Arthrosis (osteoarthrosis, arthrosis deformans) is a process of slow degeneration and destruction of cartilage in the joint. The articular ends of the bones change shape and grow, and the periarticular tissue becomes inflamed. The general diagnosis "arthrosis" means a group of diseases similar in symptoms, but different in origin. The joint - the affected area - consists of articular surfaces covered by 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 the inflammatory process.
Reason
Joint arthrosis develops due to a mismatch between the amount of stress and the body's capabilities. Lack of nutrition, excess body weight, hard physical work and even exercise can be the cause.
Factors influencing the development of the disease:
- genetics, hereditary predisposition;
- age over 40 years;
- obesity, overweight;
- sedentary work, passive lifestyle;
- hard work, work that involves constant physical activity;
- inflammatory disease;
- congenital joint pathology (dysplasia);
- injury, wound;
- damage to the body (poor blood circulation, hormonal imbalance, microelements).
This disease can be primary or secondary. The causes of primary arthrosis are still not well understood. Doctors believe that this disease develops in the presence of genetic factors (predisposition) and unfavorable external conditions.
Secondary arthrosis occurs against the background of inflammatory diseases, dysplasia, and as a result of injuries, including occupational injuries.
Representatives of working professions and athletes have a greater chance of developing this disease. Representatives of the arts are also at risk: dancers (especially ballerinas), pianists. Arthrosis of the wrist and finger joints most often affects people whose work involves fine motor skills: mechanics, mechanics and pianists. "Professional" arthrosis in loaders is localized in the knees, collarbones and elbows. Drivers, painters and miners suffer from elbow and shoulder joint diseases. The ballerina's weak point is the ankle. Athletes are also more likely to experience injuries to the ankles and other arm and leg joints, depending on the type of sporting activity. For example, a tennis player will be at high risk of shoulder and elbow joint disease.
Pathogenesis
Structural changes in cartilage occur due to an imbalance between tissue damage and repair. Collagen and proteoglycans are gradually "removed" from the body, new nutrients are not supplied. Cartilage tissue loses its elasticity, becomes soft and does not withstand stress.
Regardless of the location and root cause, the disease progresses in the same way. Gradually, the cartilage is completely destroyed, the ends of the bones "rub" against each other. The patient experiences pain, the intensity of which increases depending on the stage. Joint mobility gradually decreases, the patient's movements become limited.
p>Classification
Orthopedists use the classification formulated by the professor in 1961:
- Stage I. Bones become denser, joint spaces narrow slightly. Discomfort during physical activity, which disappears after rest;
- Stage II. Joint spaces narrow, bone edges grow, and connective tissue becomes denser. The pain becomes constant, the muscles hypertrophy, the joints move less, specific symptoms appear at the site;
- Stage III. Joint space is practically non-existent, bone growth is extensive, and bone destruction beneath the cartilage is likely. The joints are completely deformed and cannot move. Acute or persistent pain may occur depending on the type and location of the disease;
Depending on the location and form of the disease, symptoms, speed of progression, and treatment methods will vary.
Form
This disease is characterized by a chronic form, but can also occur in an acute form.
If the disease spreads to several joints (for example the fingers), it is called generalized.
Anatomical shape:
- deformation (osteoarthrosis). Causes bone growth;
- open. Destroys intervertebral discs and tissue in the cervical region;
- post-traumatic. Develops as a result of trauma, injury;
- rheumatoid. Autoimmune disease, inflammation of connective tissue. May be a result of previous arthritis;
- psoriatic. Develops against the background of psoriatic arthritis.
Localization
Osteoarthritis is a disease that attacks joints throughout the body.
Spine. The causes can be autoimmune diseases, back diseases, increased stress, injuries, micronutrient deficiencies and hormonal imbalances.
Localization:
- coccyx;
- lumbar area;
- thoracic spine;
- cervical region
Foot. Knees and ankles are more susceptible to arthrosis. The causes are injury, excess weight, inappropriate and excessive load. Localization type:
- gonarthrosis - knee;
- patellofemoral - femur and patella;
- ankle;
- talonavicular joint;
- feet and toes.
