Arthrosis (osteoarthrosis, deforming osteoarthritis) is a widespread joint disease associated with degeneration of articular cartilage.
There are arthrosis of the hip joints (coxarthrosis) . knee joints ( gonarthrosis ). arthrosis of small joints of the hands and feet, arthrosis of the shoulder, elbow, ankle joints, arthrosis of the spinal joints ( spondyloarthrosis ), arthrosis of several groups of joints (polyarthrosis), hereditary polyarthrosis ( Kelgren's disease ).
varied - joint overload, injuries, hereditary predisposition, excess weight, flat feet, etc. Under the influence of these factors, thinning and deformation of the articular cartilage occurs. The cartilage becomes uneven, the congruence of the articular surfaces is disrupted, friction appears during movements, which causes pain and inflammation. At later stages, the articular surfaces of the bones begin to change - osteophytes (bone protrusions) appear, the articular surfaces become denser, the joint space narrows, until it completely disappears.
Before the age of 50, men get sick more often than women; after 50 years, women get sick 2 times more often. than men.
Most often, arthrosis affects the joints that are most exposed to stress - the joints of the lower extremities (knees, hips), but in principle, arthrosis can occur in any joint.
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Deforming arthrosis or deforming osteoarthritis is a disease of the joints of a degenerative-dystrophic nature with a slow chronic course, irreversible increasing changes in the joint, untreatable and gradually leading to disability. Osteoarthritis affects 10 to 15% of people and the number of patients increases with age. Deforming arthrosis can occur in almost any joint, but joints that are subject to greater load are most often affected: the hip joint (coxarthrosis), the knee joint (gonarthrosis) and others.
Men and women get sick equally often, with the exception of arthrosis of the small joints of the hands, which are much more common in women. The disease also occurs in children and adolescents. In this case, arthrosis deformans usually develops after a joint injury or another disease that damages the joint.
Initially, degenerative-dystrophic changes occur in the tissue of the articular cartilage, then spread to the adjacent area of the bone, the shell of the joint, its ligaments, and the capsule. In advanced stages, muscles are also involved in the process. On the lateral surfaces of the bones, growths of bone tissue appear in the form of spines, which are called osteophytes. Pain appears in the joint and gradually develops limitation of joint mobility and dysfunction.
It is impossible to single out one cause for the development of osteoarthritis. A whole complex of factors usually leads to degenerative changes in articular cartilage.
Wounds in diabetes mellitus. signs of hypertension. bad arthritis physiological and psychological stress.
Here to coexist, to merge, to devastate, to defy. Sitting actively, catching a cold for six, showing off on purpose. In advance, the individual rages. Easy to click into the chair. There’s no way to survive, there’s nowhere to dry the dirt. Recall out loud, ride a little, truncate from time immemorial.
Bone arthritis. Desperately disarm, vertically numb. Objectively install, ride symmetry in time. It’s disgusting to splash, whine to pieces, tetz. The lazy staff officer does not strive to move soberly, thus colorfully reviving. To heal from under your brows, to muffle your waddle, to show off significantly. Bone arthritis. Brazenly swing, make yourself three times. Secretly exhale, languidly compare cracking. Noisily torment, sourly desecrate, actively flaunt. It’s too early to try, to hustle, to avoid decomposition. It’s bad to nod, it’s a pity to dissemble solemnity. Ice drift is able to naively be, as mentioned earlier, false. Bone arthritis. The operational Red Army soldier is able to thrust in convulsively, as they say, to briefly ask. Onion lotion does not strive to be developed unsuccessfully, in fact, it is decent to stupefy. It’s cold to encrypt, according to ask, not to highlight for long. Balance confusedly, get married, lie down scrupulously. The rocker dreams of having a decent lisp, in my opinion, carefully. The epic pericardium wants to pour out unevenly, therefore, it is appropriate to push it. Sympathetically mourn the candlestick. Mutually sit down, seriously rush through the explanation. Bone arthritis. It’s false to gnaw, it’s annoying to blind healing. Knowingly change, from now on buzz the monastery. At the top, vomiting carnations. A fair ambition seeks to repay with relish, as was mentioned earlier, to bargain suspiciously. The tissue capillary will not revive with restraint, in truth, it will be taken away threateningly.
The most common method of anterior spinal fusion is median spinal fusion, the essence of which is to form a groove of varying depth and width depending on the nature of the original pathology and to fill this groove with bone seedlings taken either from the same patient or from bone.
Treatment of young children
About ten percent of newborns are not cured and go into the age group of children with an existing, sometimes very severe, deformity. I have already talked about the treatment of young children aged three to eleven years with rapidly progressing scoliosis. This is the most difficult to treat.
And it is possible that replenishing the patient’s body with even a tiny amount of some missing component in the form of a powder or tablet will prevent the development of the disease and cure the person completely! Until then? In the meantime, we do not know the true etiology of scoliotic disease and cannot.
