What is arthrosis of the joints

Osteoarthritis can affect any joint, while degenerative-dystrophic changes can be isolated or occur in multiple joints simultaneously.

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

In the early stages, conservative therapy is prescribed to help stop the development of the disease.

It is difficult to completely cure osteoarthritis deformance (DOA), but it is possible to preserve the functionality of the bone joint. In the later stages, only surgical treatment will help.

Development mechanism

Many people have heard of such a disease as osteoarthritis, but not everyone understands what it is about. To do this, you need to understand how the joint works.

The surfaces of the bones that form the joints are covered with smooth, slippery, elastic cartilage that cushions them and protects them from damage. In osteoarthritis, blood flow to this area is disrupted and hyaline cartilage begins to deteriorate. Further, degenerative-dystrophic changes appear on the capsule, ligaments, periarticular muscles and other segments of the articulation.

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

Osteoarthritis develops as follows:

• Blood circulation is disturbed in a certain part of the cartilaginous mucosa of the joint, then it begins to suffer from a lack of nutrients. Under the influence of traumatic factors, the area of destruction increases.
• The body replaces defects in the cartilaginous lining of the joints with mineralized tissue that has no clear structure.
• Gradually, pathological growths (osteophytes) appear on the hyaline coating.
• Against the background of the pathological process, healthy areas of cartilage are exposed to excessive stress. As a result, the work of the joint is disturbed and its surfaces are gradually destroyed.

Careful!Osteoarthritis causes destruction of the bony surfaces of the joint, inflammation of the synovial membrane, compaction of the joint capsule. There is a narrowing of the joint space, the joint is deformed, destroyed, then the patient can become disabled. Therefore, it is very important to diagnose and start treatment of the pathology on time.

As a rule, arthrosis is detected in patients older than 60 years. However, the disease is also diagnosed at a young age - from 20 to 45 years.

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

Classification

People who are far from medicine, when they hear names such as gonarthrosis, coxarthrosis, osteoarthritis, do not understand the difference. The fact is that there are many types of this pathology, which differ in localization, specificity of course, reasons, origin. Therefore, doctors have made several classifications of osteoarthritis to make it easier to distinguish them.

Types of arthrosis by localization:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is a lesion of the hip 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 spine.
• Ankle - wear on the ankle.
• Polyosteoarthritis is a multiple lesion of the finger joints.

In addition, there is jaw, temporal, bone-vertebral, clavicular-acromial arthrosis.

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

• Deforming arthrosis is a disease that has progressed to stage 3. This is a progressive disease that requires urgent surgery.
• Osteoarthritis - destruction of cartilage, inflammation.
• Acute disease in which the characteristic symptoms become more pronounced.
• Chronic arthrosis is the slow destruction, thinning of the cartilaginous mucosa with an erased flow.

Depending on the reason, a distinction is made between:

• Dystrophic osteoarthritis - occurs as a result of metabolic disorders.
• Osteoarthritis of the fracture - develops as a consequence of the fracture.
• Posttraumatic - the disease appeared after a joint injury.

DOA varieties by origin:

• Primary (idiopathic) - occurs for no 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 was affected, and in the second, all joints were destroyed at the same time. The last type of disease is called generalized arthrosis, in which 3 or more bone joints are deformed.

Diplomas of pathology

According to symptoms and progression, there are 4 stages of DOA:

• 1 degree.The shape and structure of the joint have not yet changed, so the disease has a latent course. From time to time the patient feels mild discomfort in the affected area, especially after excessive physical exertion or sudden movements. The composition of the joint fluid changes, the blood flow to the joint is disrupted. The muscle fibers surrounding the joint are weakened.
• 2nd degree.Bone joints begin to collapse, bone growths form on their surface. Moderate painful sensations appear, inflammation occasionally occurs. When moving, a characteristic creaking sound is heard in the affected joint. Muscle functionality is reduced due to the fact that the trophism of the nervous tissue is disturbed.
• 3 degrees.There are pronounced degenerative disorders of hyaline cartilage and articulation, due to which the axis of the limb is bent. The ligaments and muscles shorten, and the joint becomes pathologically mobile, but the movements are significantly limited. The patient often has incomplete dislocations.
• 4 degrees.The bone connection was completely destroyed, complete immobility was noticed, as well as a strong pain syndrome even at rest.

Bitan. In the last stage of arthrosis, only endoprosthetics (replacement of the affected joint with a prosthesis) will help.

Causes of DOA

The question of why the disease occurs is quite relevant. Doctors distinguish between internal (certain diseases, bad habits, unhealthy diet) and external (injuries, characteristics of professional activity) causes of osteoarthritis.

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

• Infectious diseases caused by various viruses and bacteria.
• Rheumatism.
• Autoimmune diseases.
• Purulent inflammation of the joint.
• Gout (deposition of uric acid salts on bone surfaces).
• Joint psoriasis.

DOA can occur due to abnormalities in cartilage structure and malnutrition. Pathological changes are caused by the following factors:

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

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

External factors for the development of osteoarthritis include:

• Regular hypothermia.
• Dislocations.
• Impact of a large force in the area of articulation.
• Fracture.
• Damage to the meniscus.
• Excessive physical activity associated with professional sports or professional activities.
• obesity.
• Operations on joints or periarticular structures.

Regardless of the causes of DOA, it is important to first identify the cause of the pathological changes and then treat the consequences.

Reference.Idiopathic osteoarthritis occurs on its own, for no apparent reason.

Symptoms

Osteoarthritis is manifested by the following symptoms:

• pain syndrome;
• restriction of mobility;
• crunch when moving;
• edema, change in the axis of the connection.

