What is arthrosis of the joints

Arthrosis can affect any joint, and degenerative-dystrophic changes can be isolated or occur in several joints simultaneously.

This pathology is not life-threatening, but significantly reduces its quality. Severe pain, limited mobility increases over time, provoking disability.

At an early stage, conservative therapy is prescribed to help stop the disease from developing.

It is difficult to completely cure osteoarthritis (DOA), but it is possible to maintain bone function. In the later stages only surgical treatment will help.

Development mechanism

Many have heard of a disease like osteoarthritis, but not all of them understand what it is. To do this, you need to understand how the joint works.

The bone surfaces that form the joints are covered with smooth, sliding, elastic cartilage that strengthens and protects them from damage. During osteoarthritis, the blood supply to this area is disrupted and the hyaline cartilage begins to deteriorate. In addition, degenerative-dystrophic changes occur with the capsule, ligaments, periarticular muscles, and other segments of the articulation.

Usually the disease develops slowly, but the pathological process can be accelerated under the influence of external factors. Much depends on the patient's body characteristics, comorbidities, lifestyle.

Osteoarthritis develops as follows:

• Blood circulation is disrupted in a certain area of the articular cartilage, then it begins to lack nutrients. Under the influence of traumatic factors, the area of destruction increases.
• The body replaces cartilage defects in the joints with mineralized tissue that does not have a distinct structure.
• Gradually, abnormal growths (osteophytes) appear on the hyaline cover.
• Healthy areas of cartilage are subject to excessive stress against the background of the pathological process. As a result, the work of the joint is disrupted and its surfaces are gradually destroyed.

Be careful!Osteoarthritis causes destruction of the bone surfaces of the joint, inflammation of the synovial membrane, compaction of the joint capsule. The joint space is narrowed, the joint is deformed, destroyed, then the patient may become disabled. It is therefore very important to timely diagnose and treat the pathology.

Osteoarthritis usually manifests itself in patients older than 60 years. However, the disease is diagnosed at a young age - from 20 to 45 years.

Reference. Arthritis and osteoarthritis are similar, so many patients are interested in the question of how the first disease differs from the second. Only joints are damaged during DOA, while arthritis is characterized by inflammatory damage not only to the bone junction but also to internal organs (liver, kidneys, heart). This is the main difference between these pathologies.

Classification

People who are far from medicine, when they hear names like gonarthrosis, coxarthrosis, osteoarthritis, do not realize the difference. The fact is that there are many types of this pathology, which differ in localization, course specificity, causes, origin. Physicians have therefore developed several classifications of osteoarthritis to facilitate their differentiation.

Types of arthrosis according to localization:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is an injury to the femoral joint.
• Uncovertebral - Deformity of the cervical spine.
• Dystrophic changes in the shoulder joint.
• Interphalangeal - Deformation of the interphalangeal joints of the bones.
• Spondyloarthritis is a degenerative change in the joints of the spinal column.
• Ankle - Wearing the ankle joint.
• Polyosteoarthritis is a multiple lesion of the finger joints.

In addition, there are also temporal, cost-vertebral, clavicular-acromial arthrosis of the jaw.

Depending on the characteristics of the course, the following types of pathology are distinguished:

• Deformed arthrosis is a disease that has progressed to stage 3. It is a progressive disease that requires urgent surgery.
• Arthritis-arthritis - destruction of the cartilage mucosa, inflammation.
• Acute disease in which the characteristic symptoms are more pronounced.
• Chronic arthrosis is a slow destruction of the cartilage, thinning at an erased rate.

Depending on the reason, there are:

• Dystrophic osteoarthritis - occurs as a result of metabolic disorders.
• Fracture arthrosis - develops as a result of a fracture.
• Posttraumatic - The disease arose after a joint injury.

DOA varieties by origin:

• Primary (idiopathic) - occurs for no apparent reason, often due to age-related changes in the bone joints.
• Secondary - degenerative-dystrophic disorders are provoked by many factors (metabolic disorders, hormonal imbalance, trauma).

Doctors distinguish between monoarthrosis and polyarthrosis. In the first case 1 joint is damaged, in the second all joints are destroyed at once. The last type of disease is called generalized arthrosis, in which 3 or more bone joints are deformed.

