in OA, leading to its thinning and eventual loss (van den Bosch, 2021). Additionally, the subchondral bone, which lies beneath the cartilage, undergoes remodeling and may develop sclerosis, cysts, and other structural changes. As the cartilage deteriorates, the bones in the joint can come into direct contact, causing pain, swelling, and limited range of motion. The loss of the protective cushioning provided by healthy cartilage contributes to the symptoms associated with OA.
Role of Osteophytes in OA
Osteophytes, or bone spurs, are bony outgrowths that commonly develop in response to the stress and instability caused by articular cartilage degeneration in OA. These outgrowths form at the joint margins as the body attempts to stabilize and support the weakened joint. While osteophytes may initially serve a protective role, they can contribute to pain and functional impairment as they grow larger (van den Bosch, 2021). Osteophytes can limit joint movement and cause further damage to surrounding tissues.
Effect of NSAIDs on OA
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage symptoms of OA. They work by inhibiting enzymes called cyclooxygenases (COX), which play a role in the production of inflammatory molecules. By reducing inflammation and alleviating pain, NSAIDs can provide relief to individuals with OA (Hawker, 2019). However, it’s important to note that NSAIDs do not alter the underlying structural changes in the joint and may have side effects, particularly in the gastrointestinal system and kidneys, necessitating careful consideration of their use.
Impact of Weight Loss on OA
Weight loss is crucial in managing OA, especially in weight-bearing joints like the knees and hips. Excess body weight contributes to increased joint stress, accelerating OA’s progression. By losing weight, individuals can reduce the load on affected joints, relieving pain and improving function (Hawker, 2019). Furthermore, weight loss may have systemic effects, such as reducing inflammation, which can benefit individuals with OA throughout their body.
References
Hawker, G. A. (2019). Osteoarthritis is a serious disease. Clin Exp Rheumatol, 37(Suppl 120), 3-6.
van den Bosch, M. H. (2021). Osteoarthritis year in review 2020: biology. Osteoarthritis and Cartilage, 29(2), 143-150. https://doi.org/10.1016/