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7/21/2019 Osteo Art Ritis
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ANATOMI FISIOLOGI SENDI
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SENDI LUTUT NORMAL
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Adalah suau pen!aki ulan" k#onik di$ana e#%adi pelunakan dan desine"#asi da#i ulan" #a&an sendi
dise#ai pe$'enukan ulan" dan ulan" #a&an 'a#u pada epi sendi (oseo)i* dan e#%adi )i'#osis kapsulsendi.
OSTEOARTRITIS
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PENYEBAB
Mekanisme abnormal pada proses
penuaan
Trauma
Kerusakan ulan! ra"an sendi
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Kelainan yang dapatmenimbulkan
osteoartritis Ter#adin$a kerusakan pada ulan!
sub%arikuler Menin!kan$a ekanan pada iik
erenu pada ra"an sendi
Beban berlebi&an aau kerusakanulan! ra"an sendi ole& karenasuau &al'
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A B C
Oseoarriis akiba (
A' Kerusakan pada ulan! sub%arikuler
B' Menin!kan$a ekanan pada iik erenu
)' Kerusakan ulan! ra"an sendi ole& karenasuau &al
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KLASIFIKASI1. Osteoartritis Primer
Tidak dikea&ui pen$ebabn$a*ania kuli pui&
Usia peren!a&an PoliarikularNodus +eberden
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. OsteoartritisSekunder
Disebabkan ole& pen$aki$an! men$ebabkan
kerusakan pada sino,ial'
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Beberapa pen$ebab ( Trauma - insabilias
.akor !eneik -perkemban!an
Pen$aki meabolik - endokin
Oseonekrosis
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ETIOLO!IFaktor predisposisi" Umur /enis kelamin Ras .akor keurunan .akor meabolik-endokrin
Trauma dan 0akor okupasi )ua1a-iklim Die
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I#SI$E#S Teruama di aas 23 a&un
Dapa pada usia muda akiba kerusakan
ulan! ra"an sendi
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PATO4ENESIS
FAKTOR
!E#ETIK
PE#%E&A&
EKSTER#AL
Peruba'an (ungsik'ondrosit melepasen)im peng'an*ur
Stressmekanik
Peruba'anmatriks
proteogly*an
Peruba'anmatrikskolagen
+ineralisasi
Radang syno,ia
Peruba'antulang ra-an
$estruksikartilago
!eala OA
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PATOLO!I
5' Tulan! ra"an sendi
6' Tulan!
7' Membran sino,ial8' Kapsul sendi
2' Badan lepas 9loose bodies:
;' E0usi<' Nodus +eberden dan Bou1&ard
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Tulan! ra"an sendi
Berkuran!n$a kondroiin sul0a
Ter#adi perlunakan danire!ularias pada ra"an sendi
Permukaan sendi men#adi kasar
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Tulan!
Ter#adi penin!kaan ,askularisasi
dan pembenukan oseo= Terbenuk kisa $an! ber&ubun!an
den!an sendi dan berisi 1airan
sino,ial melalui de0ek pada ulan!
subkondral
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Membran sino,ial
Ter#adi &iperro= ,ilus
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Kapsul Sendi
Ter#adi =brosis dankonrakur kapsul sendi
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Badan lepas 9loose
bodies: Tulan! ra"an $an! nekrosis
men!alami abrasi dan erlepas ke
dalam ruan! sendi> menimbulkanreaksi pada membran sino,ial'
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E0usi
Pada sadium a"al
Pada eksaserbasi in?amasi aku
)airan bersi0a #erni& @iskosias in!!i
Proein renda&
Pada oran! ua dapa&emora!ik
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Nodus +eberden dan
Bou1&ard Akiba de!enerasi membran kapsul
dan #arin!an lunak sendi
Membenuk kisa men!andun!asam &ialurona
Ter#adi meaplasia ulan! dan ulan!
ra"an
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Normal Oseoarriis
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!E/ALA KLI#IS N$eri
Kaku sendi Pemben!kakan 4an!!uan per!erakan
De0ormias Nodus +eberden dan Bou1&ard
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#odus 0eberden dan&ou*'ard
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LA&ORATORI+ La#u endap dara& biasan$a normal
Serum koleserol sediki menin!!i
.akor reumaoid 9%:
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PE+ERIKSAA#
RA$IOLO!IK 1. Foto polos
. Radionuklidas*anning
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Foto PolosDensias ulan! normal aau menin!!iPen$empian ruan! sendiSklerosis ulan! subkondralOseo= pada epi sendi
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Radionuklida
S*anning Men!!unakan m T1%+DP
Terli&a penin!kaan aki,ias ulan!
pada subkondral sendi
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Oseoarriis Pan!!ul
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Oseoarriis pan!!ul
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Oseoarriis luu
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Oseoarriis luu
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Oseoar&riis ba&u kanan
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Oseoarriis pada sendi iner0alan!
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PE#!O&ATA#5' Pen!obaan Umum
6' Oba%obaan
7' Aspirasi bila ada 1airan sendi
8' Bidai
2' Tindakan operasi
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Pengobatan
mum5' Isira&a eraur
6' Men!uran!i beban pada
sendi7' Lai&an sais
8' .isioerapi
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Obat2obatan
Anal!eik dan ani in?amasi
In#eksi seroid
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IN/EKSI INTRA%ARTIKULAR
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Aspirasi bila ada*airan sendi
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Bidai
Pada n$eri aku
Men!oreksi de0ormias
Men!uran!i beban ubu&
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Tindakan operasi
N$eri $an! idak eraasi den!an oba aau
indakan lokal
Sendi $an! idak sabil karena subluksasi aau
de0ormias
Kerusakan sendi lan#u
Men!oreksi beban pada sendi a!ar
disribusin$a erba!i sama raa
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Sendi
panggul"Oseoomi
9A5>A6:Arroplasi
Arrodesis 9B:
A5 A6 B
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Sendi luu( Oseoomi in!!i ibia 9): +emiarroplasi Arroplasi oal 9D: Arrodesis
D
)6)5
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Oseoomi pan!!ul
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Oseoomi ibia
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+ip #oin repla1emen
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+ip ar&roplas$
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Arroplasi luu
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Knee #oin repla1emen
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Knee ar&roplas$
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S&oulder ar&roplas$
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Arrodesis pan!!ul
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Arrodesis luu
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*ASSALAM'