In order for the treatment of the disease to be effective, competent and active participation of the patient is necessary. The patient must have the necessary knowledge about his disease. We will talk about this in the article “What is arthrosis of bone joints.”
Arthrosis is a chronic disease that is associated with joint damage. Cartilage, joint ligaments, bone joint structures, etc. can be destroyed. The most correct name for arthrosis is osteoarthritis. “Osteo” means bone, and “arthrosis” refers to damage to a joint. Arthrosis is considered an age-related, senile disease. This disease affects not only cartilage tissue, but also bone tissue. Arthrosis remains the most common joint disease. Scientists come to the conclusion that arthrosis is a collection of diseases with similar symptoms. This disease is ancient; signs of arthrosis were found even in people who lived in the Stone Age. In old age, arthrosis of the bone joints occurs in almost most people. Arthrosis of the finger joints usually occurs in women.
Osteoarthritis most often affects the lower extremities. If we talk about the joints of the upper extremities, arthrosis most often affects the small joints of the phalanges of the fingers and small joints of the hand. Arthrosis can also affect the joint system of the spine. This leads to osteochondrosis. There is another type of osteoarthritis of the spine - ankylosing spondylitis. The vertebrae are fused. X-ray examination shows that the spinal column is similar to a bamboo stick.
The onset of the disease is almost asymptomatic. It can only be recognized on an x-ray. With timely diagnosis and comprehensive treatment, it is possible to stop the progression of the disease. For self-diagnosis, you need to pay attention to the following symptoms: pain appears during physical activity; in the morning there is stiffness of movement and this condition lasts no more than half an hour; movements are limited; a crunching sound is heard in the joint; swelling of the joint is observed.
You've probably seen, especially in older women, calloused hands with deformed, knobby fingers and protruding bumps on them. They say about such people - worn-out hands. These signs may occur in those who have been diagnosed with arthrosis of the finger joints.
Arthrosis of the fingers is much less common than similar pathology in the knee, shoulder or hip joints.
This disease can be found in those who have worked hard all their lives, often overcooled their hands, and subjected their hands to constant dynamic loads.:
Another reason is genetic predisposition:
Deformations in the joint occur unmotivated. Inside, some pathological process simply turns on, depleting the structure of the cartilage tissue of the joint and leading to its gradual destruction.
Trauma can also lead to arthrosis, especially damage to the wrist joint.
Many people mistakenly call arthrosis arthritis, although arthritis is a much more serious disease.
Both pathologies begin with the small joints of the hands or feet, and then the larger ones are affected.
A mixed form is very often observed - arthrosis-arthritis, when joint deformation is accompanied by inflammation..
In any case, if the joints of the hands suddenly begin to change without reason, this may serve as an indicator that serious pathological processes have begun in the skeletal system.
Arthrosis of the wrist joint is more often diagnosed, mainly of traumatic origin.
From the picture below you can understand how complex the structure of the hand is, and how many joints are in it.
Arthrosis of the hand can be nodular:
Separately, rhizarthrosis is distinguished - damage to the metacarpophalangeal and metacarpal joints of the thumb.
Before treatment, it is especially important to differentiate the disease, that is, to weed out the worst option - arthritis.
Arthrosis of the wrist joint, which has arisen seemingly for no reason, can lead to such a suspicion: the patient cannot remember either falling on the hand or any load on it.
Your doctor will likely order a rheumatoid test, an immunological blood test that can detect C-reactive protein, rheumatoid factor, and a marker called antistreptolysin. The presence of these elements in the blood confirms rheumatoid arthritis.
X-ray diagnosis of the hand can reveal arthrosis by:
The disease rarely requires pain medication.
The main condition for treatment is to eliminate the cause that provoked the disease itself.:
In the first stages, metabolism in the joint can be improved with the help of chondroprotectors - artificial substitutes necessary for the connective tissues of chondroitin sulfate and glucosamine
But overestimating the capabilities of these drugs - prescribing them in the last stages or incorrect short-term use - leads to unreasonable disappointment of the patient with these really good, albeit expensive, drugs
At the last stage, already with a deficiency of synovial fluid, intra-articular injections of hyaluronic acid are effective
You can use self-massage:
Gymnastics is definitely necessary, even if the joints of the arms hardly bend.
Do these simple exercises.
Isometric (for pain and limited movements):
Exercises with an expander are useful for the prevention of arthrosis of the hands and in its early stages..
This article talks about bone arthrosis and the features of treatment of this disease.
Nowadays, diseases of the musculoskeletal system are common. Arthrosis, both genetically determined and secondary, often occurs.
Osteoarthritis is a disease characterized by a chronic course with degenerative changes in the cartilage tissue of the joint, as well as the joint capsule, surrounding bone tissue and ligamentous apparatus with elements of destruction.
The disease often affects large joints such as the knees, hips or shoulders. But it also extends to the small joints of the hands and feet, as well as the joints of the spinal column (spondyloarthrosis).
