Arthrosis (osteoarthrosis, arthrosis deformans) is a process of slow degeneration and destruction of cartilage in the joint. The articular ends of the bones deform and grow, and the periarticular tissues become inflamed. The general diagnosis "arthrosis" means a group of diseases that are similar in symptoms, but differ in origin. The joint - the affected area - consists of articular surfaces covered with cartilaginous tissue, a cavity with synovial fluid, a synovial membrane and a joint capsule. With an advanced disease, mobility is lost, and the patient feels pain due to inflammatory processes.
Causes
Arthrosis of the joints occurs due to a discrepancy between the amount of stress and the body's ability. Lack of nutrients, excess body weight, heavy physical work and even sports can cause this.
Factors affecting 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 diseases;
- congenital joint pathologies (dysplasia);
- injuries, wounds;
- disorder in the functioning of the body (poor blood circulation, imbalance of hormones, microelements).
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 (predisposition) and external adverse conditions.
Secondary arthrosis occurs against the background of inflammatory diseases, dysplasia and as a result of 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 joints of the wrist and fingers most often affects people whose work involves fine motor skills: mechanics, mechanics, 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 the ballerina is the ankle joint. Athletes are also more likely to have injuries to the ankle joint 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 of shoulder and elbow disease.
Pathogenesis
Structural changes in cartilage occur due to an imbalance between tissue breakdown and repair. Collagen and proteoglycans are gradually "washed out" from the body, no new nutrients are supplied. Cartilage tissue loses its elasticity, becomes soft and cannot withstand stress.
Regardless of location and underlying cause, the disease develops in the same way. Gradually, the cartilage is completely destroyed, the ends of the bones "grind" against each other. The patient feels pain, the intensity of which increases depending on the stage. Joint mobility gradually decreases, the patient is limited in movements.
p>Classification
Orthopedists use the classification formulated by the professor in 1961:
- Phase I. The bone becomes denser, the joint space is slightly narrowed. Discomfort during physical activity, which disappears after rest;
- Phase II. The joint space is noticeably narrowed, the edges of the bones grow, and the connective tissue becomes denser. The pain becomes constant, the muscles are hypertrophied, the joint is significantly less mobile, specific symptoms appear at the site;
- Phase III. The joint space is practically absent, the bony growths are extensive and destruction of the bone beneath the cartilage is likely. The joint is completely deformed and immobile. Acute or constant aching pain is possible depending on the type and location of the disease;
Depending on the location and form of the disease, symptoms, speed of development and treatment methods will differ.
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 leads to bone growths;
- uncovertebral. It destroys discs and intervertebral tissue in the cervical region;
- post-traumatic. It develops as a result of trauma, injury;
- rheumatoid. Autoimmune disease, inflammation of the connective tissue. It can be a consequence of previous arthritis;
- psoriatic. It develops against the background of psoriatic arthritis.
Localizations
Osteoarthritis is a disease that affects joints throughout the body.
Spine. Causes can be autoimmune diseases, back diseases, increased stress, injuries, lack of microelements, hormonal imbalance.
Localizations:
- coccyx;
- lumbar region;
- thoracic spine;
- cervical region
Legs. Knees and ankles are more susceptible to arthrosis. The reasons are injuries, excess weight, irregular, excessive loads. Types of localization:
- gonarthrosis - knees;
- patellofemoral - femur and patella;
- ankle;
- talonavicular joint;
- feet and toes.
Hands. Lesions of the hands and fingers are more common, and are most often associated with professional activities, 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 compared to arthrosis of the extremities. Lesions are associated with professional activity, sedentary lifestyle (stagnation).
Types of localization:
- clavicle. "Clicks" and pain are felt when moving. Weightlifters and military personnel are at risk due to possible injuries;
- hip joints (coxarthrosis). The disease is manifested by pain in the groin area.
Head>. Sometimes dental problems, autonomic disorders and even hearing loss are caused by damage to the temporomandibular joint. The swelling disturbs the symmetry of the face, can affect the ear and cause headaches.
Symptoms
Symptoms of the disease depend on its location. Common manifestations for all types are:
- pain in the affected area. In the early stages - during movement, work, in the later stages - at rest;
- inflammation, swelling. Periarticular tissues swell, the skin becomes red;
- "clicks", crunching. When moving, characteristic sounds are heard;
- difficulty in movement. As the disease progresses, the mobility of the affected area is reduced;
- reaction to cold. Many types of arthrosis are characterized by exacerbations in rainy and cold weather.
Exacerbations of the disease are associated with a general weakening of health. Due to viral diseases and increased stress, it takes on 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, to the point of complete loss of mobility, and to perform usual tasks.
Possible complications
The main danger is the loss of mobility of the joint, 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 increased pressure on internal organs, their displacement, compression. Accompanying diseases and malfunctions 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 disturbances in the autonomic system: dizziness, sleep disturbance. A patient with arthrosis can become disabled.
Diagnostics
To make a diagnosis, a comprehensive examination is carried out:
- history taking;
- radiography in several projections;
- MRI and CT to rule out tumors and obtain a three-dimensional image;
- blood and urine tests to rule out underlying diseases and assess the general state of health.
Depending on the cause of the disease, the patient is referred to a rheumatologist, traumatologist, surgeon or orthopedist.
Treatment
And the stage of the disease is best treated. Patients with stage II can expect long-term relief from bone destruction. Stage III usually requires surgical intervention.
Conservative (non-surgical) treatment:
- physiotherapy, use of orthoses, sticks, crutches to reduce the load. Removal of accompanying and aggravating factors (for example, weight loss, stress, change of activity);
- taking non-steroidal anti-inflammatory drugs. Selective COX-2 inhibitors are the most effective. As auxiliary agents, chondroprotectors and atypical antidepressants are prescribed;
- 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 dissection of bone tissue;
- chondroplasty - cartilage restoration;
- arthrodesis - artificial immobilization of a joint (usually the ankle joint);
- endoprosthetics - removal and replacement of damaged joints with artificial ones.
Cardinal treatment allows you to stop the disease even at a late stage. It is possible to restore mobility in isolated cases (after replacement with an artificial one). However, this method is effective in the fight against pain. After surgery, recovery with physiotherapeutic and medicinal methods is required.
Prognosis and prevention
After the treatment of stage I and II arthrosis is started, there is a permanent improvement: pain and inflammation disappear. In this case, complete relief of the disease or its long-term preservation is possible.
In the treatment of stage III arthrosis, improvements do not occur immediately. In some cases, the disappearance of pain is possible only after surgery. Often the joint remains immobilized or deformed. Patients with severe forms of arthrosis of the hip and knee joints receive disability I or II.
It has been proven that there is no effective prevention against arthrosis. Weight control, a balanced diet and moderate amounts 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 careful attention to health will allow you to recognize the disease at an early stage.