What is arthrosis of the joints

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

This pathology is not fatal, but it significantly reduces its quality. Severe pain, limited mobility increases over time, causing disability.

In the early stages, conservative therapy is prescribed, which helps to stop the disease from developing.

It is difficult to completely cure osteoarthritis deformans (DOA), but it is possible to preserve the functionality of the bone connection. 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 joint works.

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

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

Osteoarthritis develops in this way:

• Blood circulation is impaired in a certain area of the joint's cartilage lining, so 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 cartilage lining of the joints with mineralized tissue, which lacks a clear structure.
• Gradually, pathological growths (osteophytes) appear on the hyaline lining.
• In the context of the pathological process, healthy areas of cartilage are exposed to excessive stress. As a result, the work of the joint is interrupted and its surfaces are gradually destroyed.

Carefully!Arthrosis causes destruction of the bone 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, so the patient may be incapacitated. Therefore, it is very important to diagnose and start treating the condition in time.

As a rule, arthrosis is detected 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 arthrosis are similar, so many patients are interested in the question of how the first disease differs from the second. With DOA, only joints are damaged, and arthritis is characterized by inflammatory damage not only in the bone junction, but also in 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, coxoarthrosis, osteoarthrosis, they don't understand the difference. The fact is that there are many types of this pathology, which differ in location, specificity of the course, reasons, origin. Therefore, doctors created several classifications of arthrosis to make it easier to differentiate between them.

Types of arthrosis by location:

• Goonarthrosis is a pathological process in the knees.
• Lumbarthrosis is an injury to the hip joint.
• Uncovertebral - cervical spine deformity.
• Dystrophic changes in the shoulder joint.
• Interphalangeal - deformation of the interphalangeal joints of bones.
• Spondyloarthrosis is a degenerative change in spinal joints.
• Ankle - Wear at the ankle joint.
• Polyosteoarthritis is a multiple injury to the finger joints.

In addition, there is also mandibular, temporal, cost-vertebral, clavicular-acromial arthrosis.

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

• Arthrosis deformans is a stage 3 disease. This is a progressive disease that requires immediate surgery.
• Arthrosis-arthritis - destruction of the cartilage lining, inflammation.
• Acute illness in which characteristic symptoms become more pronounced.
• Chronic arthrosis is a slow destruction, thinning of the cartilaginous lining with an effaced course.

Depending on the reason, a distinction is made between:

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

DOA varieties by origin:

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

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

Pathology degrees

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

• 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 slight 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 cut off. The muscle fibers surrounding the joint are weakened.
• 2nd degree.Bone joints begin to collapse, and bony growths form on their surface. Mild painful sensations appear, inflammation occurs periodically. During movement, a characteristic snap is heard in the affected joint. The functionality of muscles decreases due to the fact that the trophism of the nervous tissue is disturbed.
• 3 degrees.There are pronounced degenerative disorders of the hyaline cartilage and joint, so the limb axis is bent. Ligaments and muscles are shortened and the joint becomes pathologically mobile, but movement is significantly limited. 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 during rest.

Important. In the last stage of arthrosis, only the endoprosthesis will help (replacement of the affected joint by a prosthesis).

DOA causes

The question of why the disease occurs is very relevant. Doctors distinguish between the 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 context of the inflammatory process:

• Infectious diseases that cause 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 calcium deficiency).
• Hormonal imbalance.
• Disorders of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies accompanied by muscle weakness.
• Prolonged intoxication.

The exacerbation of musculoskeletal system diseases also causes degenerative changes in cartilage tissue.

External factors for the development of arthrosis include:

• Regular hypothermia.
• Dislocations.
• Large force impact on the articulation area.
• Fracture.
• Damage to the meniscus.
• Excessive physical activity associated with professional sports or professional activities.
• Obesity.
• Surgery on joints or periarticular structures.

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

Reference.Idiopathic arthrosis occurs on its own for no apparent reason.

Symptoms

Arthrosis is manifested by the following symptoms:

• pain syndrome;
• mobility limitation;
• crunch when moving;
• edema, change in connection axis.

These are characteristic symptoms that occur in all patients.

