OSTEOARTHRITIS

Definisi OA
Merupakan penyakit sendi degeneratif yang progresif
dimana rawan kartilago yang melindungi ujung
tulang mulai rusak, disertai perubahan reaktif pada
tepi sendi dan tulang subkhondral yang
menimbulkan rasa sakit dan hilangnya kemampuan
gerak.
 EPIDEMIOLOGI
• National Centers for Health Statistics, diperkirakan 15.8
juta (12%) orang dewasa antara 25-74 tahun.

• The National Arthritis Data Work Group dengan

menggunakan The First National Health and Nutritional
Examination Survey (HANES I) dan data lain meramalkan,
bahwa pada tahun 2020 diperkirakan 18,2% masyarakat
Amerika akan menderita OA

• Data di Indonesia, diketahui sekitar 56,7% pasien di

poliklinik Rheumatologi RSUPN Dr. Cipto Mangunkusumo,
Jakarta didiagnosis menderita OA.
 ETIOLOGI
1. kadar insulin-like growth factor 1 (IGF-
1) rendah
2. Usia
3. Obesitas
4. jenis kelamin wanita,
5. genetik,
6. aktifitas fisik
7. trauma,
8. kepadatan massa tulang
9. Merokok
10. endothelial cell stimulating
factor
Healthy Joint Vs OA
• Natural history of OA:
1. Progressive cartilage loss,
2. subchondral thickening,
3. marginal osteophytes
Region of OA dan Manifestasi klinis
 Tujuan Terapi
• Menghilangkan Nyeri dan Kekakuan
• Menjaga atau meningkatkan mobilitas sendi
• Membatasi kerusakan fungsi
• Mengurangi faktor penyebab
• Meningkatkan kualitas hidup
 Non Farmakologi Terapi
• Edukasi pasien
• Terapi Fisik, okupasional,
• Istirahat dan merawat persendian
• Penurunan berat badan
• Bedah (pilihan terakhir)
• Akupunktur
• Biofeedback
• Cognitive Behavioural Therapy
• Hipnosis dan teknik relaksasi (yoga dan meditasi) dll
Farmakologi Terapi
 Topical Agent
• Capcaisin cream
Gel, lotion, cream, 3-4 x/days
it may require up to 2 weeks to take effect. Adverse
effects are primarily local with one third of patients
experiencing burning, stinging, and/or erythema
that usually subsides with repeated application.
• Glucosamine dan Chondroitin
 Terapi Lain
• Intraarticular Corticosteroid
Local adverse effects can include infection, osteonecrosis,
tendon rupture, and skin atrophy at the injection site.
Diberikan 2-4 kali dalam 1 tahun
1. Triamcinolone
Dosis : 10-20 mg / injeksi

1. Methylprednisolon
Dosis :20-40 mg/injeksi
• Systemic corticosteroid
therapy is not recommended in OA, given lack of prove
benefit and wellknown adverse effects with long-term use
• Injeksi Hyaluronat
- ↓ Hyaluronat Endogen di cairan sinovial
- Beneficial for Knee OA unresponsive to other
therapy
- Injections do not provide clinically meaningful
improvement and may be associated with serious
adverse events (eg, increased pain, joint swelling,
and stiffness).
- Expensive
• Tramadol
25 mg in the morning Titrate dose in 25-
mg increments to reach a maintenance dose of
50–100 mg 3 times a day.
There is increased risk of serotonin syndrome
when tramadol is used with other serotonergic
medications, including duloxetine.
 Monitoring Terapi
• VAS/NAS
• Kekuatan dan kemampuan berjalan
• ADR
• Scr, Hematologi, dan fungsi Hati