OA (AOTA)

Question 1

What is OA

Answer 1

most common joint disorder; a non-inflammatory condition that causes breakdown of articular cartilage as a result of mechanical and chemical factors, resulting in reduced joint space and painful bone-bone contact. past age 50, more common in women than men

Question 2

primary OA

Answer 2

localized or generalized joint involvement with no known cause

Question 3

secondary OA

Answer 3

related to trauma, congenital abnormalities, infection, or necrosis

Question 4

most commonly affected joints

Answer 4

DIP PIP MCP CMC first metatarsophalangeal joint of foot cervical and lumbar apohpyseal joints knee hip

Question 5

symptoms of OA

Answer 5

joint pain joint stiffness limited ROM local inflammation crepitus of the joint pain and stiffness with activity that relieves with rest

Question 6

Bouchard’s nodes

Answer 6

osteophyte on PIP joint

Question 7

Heberden’s node

Answer 7

osteophyte on DIP joint

Question 8

diagnosing OA

Answer 8

symptoms of use related pain and stiffness after inactivity

rule out rheumatoid arthritis

radiologic study revealing osteophytes, asymmetric joint space narrowing, and subchondral bone sclerosis

Question 9

Is there a cure for OA?

Answer 9

no

Question 10

potential progress of OA

Answer 10

1. large sections of cartilage wear away
2. osteophytes form where ligaments and capsule attach to bone
3. joint may lose normal shape
4. fluid filled cysts may form near the joint
5. bone and cartilage particles may float loose in joint space

Question 11

medical management of OA

Answer 11

1. systemic medications: anti-inflammatory, analgesic
2. local medications: cortisol injection or topical capsaicin

Question 12

surgical management of OA

Answer 12

arthroscopic joint debridement

resection or perforation of subchondral bone to stimulate formation of cartilage

cartilage grafts

joint fusion

joint replacement

Question 13

OT eval for OA

Answer 13

1. ADLs/IADLs impacted by OA
2. job analysis
3. psychosocial (d/t sleep loss, depression, body image, ect)
4. current coping strategies
5. assess understanding of and adherence to post-surgical precautions if applicable
6. ROM and stability
7. Driving eval

Question 14

OT interventions for OA

Answer 14

1. environmental modifications to reduce fall risks (LE OA) /job modifications
2. PAMS for increased ROM and decreased pain
3. AROM exercises
4. isometric/isotonic strengthening exercises as tolerated (pinching exercises may be contraindicated with CMC joint instability)
5. low impact aerobic conditioning
6. spica splints for stability of CMC joint during pinching activities
7. AE with built-up or extended handles
8. education on symptom management, process of disease, joint protection, fatigue management

Question 15

principles of joint protection and fatigue management

Answer 15

1. respect pain
2. maintain muscle strength and joint ROM
3. use each joint in most stable anatomical and functional plane
4. avoid positions of deformity
5. use strongest joint available
6. ensure correct patterns of movement
7. avoid staying in one position for long periods of time
8. avoid starting an activity that cannot be stopped immediately if it becomes too stressful
9. balance rest and activity
10. reduce force and effort