Expertise Details



Osteoarthrosis is a degenerative condition of the joints. As there is no inflammatory process, the earlier terminology of osteoarthritis is no longer used. Osteoarthrosis can be broadly grouped as follows-

1- Primary osteoarthrosis when there is no previous pathology.

2- Secondary osteoarthrosis when it is secondary to some previous pathology.

Primary Osteoarthrosis

Primary osteoarthrosis is due to the wear and tear changes occurring in old age in which weight bearing joints like the hips and knees are more commonly affected. It is uncommon in non - weight bearing joints like the shoulder and elbow. Obesity is a predisposing factor.

Osteoarthrosis is a progressive process affecting the articular cartilage of aging joints. It is characterised by focal degeneration of the articular cartilage. As the articular cartilage is cyclically loaded during movements of joints, it undergoes fatigue failure leading to fragmentation of the surface and fibrillation. In the later stage, the cartilage gets completely eroded, exposing the sclerosed ( eburnated ) bone and subchondral cysts are also formed .

The bone undergoes reactive hypertrophy forming peripheral osteophytes. The synovial membrane undergoes hyperemia and reactive inflammatory thickening. As there is no destructive pathology, the joint does not get ankylosed.

Secondary Osteoarthrosis

Secondary osteoarthrosis is due to an abnormal wear and tear in a joint, caused by mechanical incongruity of the articular surfaces. This incongruity may be the result of a preceding fracture involving the articular surface or partial destruction or deformity due to a previous discase.


Primary osteoarthrosis of the knee is a common clinical problem. The patient is usually a male above 50 years and presents with pain, swelling and restricted movements and inability to squat in the Indian toilet. The onset is insidious starting with a mild aching pain in the joint which is relieved by rest. The other main symptom is stiffness, which is maximum at the end of a long rest period and loosens on activity for a few minutes.

The cause of secondary osteoarthrosis in the knee joint is alterations in the congruity of the articular surfaces due to various lesions, such as

1- Malunion of fractures involving the articular surfaces of tibia, femur or patella

2- Loose bodies in the joint

3- Malalignment of the bones due to deformity like genu valgum or genu varum

Clinical features

On examination, the joint is swollen and there may be an effusion into the joint. The synovium is thickened and is tender. There is tenderness in the joint line and over the attachment of the medial ligament. Movements are restricted. Crepitations are felt on movement. In late cases there is often a genu varum deformity.

Radiological features

The earliest change seen is the narrowing of the joint space and subchondral sclerosis in the medial compartment of the joint. Later, osteophytes are seen in the periphery of the articular surfaces of the femur, tibia and patella.

Conservative Treatment

Physiotherapy including short wave diathermy, interferential therapy or laser therapy helps in relieving the pain. Quadriceps exercise is very important in the treatment of the osteoarthrosis of the knee joint. It helps in maintaining the stability of the joint, controls the effusion and improves the blood supply to the joint structures.



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