Oa progression

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Starts with damage of a highly loaded part

Focal wear then painful symptoms

Pain and inactivity -- diet changes

Increasing weight -- increasing load

Inactivity weakens cartilage, bone, ligaments and muscles with more loss of support

Localized wear changes alignment and adds further to load and increasing damage.

Vicious cycle: increase load -> decrease use = more damage Vicious cycle: increase load -> decrease use = more damage

How Does Knee OA Progress?How Does Knee OA Progress?

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Speeds Up Inactivity

Excessive load

Weight gain

Delaying treatment

Slows Down Keeping mobile and strong

Modifying loading activity

Weight loss

Early treatment

Factors Affecting ProgressionFactors Affecting Progression

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Mild varus Mild varus Grade 2 damageGrade 2 damageJoint Replacement Joint Replacement not indicatednot indicated

Marked varus Marked varus Grade 8 damageGrade 8 damageJoint Replacement Joint Replacement indicatedindicated

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What the surgeon seesHealthy

ProgressionProgression