Arthrosis

Arthrosis (osteoarthrosis, arthrosis deformans) is a process of slow degeneration and destruction of cartilage in the joint. The joint ends of the bones become deformed and grow, and the periarticular tissues become inflamed. The general diagnosis of "arthrosis" means a group of diseases with similar symptoms but different origins. The joint - the affected area - consists of articular surfaces covered with 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.

Reasons

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

Factors affecting the development of the disease:

• genetics, hereditary tendency;
• Age over 40 years;
• obesity, overweight;
• sedentary work, passive lifestyle;
• hard work, work involving constant physical activity;
• inflammatory diseases;
• congenital joint pathologies (dysplasia);
• wounds, sores;
• malfunction 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 (tendency) and external unfavorable conditions.

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

Representatives of working professions and athletes have an increased chance of developing the disease. Representatives of the arts are also at risk: dancers (especially ballerinas), pianists. Arthrosis of the wrist joints and fingers most often affects people who involve fine motor skills: mechanics, mechanics and pianists. "Professional" arthrosis of loaders is localized in the knees, collarbones 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 injure their ankles and other joints of the arms and legs, depending on the type of sports activity. For example, a tennis player will be at high risk for shoulder and elbow joint diseases.

Pathogenesis

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

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

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Classification

Orthopedists use the classification drawn up by the professor in 1961:

• Stage I. The bone becomes denser, the joint space narrows a little. discomfort during physical activity that disappears after rest;
• Stage II. The joint space narrows noticeably, the bone edges grow, and the connective tissue becomes denser. The pain becomes constant, the muscles undergo hypertrophy, the joint becomes less mobile, specific symptoms appear at the site;
• III stage. The joint space is practically absent, bone growths are extensive, and there is a possibility of destruction of the bone under the cartilage. The joint is completely deformed and immobile. Depending on the type and location of the disease, acute or constant aching pain is possible;

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

Forms

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

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

Anatomical forms:

• deformation (osteoarthrosis). It causes bone growth;
• spineless. It destroys discs and intervertebral tissues in the cervical region;
• after trauma. Trauma develops as a result of injury;
• rheumatoid. Autoimmune disease, connective tissue inflammation. May be the result of previous arthritis;
• psoriatic. It develops against the background of psoriatic arthritis.

Localizations

Osteoarthritis is a disease that affects joints throughout the body.

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

Localizations:

• coccyx;
• lumbar region;
• thoracic spine;
• cervical region

Feet. Knees and ankles 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 occur more often, and in most cases they are associated with occupational activity, injuries, age-related and hormonal changes. In addition, the disease is localized in the shoulder, wrist and elbow joints.

Torso. Localization in the trunk is less common than arthrosis of the extremities. Lesions are associated with professional activity, sedentary lifestyle (stagnation).

Types of localization:

• clavicle. When moving, "clicks" and pain are felt. Weightlifting athletes and military personnel are at risk for possible injuries;
• hip joints (coxarthrosis). The disease manifests itself as pain in the groin.

Head>. Sometimes dental problems, autonomic disorders and even hearing loss cause 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. General manifestations for all types:

• pain in the affected area. In the initial stages - during movement, during work, in the later stages - during rest;
• inflammation, swelling. Periarticular tissues swell, the skin becomes red;
• "clicks", creaking. Characteristic sounds are heard when moving;
• difficulty moving. As the disease progresses, the mobility of the affected area is impaired;
• reaction to cold. Many types of arthrosis are characterized by exacerbation in rainy and cold weather.

Aggravation of the disease is associated with a 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, completely lose the ability to move and perform the usual work.

Possible complications

The main danger is the loss of joint mobility, its deformation beyond the possibility of recovery. Due to the displacement of the axis, the posture is disturbed and the figure loses its symmetry. Possible increase in pressure on internal organs, their displacement, compression. Accompanying diseases and failures appear in body systems. For example, gynecological complications are possible with arthrosis of the coccyx in women, and arthrosis of the temporomandibular joint or cervical spine causes disorders in the autonomic system: dizziness, sleep disorders. A patient with arthrosis may become disabled.

Diagnostics

A comprehensive examination is performed to make a diagnosis:

• taking an anamnesis;
• radiography 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 consults 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 requires the most 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 in activity);
• taking non-steroidal anti-inflammatory drugs. Selective COX-2 inhibitors are the most effective. Chondroprotectors and atypical antidepressants are prescribed as auxiliary means;
• 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 splitting of bone tissue;
• chondroplasty - cartilage restoration;
• arthrodesis - artificial immobilization of a joint (usually ankle);
• endoprosthetics - removal and replacement of damaged joints with artificial ones.

Cardinal treatment allows to stop the disease even in the late stage. In individual cases (after replacement with an artificial one) it is possible to restore mobility. However, this method is effective in the fight against pain. After the operation, recovery using physiotherapeutic and drug methods is required.

Prognosis and prevention

After starting treatment for stage I and II arthrosis, continuous improvement occurs: pain and inflammation disappear. In this case, it is possible to completely eliminate the disease or maintain it for a long time.

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

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