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

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

A decrease in the mobility of the bone junction indicates degenerative changes in its structure. At first, the patient feels stiff, especially in the morning. Later on, it becomes increasingly difficult for the patient to perform active movements. With further development, restriction of movement occurs even with additional help. If left untreated, a joint contracture occurs and, over time, its motor activity is blocked.

Many patients complain of crushing of the joints during movement, which is 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 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, so the likelihood of damage to their cartilage lining increases.

establishing a diagnosis

If you notice signs of osteoarthritis, seek medical attention immediately. The diagnosis of AOD is made after anamnesis, laboratory and instrumental studies.

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

Comprehensive diagnosis involves laboratory research. Blood tests may 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.

Arthrosis is diagnosed using the following instrumental studies:

• X-rays help to see the change in shape of the joint.
• Contrast agent arthrography is a more accurate diagnostic method than x-rays.
• CT is used to assess the structure of the joint.
• Radionuclide diagnosis is performed with radiopharmaceuticals. This study allows us to assess the anatomical and functional state of the connection.

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

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

After the diagnostic measurements, the doctor outlines a treatment regimen.

healing methods

In arthrosis of any stage, medical attention is required. Complex therapy in the early stages helps to stop pathological changes and restore joint functionality. If the patient sees a doctor in an advanced stage of DOA, the prognosis is poor.

In 1st degree arthrosis, drug treatment is performed. Chondroprotectors are used to restore the structure of the cartilage lining. The patient is prescribed medications in the form of pills and capsules. They need to be taken in 3-4 month courses twice a year. The medicine contains the structural elements of the cartilage lining.

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

DOA treatment is performed using physical therapy methods:

• Magnetic therapy.
• Ultra-high frequency therapy.
• Electrophoresis.
• Shockwave therapy.
• Paraffin therapy.
• Mud treatment.

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

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

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

During therapy, the patient must eat properly. You must give up sugar, flour, fatty and spicy foods, potatoes, tomatoes, eggplants. And it is recommended to get rid of bad habits (alcohol, smoking) forever.

For arthrosis, intra-articular injections are used:

• Glucocorticosteroids help to normalize the blood supply to the affected area, stop the inflammatory process, and increase the elasticity of the bone tissue.
• Synovial fluid analogues with chondroprotective properties. These medications reduce pain, improve joint mobility, and speed up collagen and elastane production.

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

• Endoprosthesis.
• Arthrodesis.
• Arthroscopy.

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

If arthrodesis cannot be performed, the patient will receive a prescription for arthrodesis. During the operation, the bone surfaces are immobilized with a special plate. Arthrodesis helps relieve severe pain but does not restore motor activity to the joint.

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

DOA is dangerous, so it's important to identify and treat it in time.

Assessments

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

• The first review: "I was diagnosed with 2nd degree knee arthrosis 1 year ago. I took special medications, physiotherapy, diet. At first, the pain went away, mobility was restored, but after 3-4 months the symptoms they came back again. Sometimes the pain was accompanied by an increase in temperature. The doctor advised me to take capsules with hondoprotectors. With them my condition improved, I have not felt pain for six months. "
• Second review: "A few years ago, I was diagnosed with grade 3 coxoarthrosis. I suffered from pain all the time, even at night, I could not move my leg normally. The doctor advised me to have an operation, but at first I refused and decided to try intra-articular injections. However, after the procedures, my condition did not change much. As a result, I decided on a radical method. After endoprosthesis, she recovered for 1 year and 3 months. During this period, she took medication, did special exercises, I was doing massages, physiotherapy, dieting. Now I'm living a full life. I advise everyone not to hesitate in the treatment. "
• Third review: "I was diagnosed with torn internal meniscus of the knee and grade 1 gonoarthrosis after MRI. Doctors prescribed chondroprotectors. I also used the ointment twice a day. To protect the knee, I wore an orthosis, I only took it off at home during the After the course of injections began electrophoresis, paraffin therapy, he also bought a magnetotherapy device, he had already performed 10 sessions. After another diagnosis, the doctors said that the joint had recovered in 70%. I continue the treatment and I 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 physician will be able to determine the type, degree of complexity of the disease and devise a competent treatment regimen. DOA is easier to deal with in the beginning.