Hand. Lesions of the hands and fingers are more common, and in most cases are associated with professional activities, injuries, hormonal and age-related changes. In addition, the disease is localized in the shoulder, wrist and elbow joints.
Torso. Localization on the trunk is less common than arthrosis of the extremities. Lesions are associated with professional activity, a sedentary lifestyle (stagnation).
Localization type:
- collarbone. When moving, it feels "clicking" and painful. At risk are weightlifters and military personnel due to possible injury;
- hip joint (coxarthrosis). This disease manifests itself as pain in the groin area.
Head>. Sometimes dental problems, autonomic disorders and even hearing loss are caused by damage to the temporomandibular joint. Swelling disrupts facial symmetry, can affect the ears and cause headaches.
Symptom
Symptoms of the disease depend on the location. Common manifestations for all types are:
- pain in the affected area. At the initial stage - during movement, work, at the later stage - at rest;
- inflammation, swelling. Periarticular tissues swell, skin turns red;
- "click", crackling. When moving, a characteristic sound is heard;
- difficulty moving. As the disease progresses, the mobility of the affected areas is impaired;
- reaction to cold. Many types of arthrosis are characterized by exacerbation in rainy and cold weather.
Exacerbation of the disease is associated with a general weakening of health. Due to viral diseases and increased stress, the disease becomes acute and progresses many times faster. During an exacerbation, symptoms, especially pain, become more pronounced. It is difficult for the patient to move, to the point of loss of mobility, and do ordinary work.
Possible complications
The main danger is loss of joint mobility, joint deformation beyond the possibility of recovery. As a result of the displacement of the axis, body posture is disturbed and the image loses symmetry. Possible increase in pressure on internal organs, their displacement, compression. Concomitant diseases and failures of body systems appear. For example, with arthrosis of the coccyx in women, gynecological complications are possible, and arthrosis of the temporomandibular joint or cervical spine causes disorders of the autonomic system: dizziness, sleep disturbance. A patient with arthrosis may become disabled.
Diagnostic
To establish a diagnosis, a thorough examination is carried out:
- taking anamnesis;
- radiography in several projections;
- MRI and CT to rule out tumors and obtain three-dimensional images;
- blood and urine tests to rule out comorbidities and assess general health.
Depending on the cause of the disease, the patient is referred to a rheumatologist, traumatologist, surgeon or orthopedist.
Treatment
Stage I of the disease is best treated. Patients with stage II can expect long-term recovery from bone damage. Stage III most often requires surgical intervention.
Conservative (non-surgical) treatment:
- physiotherapy, use of orthoses, canes, crutches to reduce the load. Elimination of accompanying and aggravating factors (eg 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 additional agents;
- intra-articular injection of glucocorticoid hormone to reduce severe pain and inflammation.
Surgical method:
- arthroscopy - internal examination of the joint and removal of cartilage fragments;
- arthroplasty - implantation of artificial cartilage;
- osteotomy - removal or dissection of bone tissue;
- chondroplasty - restoration of cartilage;
- arthrodesis - artificial immobilization of a joint (usually the ankle);
- endoprosthetics - removal and replacement of damaged joints with artificial joints.
Primary treatment allows you to stop the disease even at the final stage. It is possible to restore mobility in isolated cases (after replacing it with an artificial one). However, this method is effective in fighting pain. After surgery, recovery is necessary using physiotherapy and medication methods.
Prognosis and prevention
After starting treatment for stage I and II arthrosis, lasting improvements occur: pain and inflammation disappear. In this case, complete cure of the disease or its long-term preservation is possible.
When treating stage III arthrosis, improvement does not occur immediately. In some cases, relief of pain is possible only after surgery. Often the joint remains immobile or deformed. Patients with severe forms of arthrosis of the hip and knee joints receive I or II disability group.
It has been proven that there is no effective prevention of arthrosis. Weight control, a balanced diet and moderate exercise will help reduce the risk of developing this disease. Examination at the first signs of arthrosis (especially after injuries and infectious diseases) and careful attention to health will allow you to identify the disease at an early stage.