Discussing Osteoarthritis - Essay Example

Osteoarthritis Name Course Name and Code Instructor’s Name Date Word Count: 1513 Introduction Across the world, numerous diseases exist that affects the body differently. An example of such disease is osteoarthritis. Osteoarthritis is also called degenerative arthritis is a disease that causes mechanical abnormalities that degenerates the joints that include the subchondral bone and articular cartilage. Some symptoms associated with the disease include tenderness, joint pain, locking, stiffness and sometimes effusion. The disease is associated with numerous causes that include developmental, mechanical, metabolic and hereditary that may initiate the loss of cartilage (Van, Nace and Mont, 2012). When the joint cartridge becomes less effective it results osteoarthritis. Therefore, the aim of this paper is to discuss osteoarthritis bringing into consideration structural/functional capabilities and pathphysiology. Osteoarthritis To enable understanding of osteoarthritis, it is important to understand joints and other structures that come together to form the joint and fulfil its functions (Sharma and Berenbaum, 2007). Joints allows mammals to move, bend, rotate and close hand to name some functions of a joint, and therefore, joints allows individuals to interact easily with the environment. Joints and movements also define stability since the more the joints, the greater instability an individual looses (Van, Nace and Mont, 2012). The extent of stability is also determined by extend in which that joint functions. For example, the shoulder joint is less stable compared to pelvic joint because the shoulder joint has numerous functions compared to the pelvic joint that has fewer joints. This means that joints is composed of specialised structures and tissues that allows for a varying degree of stability and mobility specific to a given task. Synovial Joint It is also refereed as the diarthrosis is one of the mammals’ joints and it is also the joint that can be moved most. The joins allows for movement through contacting point with bones surrounding it among other joints. However, there are functional and structural differences that exist, which allow distinguishing between synovial joints with other type of joints (Van, Nace and Mont, 2012). Major difference of synovial joint from other joints is the presence of capsules and lubricating fluid. Numerous synovial joints exist such as hinge joints, gliding joints, condyloid joints, socket and ball joints, saddle joints, compound joints and pivot joints (Deweber, Olszewski and Ortolano, 2011). These different joints fulfil different functions and are responsible for accomplishing certain tasks. Cartilage Structure Cartilage is a major component within the joint and also a factor in causing osteoarthritis. The aim of a joint is to separate two ends of a bone. However, the bones are not supposed to rub against each other and thus the importance of cartilage (Van, Nace and Mont, 2012). The cartilage is attached to the bone and it has certain characteristics that lubricate resulting in a surface that is frictionless and allows easy movement (Altman and Barkin, 2009). Within this cartilage, presence of some cells known as chondrocytes exist that allows production of proteins, which are called proteoglycans that are able to retain huge amounts of water. This feature reduces friction and also makes the cartilage to become an effective shock absorber. Another important component that makes up a joint is the joint capsule, which encloses the joint and defines the boundary of a joint. The cells that lines up the capsule are known as synoviocytes. The synoviocytes also contributes the lubricating fluid that allows for frictionless motion (Van, Nace and Mont, 2012). Moreover, these cells monitor and respond to any invaders and are usually the target of rheumatoid arthritis. In addition, ligaments also play a major role in fulfilling the functions of joints (Deweber, Olszewski and Ortolano, 2011). Ligaments can be viewed as struts that control movements and prevent movements that are unwanted. This means that it ensures that a joint is stable (Van, Nace and Mont, 2012). Another component that contributes to this stability includes the tendons and muscles. In addition to cartilage, there is another membrane referred as meniscus that acts as shock absorber and stability controller. Pathophysiology of the Disorder and associated symptoms to normal function Osteoarthritis usually affects the cartilage in which a cell known as the chondrocyte is found. These cells originate from chondroblasts, which is trapped in regions where cartilage developed called lacunae. From this region, these cells operate to produce constitutes e.g. collagen that creates the functional characteristics found in cartilage (Van, Nace and Mont, 2012). A disadvantage that exists on the presence of these chondrocytes been located within lacunae region is that they can move easily towards the regions that are damaged. Due to this effect, cartilage has poor disadvantage of healing. Moreover, the situation is worsened by cartilage matrix that acts as a barrier to cells that are immune, such as immunoglobulins and lymphocytes, which contributes to healing process (Deweber, Olszewski and Ortolano, 2011). In addition, the absence of blood flowing into the cartilage means that formation of new matrix is slow resulting in lack