What is osteoarthritis of the joints?

Osteoarthritis can affect any joint, while degenerative-dystrophic changes can be isolated or occur in multiple 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, causing disability.

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

Deforming osteoarthritis (DOA) is difficult to cure completely, but the functionality of the bone connection can be preserved. In the later stages, only surgical treatment will help.

Development mechanism

Many people have heard of a disease such as 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 form the joints are covered with smooth, flowing and elastic cartilage that cushions and protects them from damage. With osteoarthritis, the blood supply to this area is cut off and the hyaline cartilage begins to deteriorate. Also, degenerative-dystrophic changes occur with the capsule, ligaments, periarticular muscles, and other segments of the joint.

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 like this:

• Blood circulation is impaired in a certain area of the cartilage lining of the joint, 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 does not have a clear structure.
• Gradually, pathological growths (osteophytes) appear on the hyaline lining.
• 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!Osteoarthritis causes the destruction of the bony 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 can become disabled. Therefore, it is very important to diagnose and start treating the pathology in time.

As a rule, osteoarthritis is detected in patients over 60 years of age. However, the disease is also diagnosed at a young age, from 20 to 45 years old.

Reference. Arthritis and osteoarthritis 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 names like gonarthrosis, coxoarthrosis, arthrosis, 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 osteoarthritis to facilitate differentiation.

Types of osteoarthritis by localization:

• Gonarthrosis is a pathological process in the knees.
• Coxarthrosis is an injury to 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 injury to the joints of the fingers.

In addition, there is also maxillary, temporal, costo-vertebral, clavicular-acromial osteoarthritis.

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

• Deforming osteoarthritis is a disease that has progressed to stage 3. This is a progressive disease that requires immediate surgery.
• Osteoarthritis-arthritis - destruction of the cartilage lining, inflammation.
• An acute disease in which the characteristic symptoms become more pronounced.
• Chronic osteoarthritis is a slow destruction, thinning of the cartilage lining with a cleared course.

Depending on the reason, a distinction is made between:

• Dystrophic osteoarthritis - occurs due to metabolic disorders.
• Fracture osteoarthritis: develops following 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 the bone joints.
• Secondary: degenerative-dystrophic disorders cause many factors (metabolic disorders, hormonal imbalances, 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 osteoarthritis, in which 3 or more bony joints are deformed.

Degrees in pathology

Based on symptoms and progression, there are 4 phases of DOA:

• 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 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 cut off. The muscle fibers surrounding the joint are weakened.
• 2nd degree.Bone joints begin to collapse, bone growths are formed on their surface. Moderate painful sensations appear, inflammation occurs periodically. During movement, a characteristic crunch is heard in the affected joint. The function of the muscles decreases due to the trophism disturbance of the nerve tissue.
• 3 degrees.There are pronounced degenerative disorders of the hyaline cartilage and the joint, due to this, the axis of the limb is bent. Ligaments, muscles shorten, 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 and severe pain syndrome are observed even during rest.

Important. In the last stage of arthrosis, only the endoprosthesis 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 (some diseases, bad habits, poor nutrition) and external (injuries, characteristics of professional activity) causes of osteoarthritis.

Often secondary degenerative-dystrophic disorders develop against the background 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 the bone surfaces).
• Joint psoriasis.

DOA can occur due to abnormalities in the 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 the bones due to calcium deficiency).
• Hormonal imbalance.
• Disorders of metabolic processes.
• Lack of vitamins, minerals.
• Pathologies that are accompanied by muscle weakness.
• Prolonged intoxication.

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

External factors for the development of osteoarthritis include:

• Regular hypothermia.
• dislocations.
• Great force impact in the joint 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 osteoarthritis occurs on its own, for no apparent reason.

Symptoms

Osteoarthritis manifests itself with the following symptoms:

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

These are characteristic symptoms that occur in all patients.

