Osteoarthritis: The Facts

204 Pages·2014·3.45 MB·English

by  David J. Hunter

facts
Osteoarthritis
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facts
Osteoarthritis
SECOND EDITION
DANIEL
PRIETO-ALHAMBRA
Senior Clinical Research Fellow
Nuffield Department of Orthopaedics, Rheumatology
and Musculoskeletal Sciences
University of Oxford, UK
NIGEL ARDEN
Professor in Rheumatic Diseases
Director of Musculoskeletal Epidemiology and Biobank
University of Oxford and Southampton, UK
DAVID J. HUNTER
Florance and Cope Chair of Rheumatology
and Professor of Medicine
Institute of Bone and Joint Research, Kolling Institute
University of Sydney and Royal North Shore Hospital,
Australia
1
1
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
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© Oxford University Press 2014
The moral rights of the authors have been asserted
First Edition published in 2008
Impression: 1
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British Library Cataloguing in Publication Data
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Library of Congress Control Number: 2014933295
ISBN 978–0–19–968391–8
Printed and bound by
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Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-to-date
published product information and data sheets provided by the manufacturers
and the most recent codes of conduct and safety regulations. The authors and
the publishers do not accept responsibility or legal liability for any errors in the
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adult who is not breast-feeding
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Acknowledgements
To all the patients that I have had the opportunity to care for, thank you for the
privilege.
To David’s adoring and beautiful wife Jo and four fantastic children (Jordan, Sam,
Charlie, and Hannah), thank you for giving me a full and complete life, and for
understanding when my obsession with my profession compromises our time together.
To my friends, colleagues, and family who read and edited this book, thank you for
your help and encouragement.
DH
To Maria, to Pau, and to little Bella
DPA
v

Contents
Abbreviations ix
Introduction to osteoarthritis xi
Part one
Background to osteoarthritis
1 What is osteoarthritis? 3
2 Why we get osteoarthritis and how to prevent it 11
3 Symptoms and signs 21
4 How is osteoarthritis diagnosed? 29
5 The outlook or prognosis 39
Part two
Management of osteoarthritis
6 The management of osteoarthritis—an overview 51
7 The role of exercise 65
8 The role of diet and weight loss 79
9 Complementary or alternative therapy 91
10 Medicines used in osteoarthritis 101
11 Device use and other therapies for osteoarthritis management 119
12 Surgical therapy 127
13 Depression and coping 143
vii
Osteoarthritis · facts
14 Which health professionals are involved in OA management?:
making the most of your healthcare team 157
Appendix 1 A typical case history 169
Appendix 2 Useful addresses 173
Glossary 177
Index 183
viii
Abbreviations
ACL anterior cruciate ligament
AC acromioclavicular
ACR American College of Rheumatology
ARC Arthritis and Rheumatism Council
ACI autologous chondrocyte implantation
ACT autologous chondrocyte therapy
BMI body mass index
CBT cognitive behaviour therapy
CT computed tomography
DIP distal interphalangeal
ESR erythrocyte sedimentation rate
EFA essential fatty acid
EULAR European League Against Rheumatism
FIFA Fédération Internationale de Football Association
FDA Food and Drug Administration
GP general practitioner
IOC International Olympic Committee
IU international units
kcal kilocalorie
kJ kilojoule
MRI magnetic resonance imaging
MCP metacarpophalangeal
MAOI monoamine oxidase inhibitors
NSAID non-steroidal anti-inflammatory drug
OT occupational therapist
OA osteoarthritis
OMM osteopathic manual medicine or osteopathic manipulative medicine
PM&R physical medicine and rehabilitation
PCP primary care physician
PMR progressive muscle relaxation
ix