of recovery. This means that even though the cartilage has unique structure that is crucial for functional characteristics, its inefficiency in recovery from injury makes it prone to risks (Van, Nace and Mont, 2012). The inefficiency in the repairing damage continues to an extent it becomes osteoarthritis. Presence of osteoarthritis causes the typical symptoms, which include deformity, pain, and finally loss of its function. From the analysis, it is evident that abnormal functionality of chondrocyte, which is a major step towards osteoarthritis. Two factors exist that contributes and accelerates the process towards the disease. These two factors are the abnormal biomechanics and genetics that place a lot of pressure to the joint translating to cartilage. The onset of osteoarthritis is attributed to initial abnormality that is associated with the chondrocyte. Consequently, the cartilage composition starts to change because of this malfunction. A large protein that usually retains water within the cartilage is not produced optimally overtime resulting in dehydration (Van, Nace and Mont, 2012). Due to dehydration, any load applied to the joint or structure increase chances of it cracking or failing. Fissuring is the process that results from cracking and overtime, the cartilage starts to flake away and absence of production of cartilage resulting in narrowing of the joint spaces (Deweber, Olszewski and Ortolano, 2011). With time, the absence of cartilage means that bone will move against bone, starting a process of irreversibility of the condition. During the early stages of the disease, the body tries to strengthen the joint by laying more bone around the joint. This bone formation contributes to the formation of osteophytes. The role and formation of bone is not to sustain this heavy and repetitive load of the joint and hence result in fatigue. The result of the fatigue on the bone is the pain (Van, Nace and Mont, 2012). The bone that is found adjacent to the joint starts to develop micro-fractures that causes swelling and then sending a signal of pain towards the brain. Progression of the disease also affects other parts of the body such as the joint lining, which contributes to the symptoms endured by the affected person (Deweber, Olszewski and Ortolano, 2011). At this stage is when the joint deformity progresses at a faster rate resulting in loss of function and hence preventing capacity of performing desired tasks. Apart from genetics, other factor that affects the chondrocyte function is joint load. This may come in terms of forces across joint distribution and traumatic event (Van, Nace and Mont, 2012). For example, a traumatic event on the ligaments or joint such as fracture contributes to the development of osteoarthritis (Moskowitz, 2007). This is independent to any medical approach or measure. An example of situation in which a ligament can be affect is during sport events such as rugby and football whereby a person is required to make dramatic change of direction resulting in rupture of anterior cruciate ligament of the knee (Van, Nace and Mont, 2012). The injured athlete proceeds for surgical repair and even though the situation may be repaired, incidence of occurrence of osteoarthritis increases. From this analysis, the injury sustained during sporting incites changes of chondrocyte function that contributes to failure subsequently to osteoarthritis development. Biomechanics defines those components that are within the joint that may include tendons, muscles and joints either below or above (Carr et al., 2012). Positioning of these joints including tendons may contribute to osteoarthritis and also the shape and structure of the bones may contribute to the disease because of genetics. These two factors contribute immensely to the functioning of the joint and define contributing factors to occurrence of the disease. Conclusion Osteoarthritis is an example of degenerative disease that affects the joints. The disease results from decrease in cartilage that may be associated to mechanical or genetic factors. In the case of mechanical, injuries on joints during is a factor that may lead to the disease while genetic may define orientation of the joint and thus may translate in causing the disease. The cartilage provides means in which the joints are lubricated reducing friction and hence allows the joint to operate effortless but any external injury may force it to function less efficient. References List Altman, R., and Barkin, R. 2009. Topical therapy for osteoarthritis: clinical and pharmacologic perspectives. Postgraduate Med., vol. 121, no. 2, pp. 139–47 Carr, A., Robertsson, O., Graves, S., Price, J., Arden, N., Judge, A., and Beard, D. 2012. Knee replacement. Lancet, vol. 379, no. 9823, pp. 1331–40. Deweber, K., Olszewski, M., and Ortolano, R. 2011. Knuckle cracking and hand osteoarthritis. Journal of the American Board of Family Medicine, vol. 24, no. 2, pp. 169–74. Moskowitz, R. 2007. Osteoarthritis: Diagnosis And Medical/Surgical Management, 4th Ed. London: Lippincott Williams & Wilkins Sharma, L., and Berenbaum, F. 2007. Osteoarthritis: A Companion to Rheumatology. New York: Elsevier Health Sciences Van, M., Nace, J., and Mont, M. 2012. Management of primary knee osteoarthritis and indications for total knee arthroplasty for general practitioners. The Journal of the American Osteopathic Association, vol. 112, no. 11, 709–715. Read More