OSTEOARTHRITIS A CONTINUING CHALLENGE

Osteoarthritis is a disorder of cartilage that affects almost 85% of t he population by age 75. A lack of rigorous clinical and radiographic criteria for defining the disorder makes precise determination of its prevalence impossible. The process of wear and tear explains many mani festations of osteoarthritis, but it does not account for some of the clinical findings or the biochemical changes in osteoarthritic cartila ge. Thus, other factors such as heredity, hormones, and diet may play a role. Treatment consists of teaching patients about their disease, a lleviating pain, and preserving joint function. Nonsteroidal anti-infl ammatory drugs may be no more effective than simple analgesics in reli eving the pain of this disorder. Moreover, some nonsteroidal anti-infl ammatory drugs can adversely affect cartilage metabolism, and most are possibly dangerous in elderly patients. Drugs that inhibit the produc tion or activity of chondrolytic enzymes can slow the degeneration of cartilage in some animals, but their effects on humans with osteoarthr itis are unproved. The surgical repair of severely damaged joints can have gratifying results.