What is arthrosis of the joints

Osteoarthritis can affect any joint, and degenerative-dystrophic changes can be isolated or occur in several joints at the same time.

This pathology does not pose a threat to life, but significantly reduces its quality. Severe pain, limited mobility increases over time, leading to disability.

Conservative therapy is prescribed to help stop the development of the disease in the early stages.

Osteoarthritis deformity (DOA) is difficult to completely cure, but it is possible to maintain the functionality of the bone joint. In the later stages, only surgical treatment will help.

Development mechanism

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

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

The disease usually develops slowly, but under the influence of external factors, the pathological process may accelerate. Much depends on the characteristics of the patient's body, accompanying diseases, lifestyle.

Osteoarthritis develops as follows:

• In a certain area of the cartilaginous lining of the joint, blood circulation is disrupted, and then begins to suffer from malnutrition. Under the influence of traumatic factors, the area of destruction increases.
• The body replaces the defects in the cartilage lining of the joints with mineralized tissue that does not have a clear structure.
• Gradually, pathological growths (osteophytes) appear in the hyaline coating.
• Against the background of the pathological process, healthy areas of cartilage are subjected to extreme stress. As a result, the joint is damaged and its surfaces are gradually destroyed.

Carefully!Osteoarthritis causes destruction of the bone surfaces of the joint, inflammation of the synovial membrane, compression of the joint capsule. There is a narrowing of the joint space, the joint is deformed, destroyed, and then the patient may become disabled. Therefore, it is very important to diagnose in time and start treating the pathology.

As a rule, osteoarthritis is found in patients over 60 years of age. 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 the question of how the first disease differs from the second. DOA damages not only the joints, and arthritis is characterized by inflammatory damage not only to the bone joints, but also to internal organs (liver, kidneys, heart). This is the main difference between these pathologies.

Classification

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

Types of osteoarthritis by location:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is an injury to the thigh joint.
• Uncovertebral - a 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 an ankle joint.
• Polyosteoarthritis is a multiple injury to the joints of the fingers.

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

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

• Deformative osteoarthritis is a stage 3 disease. It is a progressive disease that requires immediate surgical intervention.
• Osteoarthritis - destruction of the cartilage lining, inflammation.
• An acute disease in which the characteristic symptoms are more pronounced.
• Chronic osteoarthritis is the gradual destruction and thinning of the cartilaginous lining with a deleted course.

Depending on the reason, the following is distinguished:

• Dystrophic osteoarthritis - occurs as a result of metabolic disorders.
• Fractured arthrosis - develops as a result of a fracture.
• Post-traumatic - the disease appeared after a joint injury.

Types of DOA by origin:

• Primary (idiopathic) - often occurs for no apparent reason, as a result of age-related changes in the bone joints.
• Secondary - degenerative-dystrophic disorders are triggered by many factors (metabolic disorders, hormonal imbalances, trauma).

Doctors distinguish between monoarthritis and polyarthritis. In the first case, 1 joint is affected, and in the second, all joints are destroyed at the same time. The latter type of disease is called generalized osteoarthritis, in which 3 or more bone joints are deformed.

Pathological degrees

There are 4 stages of DOA depending on the symptoms and development:

• 1 degree.The form and structure of the joint has not yet changed, so the disease has a latent course. From time to time, the patient feels mild discomfort, especially in the affected area after excessive physical exertion or sudden movements. The composition of the joint fluid changes, the blood supply to the joint is disrupted. Weakens the muscle fibers surrounding the joint.
• 2nd degree.Bone joints begin to collapse, and bone growths form on their surface. Moderately painful sensations appear, inflammation occurs periodically. A characteristic crackle is heard in the affected joint during movement. Muscle function is reduced due to impaired trophism of nerve tissue.
• 3 degrees.Hyaline has obvious degenerative disorders of cartilage and articulation, so the axis of the joint is bent. The ligaments and muscles are shortened and the joint becomes pathologically mobile, but the movements are significantly limited. The patient often has incomplete dislocations.
• 4 degrees.The bone connection is completely destroyed, complete inactivity is observed, as well as severe pain syndrome at rest.

Important. Only endoprosthetics will help in the final stages of osteoarthritis (replacement of the affected joint with a prosthesis).

Reasons for DOA

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

Often, secondary degenerative-dystrophic disorders develop against 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 occur during intrauterine development.
• Age-related changes in the body.
• Osteoporosis (increased bone fragility due to calcium deficiency).
• Hormonal imbalance.
• Disorders of metabolic processes.
• Lack of vitamins and minerals.
• Pathologies accompanied by muscle weakness.
• Long-term intoxication.

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

External factors for the development of osteoarthritis include:

• Constant hypothermia.
• Dislocations.
• The effect of a large force on the articulatory field.
• Broken.
• Damage to the meniscus.
• 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 pathological changes and then treat the consequences.

