arthrosis

Arthrosis (osteoarthrosis, arthrosis deformans) is a process of slow degeneration and destruction of cartilage in joints. The articular ends of the bones deform and grow, and the periarticular tissues become inflamed. The general diagnosis of "arthrosis" means a group of diseases that are similar in symptoms but differ in origin. The joint - the affected area - consists of articular surfaces covered by cartilage tissue, a cavity with synovial fluid, a synovial membrane and an articular capsule. With advanced disease, it loses mobility and the patient experiences pain due to inflammatory processes.

Causes

Arthrosis of the joints develops due to a mismatch between the amount of stress and the body's capabilities. Lack of nutrients, excess body weight, heavy physical work and even sports can cause this.

Factors affecting the development of the disease:

• genetics, hereditary predisposition;
• age over 40 years;
• obesity, overweight;
• sedentary work, passive lifestyle;
• hard work, work that involves constant physical activity;
• inflammatory diseases;
• congenital joint pathologies (dysplasia);
• injuries, wounds;
• dysfunction of the body (poor blood circulation, imbalance of hormones, trace elements).

The disease can be primary or secondary. The causes of primary arthrosis are still not well understood. Doctors believe that it develops in the presence of genetic factors (predisposition) and unfavorable external conditions.

Secondary arthrosis occurs against the background of inflammatory diseases, dysplasia and as a result of injuries, including professional ones.

Representatives of working professions and athletes have an increased chance of developing the disease. At risk are also representatives of the arts: dancers (especially ballerinas), pianists. Arthrosis of the joints of the wrist and fingers most often affects people whose work involves fine motor skills: mechanics, mechanics and pianists. "Professional" arthrosis of loaders is localized in the knees, clavicle and elbows. Drivers, painters and miners suffer from elbow and shoulder joints. The weak point of ballerinas is the ankle. Athletes are also more likely to have injuries to the ankle and other joints of the arms and legs, depending on the type of sporting activity. For example, a tennis player will be at high risk for shoulder and elbow joint disease.

Pathogenesis

Structural changes in cartilage occur due to an imbalance between tissue breakdown and repair. Collagen and proteoglycans are gradually "washed" from the body, new nutrients are not supplied. Cartilage tissue loses elasticity, becomes soft and cannot withstand stress.

Regardless of location and root cause, the disease develops in the same way. Gradually, the cartilage is completely destroyed, the ends of the bones "grind" against each other. The patient experiences pain, the intensity of which increases depending on the stage. Joint mobility gradually decreases, the patient is limited in movement.

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Distribution

Orthopedists use the classification formulated by the professor in 1961:

• Stage I. The bone becomes denser, the joint space narrows a little. Discomfort during physical activity, which goes away after rest;
• Phase II. The joint space narrows significantly, the ends of the bones grow and the connective tissue becomes denser. The pain becomes constant, the muscles hypertrophy, the joint is much less mobile, specific symptoms appear in the location;
• Phase III. Joint space is virtually absent, bony growths are extensive, and the bone beneath the cartilage is likely to be destroyed. The link is completely deformed and immobile. Acute or constant pain is possible depending on the type and location of the disease;

Depending on the location and form of the disease, the symptoms, speed of development and treatment methods will vary.

shape

The disease is characterized by a chronic form, but it can also appear in an acute form.

When the disease spreads to several joints (for example, the fingers), it is called generalized.

Anatomical forms:

• deforming (osteoarthrosis). Leads to bone growth;
• pambuleDestroys discs and intervertebral tissues in the cervical region;
• post-traumatic. It develops as a result of trauma, injury;
• rheumatoid. Autoimmune disease, inflammation of connective tissue. It can be a consequence of previous arthritis;
• psoriatic. It develops against the background of psoriatic arthritis.

Localisations

Osteoarthritis is a disease that affects joints throughout the body.

Back. The causes can be autoimmune diseases, back diseases, increased stress, injuries, lack of trace elements, hormonal imbalance.

Locations:

• coccyx;
• midsection;
• thoracic spine;
• cervical region

The legs. Knees and joints are more susceptible to arthrosis. The reasons are injuries, excess weight, incorrect, excessive loads. Types of localization:

• gonarthrosis - knees;
• patellofemoral - femur and patella;
• ankle;
• talonavicular joint;
• feet and toes.