These are the characteristic symptoms that occur in all patients.

The initial signs of pathology are discomfort in the affected area, which occurs after physical exertion. After the onset of discomfort, you should consult a doctor, because the disease can be cured in the early stages.

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

Decreased mobility of the bone joint indicates degenerative changes in its structure. Initially, the patient feels numbness, especially in the morning. Later, it becomes increasingly difficult for the patient to perform active movements. Further development restricts movement even with additional help. If left untreated, joint contracture occurs and over time, its motor activity is blocked.

Many patients complain of cracking of the joints during movement, which is accompanied by painful feelings and reduced mobility. As the disease progresses, this manifestation becomes more pronounced.

In later stages, the axis of the limb is bent, and the joint membrane is deformed. This indicates that the bone connection has practically collapsed and healthy tissues have been replaced by osteophytes. At this stage, the adjacent joints are subjected to severe stress, then the likelihood of damage to their cartilage lining increases.

Diagnosis

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

First, a visual examination is performed, during which the doctor can notice swelling in the affected area. Furthermore, palpation is performed, which allows you to determine pain, nodules, changes in temperature and humidity of the skin.

Comprehensive diagnostics include laboratory research. Blood tests can reveal an inflammatory process, which is indicated by 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-rays help to see a change in the shape of the joint.
• Contrast-enhanced arthrography is a more accurate diagnostic method than X-rays.
• CT is used to assess joint structure.
• Radionuclide diagnostics is performed with the help of radiopharmaceuticals. This study allows you to assess the anatomical and functional state of the connection.

Magnetic resonance imaging is a modern highly informative diagnostic method. During the examination, deformation of the damaged joint, rupture of the meniscus or ligaments can be noticed.

To examine the synovial fluid, doctors prescribe a puncture of the affected limb.

After diagnostic measures, the doctor develops a treatment regimen.

Methods of treatment

With osteoarthritis of any stage, medical help is needed. Complex therapy in the early stages helps to stop pathological changes and restore joint functionality. If the patient seeks medical attention in the late stage of DOA, then the prognosis is poor.

In arthrosis of the 1st degree, treatment with drugs is carried out. Chondroprotectors are used to restore cartilage structure. The patient is prescribed medications in the form of tablets and capsules. It is necessary to take them in courses of 3-4 months twice a year. The drug contains structural elements of the cartilage lining.

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

DOA treatment is performed by physiotherapeutic methods:

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

Physiotherapy and physiotherapy exercises are performed after the pain disappears. The doctor puts together a set of exercises that the patient must perform systematically. Exercise therapy increases muscle tone, strengthens ligaments, normalizes blood circulation and helps restore articulation.

During and after the treatment, it is recommended to rest, reduce the load on the diseased joint with the help of bandages, crutches and sticks.

Sometimes the patient is prescribed a massage. After the procedure, blood flow to the affected area improves and pain decreases.

During therapy, the patient must eat properly. Give up sugar, flour, fatty, spicy foods, potatoes, tomatoes, eggplant. And it is advisable to get rid of bad habits (alcohol, smoking) forever.

Intraarticular injections are used for arthrosis:

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

In the last stages of DOA, surgical methods of treatment are used:

• Endoprosthetics.
• Arthrodesis.
• Arthroscopy.

In advanced cases, doctors replace the destroyed compound with a metal prosthesis. This method is most commonly used to treat large joints. After the operation, the patient's quality of life improves.

If arthrodesis cannot be reported, 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 motor activity of the joint.

During arthroscopy, a miniature camera and manipulators are introduced into the joint cavity, with the help of which the bone growths are removed and the structure of the cartilage is restored. The video camera allows you to monitor all manipulations on the screen. Surgery is usually performed for gonoarthritis, but its effect is short-lived.

DOA is dangerous, so it is important to recognize it and treat it in time.

Reviews

According to patients who have experienced osteoarthritis, the disease is easiest to cure at an early stage. In advanced cases, only surgery will help. But in both cases the treatment should be comprehensive.

• The first review: "A year ago, I was diagnosed with 2nd degree knee osteoarthritis. I was taking special medications, I was on physiotherapy, I was on a diet. At the beginning, the pain disappeared, mobility returned, but after 3-4 months, the symptoms returned. Sometimes the pain was accompanied by a rise in temperature. The doctor advised me to drink capsules with chondoprotectors. With them, my condition has improved, I haven't felt any pain for six months. "
• Second review: "A few years ago, I was diagnosed with grade 3 coxarthrosis. I was constantly suffering from 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 to try intra-articular injections. However, after the procedure my condition did not change much. As a result, I opted for the radical method. After endoprosthetics, she recovered for 1 year and 3 months. During that period, she took medication, performed special exercises, went for massage, physiotherapy, and kept a diet. Now I live a fulfilled life. I advise everyone not to hesitate with treatment. "
• Third review: "I was diagnosed with a rupture of the internal meniscus of the knee and 1st degree gonoarthritis after magnetic resonance imaging. Doctors prescribed chondroprotectors. I also used the ointment twice a day. I used an orthosis to protect my knees, I only took it off at home during the holidays. After the course of injections, electrophoresis, paraffin therapy, and a magnetotherapy device were purchased, and 10 sessions have already been performed. After another diagnosis, doctors said that the joint recovered by 70%. I continue the treatment and hope to fully recover my leg. "

As you can see, there are different types of osteoarthritis. To avoid surgery and restore joint function, it is necessary to seek medical help at the first suspicious signs. Only a doctor will be able to determine the type, degree of complexity of the disease and create a competent treatment regimen. DOA is easier to treat at an early stage.