Reference.Idiopathic osteoarthritis occurs spontaneously for no apparent reason.

Symptoms

Osteoarthritis manifests itself with the following symptoms:

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

These are characteristic symptoms that occur in all patients.

The first signs of pathology are discomfort after physical exertion in the affected area. You should consult a doctor after the onset of anxiety, because the disease can be treated in the early stages.

The patient then complains of mild to moderate pain that appears and quickly disappears after loading the damaged joint.

Decreased mobility of the bone joint indicates degenerative changes in its structure. At first, the patient feels stiffness, especially in the morning. Later, it becomes increasingly difficult for the patient to be active. With more development, restriction of movement occurs even with additional assistance. When left untreated, the joint contractures and over time its motor activity is blocked.

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

In the next stages, the axis of the joint is bent, the articular membrane is deformed. This indicates that the bone joint is practically broken and healthy tissue is replaced by osteophytes. At this stage, the adjacent joints are subjected to intense stress, and then the probability of damage to their cartilaginous lining increases.

Diagnosis

If you notice signs of osteoarthritis, see a doctor immediately. DOA is diagnosed after anamnesis, laboratory and instrumental studies.

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

Comprehensive diagnostics covers laboratory studies. Blood tests can detect an inflammatory process expressed by an increase in ESR (erythrocyte sedimentation rate), an increase in the concentration of uric acid. A urine test is done to determine the level of protein.

Osteoarthritis is diagnosed using the following instrumental studies:

• X-rays help to see the change in the shape of the joint.
• Arthrography using a contrast agent is a more accurate diagnostic method than X-rays.
• CT is used to assess the structure of the joint.
• Diagnosis of radionuclides is carried out using radiopharmaceuticals. This study allows us to assess the anatomical and functional state of the joint.

Magnetic resonance imaging is a modern highly informative diagnostic method. During the examination, you can see the deformation of the damaged joint, rupture of the menisci or ligaments.

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

After the diagnostic measures, the doctor develops a treatment regimen.

Methods of treatment

With osteoarthritis of any stage need medical attention. In the early stages, complex therapy helps to stop pathological changes and restore joint function. If the patient sees a doctor in the late stages of DOA, the prognosis is poor.

Drug treatment is carried out with first-degree osteoarthritis. Chondroprotectors are used to restore the structure of the cartilage lining. The patient is prescribed drugs in the form of tablets and capsules. They should be taken twice a year in 3-4 month courses. The drug contains structural elements of the cartilage lining.

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

DOA treatment is carried out using physiotherapeutic 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 develops a series of exercises that the patient should perform systematically. Exercise therapy increases muscle tone, strengthens ligaments, normalizes blood circulation and helps restore articulation.

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

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

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

Intraarticular injections are used for osteoarthritis:

• Glucocorticosteroids help to normalize the blood supply 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 elastane.

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

• Endoprostheses.
• Arthrodesis.
• Arthroscopy.

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

If arthrodesis is not possible, 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 function.

During arthroscopy, miniature chambers and manipulators are inserted into the articular cavity, with the help of which bone growths are removed and cartilage structure is restored. The camcorder allows you to monitor all manipulations on the screen. As a rule, surgery is performed for gonoarthritis, but its effect is short-lived.

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

Reviews

For patients with osteoarthritis, the disease is easiest to treat at an early stage. In advanced cases, only surgery will help. But in both cases, treatment must be comprehensive.

• First look: "I was diagnosed with grade 2 knee osteoarthritis 1 year ago. I took special medication, received physiotherapy, kept a diet. At first the pain went away, mobility was restored, but after 3-4 months the symptoms came back. Sometimes the pain is accompanied by fever. The doctor advised me to take capsules with hondoprotectors. My condition has improved with them, I have not felt any pain for six months. "
• Second review: "A few years ago I was diagnosed with grade 3 coxarthrosis. I was always in pain and could not move my leg normally even at night. The doctor advised me to have surgery, but at first I refused and decided to inject intra-articular injections. After the procedures, my condition did not change much. As a result, I decided on a radical method. After endoprosthesis, he recovered for 1 year and 3 months. During this time, he took medication, did special exercises, went to massage, physiotherapy, diet. Now I live a full life. I advise anyone not to shy away from treatment. "
• Third review: "After the MRI, I was diagnosed with a ruptured internal meniscus of the knee and grade 1 gonoarthritis. The doctors prescribed chondroprotectors. I also used the ointment twice a day. I used an orthosis to protect the knee, only at home. I had injections. After starting the course, he bought electrophoresis, paraffin therapy, as well as a magnetotherapy machine, has already performed 10 sessions. After another diagnosis, doctors said that the joint has healed 70%. I continue treatment and hope that my foot will fully recover. "

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