ABSTRACT
Osteoarthritis is a metabolically active, dynamic process that involves all joint tissues. Generally, it tends to affect the hand, knee, hip, spine, and foot joints, where its pathology involves new bone formation at the joint margins and results in the degeneration of the hyaline cartilage synovial fluid and soft tissues of the affected joints. The medial tibio-femoral compartment of the knee is most commonly affected by osteoarthritis and this particular compartment is a good example of how biomechanical factors are now known to play a key role in the development of osteoarthritis. Pharmacologically speaking, the National Institute for Health and Clinical Excellence (NICE) guidelines confirm paracetamol in early pain management. The guidelines also suggests early consideration of topical non-steroidal anti-inflammatory drugs (NSAIDs) for knee and hand arthritis, and suggest that wherever systemic NSAIDs or cyclooxygenase-2 (COX-2) inhibitors are used, they should be co-prescribed with cover from a proton pump inhibitor (PPI).
