Apa OSTEOARTHRITIS itu?

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Osteoarthritis adalah penyakit radang kronik pada sendi yang ditandai dengan terjadinya perlunakan progresif akibat disintegrasi tulang rawan sendi (articular cartilage), disertai pertumbuhan tulang pada batas sendi (osteophyte) dan fibrosis kapsul sendi. Adapun sendi yang paling sering terkena adalah lutut, panggul, dan pergelangan kaki, yang merupakan sendi penumpu berat badan (weight bearing joints).

Pada tahap awal penderita akan merasakan nyeri pada sendi, yang bertambah saat berdiri / berjalan atau saat naik turun tangga. Nyeri ini dapat dirasakan terus menerus atau hilang timbul, dan dapat disertai pembengkakan pada sendi. Pada beberapa kasus juga kadang disertai keluhan sendi yang terasa bergesekan (crepitation). Pada tahap lanjut dapat terjadi kerusakan dan instabilitas dari sendi yang menimbulkan gangguan fungsional yang pada akhirnya memberikan keterbatasan pada penderitanya.

Terdapat beberapa faktor resiko yang telah diteliti mempengaruhi seseorang dapat terkena osteoarthritis, terdiri dari faktor resiko sistemik : usia di atas 50 tahun, obesitas, jenis kelamin (perempuan lebih banyak terkena dibanding laki-laki), dan faktor resiko biomekanik lokal sendi : bentuk dan ukuran sendi yang tidak normal, riwayat jatuh atau patah tulang di sekitar sendi, ataupun gangguan neuromuskular.

 

 

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Gambaran perubahan sendi lutut akibat Osteoarthritis.

 

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Gambaran perubahan sendi panggul akibat Osteoarthritis.

Penderita yang datang dengan keluhan nyeri sendi akan dilakukan pemeriksaan fisik meliputi cara berjalan, perubahan bentuk pada sendi, pembengkakan, nyeri tekan, ruang gerak sendi, dan stabilitas dari sendi yang terkena. Pemeriksaan penunjang antara lain dengan pemeriksaan radiologi X Ray, untuk menilai adakah penyempitan pada celah sendi, perubahan bentuk pada permukaan sendi, maupun pada tulang di bawah permukaan sendi (subchondral bone). Pemeriksaan penunjang lain yang dapat dilakukan adalah pemeriksaan laboratorium untuk menganalisa darah atau cairan sendi (joint fluid analysis).

 

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Gambaran klinis dan radiologis penderita Osteoarthritis sendi lutut..

Mengapa disematkan istilah manajemen pada penanganan osteoarthritis? Karena penanganan penyakit ini harus dilakukan secara simultan dan holistik. Edukasi kepada penderita adalah langkah pertama, meliputi penjelasan kondisi ringan atau beratnya osteoarthritis yang dialami oleh penderita, berikut usaha-usaha yang dapat dilakukan demi mencapai tujuan kesembuhan dan kenyamanan penderita. Langkah berikutnya adalah terapi non farmakologik meliputi fisioterapi, penggunaan alat bantu, dan kontrol berat badan bila diperlukan. Terapi farmakologik antara lain menggunakan obat anti inflamasi non steroid, suplemen untuk menjaga struktur permukaan sendi (glucosamine, chondroitin sulfate), atau dengan pemberian injeksi penambahan cairan sendi (hyaluronic acid joint injection).

Langkah terakhir adalah dilakukan tindakan operatif, meliputi debridement artroskopik, osteotomi untuk mengoreksi sudut sendi, maupun operasi penggantian permukaan sendi (Total Joint Arthroplasty).

 

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Gambaran radiologis Osteoarthritis Knee yang dilakukan Total Knee Arthroplasty.

rontgen tulang pinggul
Gambaran radiologis Osteoarthritis Hip yang dilakukan Total Hip Arthroplasty.

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