Hands. Lesions of the hands and fingers are more frequent and in most cases are associated with professional activities, injuries, age-related and hormonal changes. In addition, the disease is localized in the joints of the shoulders, wrists and elbows.

Bust. Localization in the trunk is less common compared to arthrosis of the extremities. Lesions are associated with professional activity, a sedentary lifestyle.

Types of localization:

• clavicle. When you move, "clicks" and pain are felt. At risk are athletes involved in weightlifting and military personnel due to possible injuries;
• hip joints (coxarthrosis). The disease manifests itself as pain in the hip area.

Head>. Sometimes dental problems, autonomic disorders and even hearing loss are caused by damage to the temporomandibular joint. Swelling disrupts the symmetry of the face, can affect the ear and cause headaches.

Symptoms

Symptoms of the disease depend on its location. Common manifestations for all types are:

• pain in the affected area. In the early stages - during movement, work, in the later stages - at rest;
• inflammation, swelling. The periarticular tissues swell, the skin becomes red;
• "clicks", crackles. During movement, characteristic sounds are heard;
• difficulty moving. As the disease progresses, the mobility of the affected area is impaired;
• reaction to cold. Many types of arthrosis are characterized by worsening in rainy and cold weather.

Exacerbations of the disease are accompanied by general weakening of health. Due to viral diseases and increased stress, it takes an acute form and develops many times faster. During an exacerbation, symptoms, especially pain, become more pronounced. It is difficult for the patient to move, to the point of complete loss of mobility, and to perform usual work.

Possible complications

The main risk is the loss of joint mobility, its deformation beyond the possibility of recovery. Due to the displacement of the axis, the attitude is broken and the figure loses its symmetry. Increased potential pressure on internal organs, their displacement, compression. Associated diseases and failures of body systems appear. For example, with arthrosis of the coccyx in women, gynecological complications are possible, and arthrosis of the temporomandibular joint or cervical spine causes disturbances in the autonomic system: dizziness, sleep disturbances. A patient with arthrosis can become disabled.

Diagnosing

To make a diagnosis, a comprehensive examination is performed:

• history taking;
• radiographs in several projections;
• MRI and CT to exclude tumors and obtain a three-dimensional image;
• blood and urine tests to rule out co-morbidities and assess general health.

Depending on the cause of the disease, the patient is referred to a rheumatologist, traumatologist, surgeon or orthopedist.

Treatment

Stage I of the disease is best treated. Patients with stage II can expect long-term relief from bone destruction. Stage III most often requires surgical intervention.

Conservative (non-surgical) treatment:

• physiotherapy, use of orthoses, canes, crutches to reduce the load. Elimination of accompanying and aggravating factors (for example, weight loss, stress, change of activity);
• taking non-steroidal anti-inflammatory drugs. Selective COX-2 inhibitors are the most effective. Chondroprotectors and atypical antidepressants are prescribed as auxiliary agents;
• intra-articular injections of glucocorticoid hormones to reduce severe pain and inflammation.

Surgical methods:

• arthroscopy - internal examination of the joint and removal of cartilage fragments;
• arthroplasty - implantation of artificial cartilage;
• osteotomy - removal or dissection of bone tissue;
• chondroplasty - cartilage restoration;
• arthrodesis - artificial immobilization of a joint (usually the ankle);
• endoprosthetics - removal and replacement of damaged joints with artificial ones.

Cardinal treatment allows you to stop the disease even at a late stage. It is possible to restore mobility in isolated cases (after replacing it with an artificial one). However, this method is effective in combating pain. After surgery, recovery is required using physiotherapeutic methods and medications.

Prognosis and prevention

After starting treatment for stage I and II arthrosis, a steady improvement occurs: pain and inflammation go away. In this case, complete relief of the disease or its long-term preservation is possible.

When stage III arthrosis is treated, improvements do not occur immediately. In some cases, the disappearance of pain is possible only after surgery. Often the joint remains immobilized or deformed. Patients with severe forms of arthrosis of the hip and knee joints receive disability group I or II.

It has been proven that there is no effective prevention against arthrosis. Weight control, a balanced diet and moderate exercise will help reduce the risk of developing the disease. An examination at the first signs of arthrosis (especially after injuries and infectious diseases) and careful attention to health will allow you to identify the disease at an early stage.