OSTEOARTHRITIS (OA)

A disease that involves degeneration

in various structures of the joint,
including cartilage, bone, synovium,
muscles & ligaments
 PREVALENCE
3

 Women > 40 years

 Men > 50 years

 Women : OA hand
 Men : OA hip
 RISK FACTOR
4

•KEGEMUKAN

•USIA LANJUT

•GG METABOLISME & HORMONAL

•CEDERA SENDI, PEKERJAAN & OLAH RAGA

•GENETIK

•KELAINAN PERTUMBUHAN
 Normal knee Osteoarthritic knee

thickened capsule
capsule
cyst formation
cartilage sclerosis in
subchondral bone
synovium
fibrillated cartilage

bone synovial hypertrophy

osteophyte formation

ACRFP
PATOGENESIS
6

 Penyakit dengan proses degeneratif yang

berlangsung aktif & progresif
 Tulang rawan menjadi tidak homogen, mudah
pecah, & akhirnya hilang seluruhnya dari
permukaan tulang sendi
 Muncul upaya kompensatorik dgn pembentukan
osteofit di tepi sendi utk memperluas
permukaan sendi
 TANDA KLINIS
7

 RASA NYERI
 PERUBAHAN BENTUK
 PERADANGAN
 HAMBATAN GERAKAN SENDI
 KAKU PAGI HARI
 KREPITASI
 PEMBESARAN SENDI
 PERUBAHAN GAYA BERJALAN
Physical Examination
 Inspeksi
 Palpasi
 Special test : Patellar grinding test
Anterior / Posterior drawer
test
The American College of
Rheumatology Criteria for the
Classification of Osteoarthritisof
the Hand, Hip & Knee
Hand
Hand pain, aching, or stiffness, and at least
three of the following :
 Hard tissue enlargement of 2 or more of 10
selected joints
 Hard tissue enlargement of 2 or more DIP
joints
 Fewer than 3 swollen MCP joints
 Deformity of at least 1 of 10 selected joints
Hip
Hip pain and at least two of the following :
 ESR < 29 mm/hr
 Radiographic femoral or acetabular
osteophytes
 Radiographic joint space narrowing
Knee
Knee pain plus at least five of the following :
 Age > 50 yr

 Stiffness < 30 min

 Crepitus

 Bony tenderness

 Bony enlargement

 No palpable warmth

 ESR < 40 mm/hr

 Rheunmatoid factor < 1:40

 Synovial fluid signs of osteoarthritis (clear, viscous, or

white blood cell count < 2000/mm3
Knee
Knee pain plus at least one of the following :
 Age> 50 yr
 Stiffness < 30 min
 Crepitus plus osteophytes
Knee
Knee pain plus at least three of the following :
 Age > 50 yr
 Crepitus
 Bony tenderness
 Bony enlargement
 No palpable warmth
Grade of OA
0 = No radiographic findings of OA

1 = Minute osteophytes of doubtful clinical significance

2 = Definite osteophytes with unimpaired joint space

3 = Definite osteophytes with moderate joint space

narrowing

4 = Definite osteophytes with severe joint space

narrowing, and subchondral sclerosis
1. Mengurangi nyeri
2. Menjaga / mempertahankan mobilitas
3. Mencegah terjadinya gangguan fungsi
4. Memperbaiki kualitas hidup
5. Mencegah efek samping obat
 PENATALAKSANAAN
18

 MEDIKAMENTOSA
 TERAPI REHABILITASI MEDIK
 BEDAH
REHABILITASI MEDIK PADA OA

 Terapi modalitas :
 Terapi panas
 Terapi dingin
 TENS
 Terapi Laser
 Hidroterapi
 Exercise
 Ortesa
 Home program/home exercise prog
TERAPI DINGIN
1. Kompres es pd bagian yg nyeri selama 15 – 20 menit
2. Massage ice tube selama 5 menit.
3. Indikasi : fase akut dengan tanda inflamasi (calor, dolor, tumor,
rubor).
4. Kontra indikasi : allergi dingin
5. Mekanisme bekerjanya → vasokonstriksi dan mengurangi
inflamasi.
TERAPI PANAS

2 Macam terapi panas

1. Terapi panas superfisial (kompres
hangat,Hot pack & infra red)
2. Terapi panas dalam (SWD, MWD & USD)

Kontra indikasi : fase akut

 Mekanisme kerja :
panas → vasodilatasi, sehingga
mengurangi inflamasi, kekakuan
Transcutaneous electrical nerve stimulation (TENS)
Mekanisme kerja : bloking gate control → nyeri ↓↓

Low Level Laser Therapy

Mekanisme kerja: Mengurangi nyeri.

1.Meningkatkan / mempertahankan luas gerak
sendi
2.Meningkatkan / memulihkan kekuatan otot –
otot sendi
3.Meningkatkan / memulihkan stabilitas sendi
lutut
4.Endurance Aerobik
Latihan ROM

Pada Lutut Pada Ankle

Latihan strengthening

QUADRICEPS ISOMETRIC EXERCISE Strengthening m.

Quadriceps dengan
Quadriceps bench
 ENDURANCE AEROBIC
JENIS LATIHANNYA :
1. Bersepeda
2. Berenang
Knee brace