Arthrosis (osteoarthrosis, arthrosis deformans) is a process of slow degeneration and destruction of joint cartilage. The articular ends of the bones are deformed and enlarged, and the periarticular tissues are inflamed. The general diagnosis of "arthrosis" means a group of diseases that are similar in symptoms but of different origins. The joint - the damaged area - consists of articular surfaces covered with cartilage tissue, a cavity with synovial fluid, a synovial membrane and a joint capsule. During the advanced disease, it loses mobility and the patient experiences pain due to inflammatory processes.
Reasons
Arthrosis of the joints develops due to a mismatch between the amount of stress and the body's capabilities. Lack of nutrients, excess body weight, heavy physical work and even sports can cause it.
Factors that affect 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;
- Malfunction 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 (tendencies) and unfavorable external conditions.
Secondary arthrosis appears against the background of inflammatory diseases, dysplasia and as a result of injuries, including professional ones.
Representatives of the working profession and athletes have an increased chance of developing the disease. Artists are also at risk: dancers (especially ballerinas), pianists. Arthrosis of the wrist joints and fingers most often affects people whose work involves fine motor skills: mechanics, mechanics and pianists. "Professional" arthrosis of loaders is localized in the knees, collarbones and elbows. Drivers, artists and miners suffer from elbow and shoulder joints. The weak point of ballerinas is the ankle. Athletes also often have injuries in other joints of the ankles and arms and legs, depending on the type of sports activity. For example, A tennis player will have a high risk of shoulder and elbow joint 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, new nutrients are not supplied. Cartilage tissue loses its elasticity, becomes soft and cannot withstand stress.
Regardless of location and root 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 experiences pain, the intensity of which increases depending on the stage. The mobility of the joint gradually decreases, the patient's movements are limited.
p>classification
Orthopedists use the classification established 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;
- II stage. The joint space becomes noticeably narrower, the edges of the bone grow, and the connective tissue becomes denser. The pain becomes constant, the muscles are hypertrophied, the joint is much less mobile, specific symptoms appear on the spot;
- III stage. There is virtually no joint space, bone formations are extensive, and bone destruction under the cartilage is likely. The joint is completely deformed and immobile. Depending on the type and localization of the disease, acute or constant painful pain is possible;
Depending on the location and form of the disease, symptoms, rate of development and treatment methods differ.
forms
The disease is characterized by a chronic form, but 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). causes bone growth;
- uncovered. destroys discs and intervertebral tissue in the cervical region;
- Post trauma. develops as a result of injury, trauma;
- Rheumatoid. Autoimmune disease, inflammation of connective tissue. May be the result of previous arthritis;
- psoriatic. It develops against the background of psoriatic arthritis.
localization
Osteoarthritis is a disease that affects joints throughout the body.
spine. The reasons can be autoimmune diseases, back diseases, increased stress, injuries, lack of microelements, hormonal imbalance.
Localization:
- coccyx;
- lumbar region;
- thoracic spine;
- Cervical region
legs. Knees and ankles are more susceptible to arthrosis. The reasons are injuries, excess weight, incorrect, excessive loads. Types of localization:
- gonarthrosis - on the knees;
- patellofemoral - femur and patella;
- foot;
- talonavicular joint;
- feet and toes.
hands. Hand and finger injuries are more common and in most cases are associated with professional activities, injuries, age-related and hormonal changes. In addition, the disease is localized in the shoulder, wrist and elbow joints.
Torso. Compared to arthrosis of the limbs, localization in the trunk is less common. Injuries are associated with professional activity, sedentary lifestyle (stagnation).
Types of localization:
- the collar. A "click" and pain are felt when moving. Athletes involved in weightlifting and military personnel are at risk due to possible injuries;
- Hip joints (coxarthrosis). The disease manifests 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 the symmetry of the face, can affect the ear and cause headaches.
symptoms
Symptoms of the disease depend on its localization. Common manifestations of all types are:
- Pain in the affected area. in the early stages - during movement, work, in the late stages - during rest;
- Inflammation, swelling. periarticular tissues are swollen, the skin is reddened;
- "Clicks", crackle. characteristic sounds are heard during movement;
- 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 often develops rapidly. During an exacerbation, symptoms, especially pain, are more pronounced. The patient has difficulty moving, up to complete loss of mobility, and performing usual work.
Possible complications
The main danger is the loss of joint mobility, its deformation beyond the possibility of recovery. Due to the movement of the axis, the posture is disturbed and the figure loses its symmetry. Increased pressure on internal organs, their displacement, compression is possible. Concomitant diseases and failure of body systems appear. For example, in women, arthrosis of the coccyx can cause gynecological complications, while arthrosis of the temporomandibular joint or cervical spine causes disturbances in the autonomic system: dizziness, sleep disturbances. A patient suffering from arthrosis can become disabled.
diagnosis
To determine the diagnosis, a comprehensive examination is carried out:
- 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 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 relief from bone destruction. Stage III most often requires surgical intervention.
Conservative (non-surgical) treatment:
- Physiotherapy, use of orthoses, crutches, crutches to reduce the load. Elimination 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. 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 dissection of bone tissue;
- Chondroplasty - restoration of cartilage;
- Arthrodesis - artificial immobilization of a joint (usually ankle);
- Endoprosthesis - removal of damaged joints and replacement with artificial joints.
Cardinal treatment allows you to stop the disease even at a late stage. Mobility can be restored in isolated cases (after artificial replacement). However, this method is effective in the fight against pain. After the operation, it is necessary to recover with physiotherapeutic and medicinal methods.
Prognosis and prevention
After starting the treatment of stage I and II arthrosis, there is a long-term improvement: pain and inflammation disappear. In this case, it is possible to completely alleviate the disease or maintain it for a long time.
In the treatment of stage III arthrosis, improvement does not occur immediately. In some cases, the pain can disappear only after the operation. Often the joint remains immobile 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 against arthrosis. Weight control, a balanced diet and moderate exercise will help reduce the risk of developing the disease. Examination of the first signs of arthrosis (especially after injuries and infectious diseases) and careful attention to health will allow you to detect the disease at an early stage.