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 life-threatening, but it significantly reduces its quality. Severe pain, limitation of mobility increases over time, provoking disability.

In the early stages, conservative therapy is prescribed, which helps to stop the development of the disease.

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 such a disease as arthrosis, but not all of them understand what it is. To do this, you need to understand how the joint works.

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

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

Osteoarthritis develops in this way:

• Blood circulation is impaired in a certain area of the cartilaginous lining of the joint, then 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 does not have a clear structure.
• Gradually, pathological growths (osteophytes) appear on the hyaline coating.
• Against the background of the pathological process, healthy areas of the cartilage are exposed to excessive stress. As a result, the work of the joint is disrupted and its surfaces are gradually destroyed.

Carefully!Arthrosis provokes the 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, then the patient can become disabled. Therefore, it is very important to diagnose and begin to treat pathology 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 the joints are damaged, and arthritis is characterized by inflammatory damage not only to the bone junction, but also to internal organs (liver, kidneys, heart). This is the main difference between these pathologies.

Classification

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

Types of arthrosis by localization:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is a lesion of the hip joint.
• Uncovertebral - deformity of the cervical spine.
• Dystrophic changes in the shoulder joint.
• Interphalangeal - deformation of the interphalangeal joints of the bones.
• Spondyloarthrosis is a degenerative change in the joints of the spinal column.
• Ankle - Wear on the ankle joint.
• Polyosteoarthritis is a multiple lesion of the joints of the fingers.

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

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

• Deforming arthrosis is a disease that has passed into stage 3. This is a progressive ailment that requires immediate surgery.
• Arthrosis-arthritis - destruction of the cartilage lining, inflammation.
• An acute illness in which the characteristic symptoms become more pronounced.
• Chronic arthrosis is a slow destruction, thinning of the cartilaginous lining with an erased course.

Depending on the reason, they are distinguished:

• 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 provoke 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 ailment 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 has not yet changed, so the disease has a latent course. From time to time, the patient feels mild 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 disrupted. The muscle fibers that surround the joint are weakened.
• 2nd degree.Bone joints begin to collapse, bone growths form on their surface. Moderate painful sensations appear, inflammation occurs periodically. During movement, a characteristic crunch is heard in the affected joint. The functionality of the muscles decreases due to the fact that the trophism of the nervous tissue is disturbed.
• 3 degree.Severe degenerative disorders of the hyaline cartilage and articulation are observed, because of this, the axis of the limb is bent. Ligaments, muscles are shortened, and the joint becomes pathologically mobile, but the movements are significantly limited. The patient often has incomplete dislocations.
• 4 degree.The bone connection is completely destroyed, complete immobility is observed, as well as severe pain syndrome even during rest.

Important. At the last stage of arthrosis, only endoprosthetics will help (replacement of the affected joint with a prosthesis).

Causes of DOA

The question of why the disease occurs is quite relevant. Doctors distinguish between internal (certain diseases, bad habits, unhealthy diet) and external (injuries, features of professional activity) causes of osteoarthritis.

Often secondary degenerative-dystrophic disorders develop against the background of the inflammatory process:

• Infectious diseases that provoke 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 fragility of bones due to calcium deficiency).
• Hormonal imbalance.
• Disorders of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies that are accompanied by muscle weakening.
• Prolonged intoxication.

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

External factors for the development of arthrosis include:

• Regular hypothermia.
• Dislocations.
• A blow of great force to 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 DOA, it is important to first identify the cause of the pathological changes, and then treat the consequences.

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

Symptoms

Arthrosis is manifested by the following symptoms:

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

These are characteristic symptoms that occur in all patients.

The initial signs of pathology are discomfort in the affected area, which occurs after physical exertion. After the appearance of unpleasant sensations, you should consult a doctor, since in the early stages the disease can be cured.

Later, the patient complains of mild 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 stiffness, especially in the morning. Later, it becomes more and more difficult for the patient to perform active movements. With further development, movement restriction occurs even with additional help. If untreated, contracture of the joint occurs, and over time, its motor activity is blocked.

Many patients complain of a joint crunch when moving, which is accompanied by painful sensations and decreased mobility. As the disease progresses, this manifestation becomes more pronounced.

In later stages, the axis of the limb is bent, and the articular membrane is 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, then the likelihood of damage to their cartilaginous lining increases.

Establishing a diagnosis

If you notice signs of osteoarthritis, then seek immediate medical attention. Diagnosis of DOA is established after taking anamnesis, conducting laboratory and instrumental studies.

First, a visual examination is performed, during which the doctor may notice swelling in the affected area. Further, palpation is carried out, which allows you to determine soreness, nodules, changes in temperature and moisture of the skin.

Comprehensive diagnostics involves laboratory research. Blood tests can reveal an inflammatory process, which is indicated 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.

Arthrosis 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.
• Radionuclide diagnostics is carried out using radiopharmaceuticals. This study allows you to assess the anatomical and functional state of the connection.

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 limb.

After diagnostic measures, the doctor draws up a treatment regimen.

Healing methods

With arthrosis of any stage, medical attention is needed. Complex therapy in the early stages helps to stop pathological changes and restore the functionality of the joint. If the patient seeks a doctor at a late stage of DOA, then the prognosis is poor.

With arthrosis of 1 degree, drug treatment is carried out. Chondroprotectors are used to restore the structure of the cartilage lining. The patient is prescribed drugs in the form of tablets and capsules. They need to be taken in courses of 3-4 months twice a year. The medicine contains the 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.

Physiotherapy and physiotherapy exercises are carried out after the disappearance of pain. The doctor draws up a set of exercises that the patient must perform systematically. Exercise therapy increases muscle tone, strengthens ligaments, normalizes blood circulation, and helps restore articulation.

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

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

During therapy, the patient must eat properly. You should give up sugar, flour, fatty, 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 bone tissue.
• Synovial fluid analogs with chondroprotective properties. These drugs reduce pain, improve joint mobility, and accelerate the production of collagen and elastane.

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

• Endoprosthetics.
• Arthrodesis.
• Arthroscopy.

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

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

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

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

Reviews

According to patients who have encountered arthrosis, it is easiest to cure the disease at an early stage. In advanced cases, only surgery will help. But in both cases, the treatment should be comprehensive.

• The first review: "I was diagnosed with arthrosis of the knee of the 2nd degree 1 year ago. I took special medications, underwent physiotherapy, went on a diet. At first, the pain went away, mobility was restored, but after 3-4 months the symptoms returned again. Sometimes the pain was accompanied by an increase in temperature. The doctor advised me to take capsules with hondoprotectors. With them my condition has improved, for six months I have not felt any pain. "
• Second review: "A couple of 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 endoprosthetics, she recovered for 1 year and 3 months. During this period, she took medications, performed special exercises, went to massage, physiotherapy, followed a diet. Now I am living a fulfilling life. I advise everyone not to hesitate with treatment. "
• Third review: "I was diagnosed with a rupture of the internal meniscus of the knee and grade 1 gonoarthrosis after MRI. The doctors prescribed chondroprotectors. I also used the ointment twice a day. To protect the knee, I used an orthosis, I took it off only at home during rest. After the course of injections began electrophoresis, paraffin therapy, also bought a magnetotherapy apparatus, had already performed 10 sessions. After another diagnosis, the doctors said that the joint had recovered by 70%. I continue treatment and hope to fully recover my leg. "

As you can see, there are different types of arthrosis. To avoid surgery and restore joint function, you need to seek medical help at the first suspicious signs. Only a doctor will be able to determine the type, degree of complexity of the disease and draw up a competent treatment regimen. DOA is easier to treat early on.