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Category: Volume 08 Issue 08 August 2020
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Title: The Role of Intra-Articular Viscosupplementation in Treatment of Early Osteoarthritis of Knee: An Interventional Study

Authors: Dr Shikha Dhaundiyal, Dr Deepak Joshi

 DOI: https://dx.doi.org/10.18535/jmscr/v8i8.47

Abstract

Introduction

OA is a degenerative joint disease and most common form of arthritis worldwide. Kneeis the most common joint . Women are most commonly affected. The prevalence increases with age and become significant after 50 years of age.1

OA is characterized by pain and progressive joint dysfunction resulting from destruction of the cartilage and subchondral bone, with reduction of the joint space, inflammation/synovitis and formation of periarticular osteophytes. Among the major joints, the knees are the most common to be affected.2

OA is the eleventh highest contributor to global disability.3-4

OA of knee may be classified as either primary or secondary. Primary OA is idiopathic, most probably natural wear and tear, while in secondary OA there is a link to a specific cause, such as previous injury to a joint, altered biomechanics or inflammatory arthritis.5-7

Characteristic changes in OA includes progressive articular cartilage loss, increased subchondral plate thickness and sclerosis, osteophytes formation at joint margins and formation of subchondral bone cyst. Junctional zone between articular cartilage and subchondral bone is known as tired mark zone which is composed of calcified cartilage remnant.8-13

When the rate of damage exceeds the rate of repair, degeneration of the bone and cartilage ensues and the joint fails to effectively dissipate load. This results in a cycle of biomechanical loading and biochemical degeneration, where the shock-absorbing cartilage is progressively destroyed, exposing the bone to greater load and leading to bone damage (bone marrow lesions).14 This leads to further loss of cartilage, narrowing of the joint space (the space between the bones) and the overgrowth of bone (osteophyte formation), which causes hard lumps to develop around the joints.15-17

Cytokines associated with adipose tissue, include leptin, adiponectin and resist in have a evolving role in OA.18

Knee most common joint in OA cause significant disability impairs patient QOL (quality of life).19-20

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Corresponding Author

Dr Shikha Dhaundiyal

Senior Resident (MD Sports Medicine) Gold Medalist Sports Injury Centre, VMMC & SJH