Degree of pathology

There are 4 stages of DOA in terms of symptoms and progression:

• 1 degree.The shape and structure of the joint has not yet changed, so the disease has a latent course. From time to time the patient experiences mild discomfort in the affected area, especially after excessive physical exertion or sudden movements. The composition of the joint fluid changes, the blood supply to the joint is disrupted. The muscle fibers that surround the joint are weakened.
• 2nd degree.Bone joints begin to collapse, and bone formations form on their surface. Moderate painful sensations appear, inflammation occurs periodically. A characteristic cramp is heard in the injured joint during movement. Muscle function is reduced due to the disruption of nerve tissue trophism.
• 3 degrees.Degenerative disorders of the hyaline cartilage and articulation are pronounced, due to which the axis of the limb is bent. The ligaments, muscles are shortened and the joint becomes abnormally moving, but the movements are significantly restricted. The patient often has incomplete dislocations.
• 4 degrees.The bone connection is completely destroyed, complete immobility is observed, as well as severe pain syndrome even at rest.

ᲛImportant. Only endoprosthesis (replacement of a damaged joint with a prosthesis) will help you in the last stage of arthrosis.

Causes of DOA

The question of why the disease occurs is quite topical. Doctors distinguish between internal (certain diseases, bad habits, unhealthy eating) and external (injuries, peculiarities of professional activities) causes of osteoarthritis.

Often secondary degenerative-dystrophic disorders develop against the background of the inflammatory process:

• Infectious diseases that provoke various viruses and bacteria.
• Rheumatism.
• Autoimmune diseases.
• Purulent inflammation of the joint.
• Gout (deposition of uric acid salts on bone surfaces).
• Psoriasis of the joints.

DOA can occur due to cartilage structure disorders and improper nutrition. Abnormal changes are caused by the following factors:

• Genetic disorders.
• Pathologies that are manifested during intrauterine development.
• Age-related changes in the body.
• Osteoporosis (increase in bone fragility due to calcium deficiency).
• Hormonal imbalance.
• Disruption of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies accompanied by muscle weakness.
• Prolonged intoxication.

Exacerbation of diseases of the musculoskeletal system also leads to degenerative changes in cartilage tissue.

External factors in the development of osteoarthritis include:

• Regular hypothermia.
• Dislocations.
• Impact of large force on the articulation area.
• Fracture.
• Meniscus injury.
• Excessive physical activity related to professional sports or professional activities.
• Obesity.
• Surgery on joints or periarticular structures.

Regardless of the cause of DOA, it is important to first determine the cause of the abnormal changes and then treat the consequences.

Reference.Idiopathic arthrosis occurs spontaneously, for no apparent reason.

Symptoms

Osteoarthritis is manifested by the following symptoms:

• Pain syndrome;
• Mobility restriction;
• Convulsions while moving;
• Swelling, change of connection axis.

These are characteristic symptoms that are found in all patients.

The initial signs of pathology are discomfort in the injured area that occurs after physical exertion. You should consult a doctor after the onset of discomfort, as the disease can be cured at an early stage.

Later the patient complains of mild to moderate pain that occurs after loading the damaged joint and disappears quickly.

Decreased bone marrow mobility indicates degenerative changes in its structure. At first, the patient feels firm, especially in the morning. Later the patient becomes more and more difficult to perform active movements. With further development, movement restriction occurs even with additional assistance. Without treatment, the joint contractures and over time its motor activity is blocked.

Many patients complain of joint cramps during movement, accompanied by painful sensations and decreased mobility. As the disease progresses, this manifestation becomes more pronounced.

In later stages the limb axis is bent and the joint membrane is deformed. This indicates that the bone connection has been virtually destroyed and healthy tissues have been replaced by osteophytes. At this point the surrounding joints are subjected to strong stress, then the likelihood of damage to their cartilage increases.

Make a diagnosis

If you notice signs of osteoarthritis, seek medical attention immediately. The diagnosis of DOA is made after taking a medical history, laboratory and instrumental studies.

First of all, a visual examination is performed, during which the doctor may notice swelling in the injured area. In addition, palpation is performed, which allows you to identify pain, nodules, changes in skin temperature and humidity.

Comprehensive diagnosis involves laboratory examination. Blood tests can detect the inflammatory process, which indicates an increase in ESR (erythrocyte sedimentation rate), an increase in uric acid concentration. A urine test is done to determine the protein level.

Osteoarthritis is diagnosed using the following instrumental studies:

• X-ray helps to see a change in the shape of the joint.
• Arthrography using a contrast agent is a more accurate diagnostic method than X-ray.
• CT is used to assess the structure of the joint.
• Radionuclide diagnosis is performed using radiopharmaceuticals. This study allows you to assess the anatomical and functional condition of the joint.

Magnetic resonance imaging is a modern high-information diagnostic method. On examination you may see deformity of the damaged joint, rupture of the meniscus or ligaments.