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

Subsequently, the patient complains of mild and 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. Subsequently, it becomes more and more difficult for the patient to perform active movements. With further development, movement restriction also occurs with additional help. If left untreated, a joint contracture occurs and, over time, its motor activity is blocked.

Many patients complain of joint crunches during movement, which is accompanied by painful sensations and reduced mobility. As the disease progresses, this manifestation becomes more pronounced.

In the later stages, the axis of the limb is bent and the joint membrane is deformed. This indicates that the bone connection has virtually collapsed and that healthy tissues have been replaced by osteophytes. At this stage, adjacent joints are subjected to severe stress, so the likelihood of damage to their cartilage lining increases.

Establish a diagnosis

If you notice any signs of osteoarthritis, see a doctor right away. The 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. In addition, palpation is performed, which allows you to determine pain, nodules, changes in temperature and humidity 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 performed to determine the level of protein.

Osteoarthritis is diagnosed using the following instrumental studies:

• X-rays help see the change in the shape of the joint.
• Contrast arthrography is a more accurate diagnostic method than X-rays.
• CT is used to evaluate the structure of the joint.
• Radionuclide diagnostics is performed using radiopharmaceuticals. This study allows to evaluate the anatomical and functional status of the connection.

MRI is a highly informative modern diagnostic method. During the examination, deformation of the damaged joint, rupture of the menisci or ligaments can be seen.

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

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

Methods of healing

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

With 1st degree osteoarthritis, 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 3-4 month cycles 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:

• Magnetotherapy.
• Very high frequency therapy.
• Electrophoresis.
• Shock wave therapy.
• Paraffin therapy.
• Mud treatment.

Physiotherapy and physiotherapy exercises are performed after the pain subsides. The doctor draws up a series of exercises that the patient must perform systematically. Physical 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 help of bandages, crutches and sticks.

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

During therapy, the patient must eat properly. You should 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 osteoarthritis, intra-articular injections are used:

• Glucocorticosteroids help normalize the blood supply to the affected area, stop the inflammatory process and increase the elasticity of the bone tissue.
• Analogues of synovial fluid with chondroprotective properties. These drugs reduce pain, improve joint mobility and accelerate the production of collagen and elastane.

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

• Endoprosthesis.
• 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, the patient is prescribed arthrodesis. During the operation, the bone surfaces are immobilized with a special plate. Arthrodesis helps relieve severe pain, but does not restore motor activity in 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 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 is important to identify and deal with it in time.

Reviews

According to patients who have experienced osteoarthritis, it is easier 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 2nd degree osteoarthritis of the knee 1 year ago. I took special medications, did physiotherapy, went on a diet. At first, the pain disappeared, mobility was restored , but after 3-4 months the symptoms returned again. Sometimes the pain was accompanied by a rise in temperature. The doctor advised me to take capsules with hondoprotectors. With them my condition improved, from six months to this part I don't feel any pain. "
• Second review: "A couple of years ago I was diagnosed with grade 3 coxoarthritis. I always had pain, even at night, I couldn't move my leg normally. The doctor advised me to have an operation, but at first I refused and I decided to try intra-articular injections. However, after the procedures, my condition did not change much. As a result, I decided for a radical method. After the endoprosthesis, she recovered for 1 year and 3 months. During this time, he was taking medications, performing special exercises, going to massage, physiotherapy, dieting. Now I am living a fulfilling life. I advise everyone not to hesitate with the treatment. "
• Third review: "I was diagnosed with internal meniscus rupture of the knee and Grade 1 gonoarthrosis after MRI. The doctors prescribed chondroprotectors. I also used the ointment twice a day. To protect my knee I used a knee joint. 'orthosis, I only took it off at home while resting. After the course of injections started, electrophoresis, paraffin therapy, he also bought a magnet therapy device, he had already performed 10 sessions. After another diagnosed, the doctors said that the joint was 70% healed. I continue the treatment and hope to fully recover my leg. "

As you can see, there are several types of osteoarthritis. To avoid surgery and restore joint function, you need to see a doctor 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 deal with in the beginning.