Doctors prescribe a puncture of the injured limb to examine the synovial fluid.

After diagnostic measures, the doctor determines the treatment regimen.

Healing methods

Medical assistance is needed for arthritis of any stage. Complex therapy at an early stage helps to stop pathological changes and restore joint function. If a patient seeks medical attention for late-stage DOA, then the prognosis is poor.

1st degree arthrosis is treated with medication. Chondroprotectors are used to restore the structure of the cartilage membrane. The patient is prescribed medications in the form of tablets and capsules. They need to be taken twice a year in 3-4 month courses. The drug contains the structural elements of the cartilage.

Nonsteroidal anti-inflammatory drugs (pills, injections) help relieve pain.

DOA treatment is performed using physiotherapy methods:

• Magnetic therapy.
• Ultra high frequency therapy.
• Electrophoresis.
• Shock wave therapy.
• Paraffin therapy.
• Mud treatment.

After the pain disappears, physiotherapy and physiotherapy exercises are performed. The doctor determines the set of exercises that the patient should perform systematically. Exercise therapy increases muscle tone, strengthens ligaments, normalizes blood circulation and helps to restore articulation.

It is recommended to provide rest during and after treatment, to reduce the load on the diseased joint with the help of bandages, crutches and crutches.

Sometimes the patient is prescribed a massage. After the course of the procedures, the blood supply to the affected area is improved and the pain is reduced.

The patient must be properly nourished during therapy. You should avoid sugar, flour, fatty, spicy foods, potatoes, tomatoes, eggplant. And it is recommended to get rid of bad habits (alcohol, smoking) forever.

Intra-articular injections are used for arthrosis:

• Glucocorticosteroids help to normalize blood supply to the affected area, stop the inflammatory process, and increase the elasticity of bone tissue.
• Synovial fluid analogues with chondroprotective properties. These drugs reduce pain, improve joint movement, and accelerate the production of collagen and elastin.

Surgical methods of treatment are used in the final stages of DOA:

• Endoprosthesis.
• Arthrodesis.
• Arthroscopy.

In advanced cases, doctors replace the destroyed compound with a metal prosthesis. Most often, this method is used to treat large joints. The patient's quality of life improves after surgery.

If arthrodesis is not possible, then the patient is prescribed arthrodesis. During the operation, the bone surfaces are immobilized with a special plate. Arthrodesis helps relieve severe pain but does not restore joint motor activity.

During arthroscopy, a miniature camera and manipulators are inserted into the joint cavity to help remove bone growths and restore cartilage structure. The camcorder allows you to control all the manipulations on the screen. Surgery is usually done during gonarthrosis, but its effects are short-lived.

DOA is dangerous, so it is important to identify and treat it in a timely manner.

Reviews

According to patients who develop osteoarthritis, it is the easiest to cure in the early stages of the disease. In advanced cases only surgery will help you. But in both cases the treatment must be comprehensive.

• First review: "1 year ago I was diagnosed with 2nd degree arthrosis of the knee. I was taking special medications, undergoing physiotherapy, staying on a diet. At first the pain disappeared, mobility was restored, but after 3-4 months the symptoms returned again. Sometimes the pain was accompanied by a rise in temperature. The doctor advised me to take capsules with chondroprotectors. "My condition has improved with them. I have not felt any pain for six months. "
• Second review: "Several years ago I was diagnosed with grade 3 coxoarthritis. I was in total pain, even at night, I could not move my leg normally. The doctor advised me to have surgery, but at first I refused and decided on intra-articular injections. However, my condition did not change much after the procedures. As a result, I decided to take a radical approach. He recovered after 1 year and 3 months after endoprosthesis. During this period he took medication, did special exercises, went for massage, physiotherapy, followed a diet. I live a full life now. I advise everyone not to try treatment. "
• Third review: "After magnetic resonance imaging, I was diagnosed with rupture of the inner meniscus of the knee and grade 1 gonarthrosis. Doctors prescribed chondroprotectors. I also used the ointment twice a day. I used an orthosis to protect my knee, only to take it home at rest. After starting the course of injections electrophoresis, paraffin therapy, also bought a magnetotherapy device, 10 sessions have already been conducted. After another diagnosis, doctors reported that the joint was 70% healed. I will continue the treatment and hope that my leg will be completely healed. "

As you can see, there are different types of osteoarthritis. To avoid surgery and restore joint function, you should seek medical attention at the first suspicious signs. Only a doctor can determine the type of disease, the degree of complexity and devise a competent treatment regimen. DOA is easier to treat early.