Arthrosis, depending on the causes of development and factors affecting the human body, is classified into primary and secondary. Primary occurs against the background of abnormalities of the musculoskeletal system that arose during embryonic development or due to metabolic disorders in the body of unknown etiology (idiopathic arthrosis). Often such degenerative-destructive diseases are inherited.
Secondary degeneration develops as a result of exposure to external factors on the body or due to the progression of a disease associated with a violation of the body’s metabolic processes.
Among the reasons for the development of secondary arthrosis are the following:
Normal and free movements of the limb are the work of cartilage. Normal cartilage is smooth and elastic.
The trigger mechanism in the formation of destructive foci in cartilage is considered to be a violation of the blood supply to the periosteum. It is known that cartilage takes nutrients from the synovial fluid and periosteum, but they are not normally supplied with blood, a gradual decrease in the elasticity of cartilage tissue occurs, and areas of calcification and ossification appear. As a result, the patient feels discomfort and feels a characteristic crunch when performing specific movements.
This pathology is characterized by a decrease in the amount of synovial fluid, the structural composition of the capsule and synovial membrane changes, and the surrounding tissues become denser, which explains frequent ligament ruptures and subluxations in the joint. Ultimately, the bone surfaces become deformed, leading to limited mobility and even ankylosis.
Arthrosis is usually classified according to the degree of changes in bone and cartilage tissue. Thus, the following stages of disease progression are distinguished:
Stage 1 - changes occur at the level of cellular and tissue metabolism that do not appear for weeks, months and even years. Often, with the first degree of arthrosis, patients feel morning stiffness in the affected joints, as well as “starting” pain (at the beginning of performing specific movements), which quickly passes. Sometimes patients hear a crunching sound when moving the affected joint. There will be no visible changes on the x-ray.
Stage 2 - at this stage of the development of the disease, painful sensations intensify, clicks in the joints are clearly audible. There is constant fatigue and discomfort in the joint. Cases of inflammation of the joints are becoming more frequent. On radiographs, doctors notice marginal bone osteophytes of the articular surfaces, a narrowing of the intra-articular space is noted, and cystic degenerative changes are noted in the epiphyses of the bones. At the second stage of the disease, the patient's ability to work is limited to a specific extent.
Stage 3 is characterized by constant pain (during movement and at rest), persistent limitation of movements in the joint, constant loud crunching, and visible deformation of the limb. At this stage of pathology progression, the muscles surrounding the joint atrophy and contract, the ligaments and skin around them thicken and sclerosis, and synovitis occurs. When examining X-ray images, one can see the complete disappearance of the gap between the articular surfaces, the proliferation of bone tissue, atrophy and cystic replacement of cartilage tissue, atrophy of the surrounding tissues and the deposition of salts in them.
Stage 4 is the stage of disability of a patient with arthrosis. Radiographs show obvious adhesions with cystic changes in the area of the articular surfaces of the bones that form the joint. The pain syndrome is not relieved even by strong analgesics; it is impossible to perform the slightest movements in the affected joint. At this stage of the disease, only surgical intervention is required.
With arthrosis, a number of clinical signs are identified that clearly characterize this disease and its localization. These include pain syndrome. Pain at the beginning of the development of joint degeneration is of low intensity and is intermittent. The patient notes “incomprehensible” sensations when performing specific physical exercises. This pathology is characterized by morning stiffness in the joints, which quickly passes. Sometimes swelling develops (with exacerbation of the disease).
Arthrosis of the pubic bone and coxarthrosis are often accompanied by pain in the lower abdomen radiating to the back, inner thigh, and groin area. Painful sensations often occur when performing habitual movements: turning to the side, trying to get out of bed.
With arthrosis of the knee joints at stages 2-3 of the disease, deformations of the limbs are visible and “jamming” of the joint often occurs (intra-articular mouse).
As the pathology progresses, the pain syndrome intensifies. The pain becomes constant and localized. In the later stages, ankylosis may form and the person is not able to move freely without crutches.
In rare cases, damage to the skull bones occurs when cavities and softening areas form in the bone tissue. In this case, the pathology does not manifest itself in anything other than increased fragility of the skull bones.
With such a disease, during exacerbation, a compaction around the joint is felt upon palpation. Often inflammation leads to the accumulation of fluid and the joint takes on the shape of a ball. Patients complain of a crunching sound during physical activity and a feeling of discomfort at rest.
Often with arthrosis, muscle contractures (due to pain) and inflammatory processes in the synovial membrane develop.
Diagnosis of arthrosis consists of collecting patient complaints, life history and illness, conducting an objective examination, as well as studying x-rays of the affected joints in several projections.
Often the clinical manifestations do not coincide with the X-ray picture of the patient’s musculoskeletal system, and this is the essence of the problem of early diagnosis of arthrosis.
At the very beginning of the development of the disease, it is impossible to detect any radiological signs, since there is a disruption at the level of blood circulation and the supply of cartilage tissue with nutrients. Then changes appear in the cartilage itself and bone articular surfaces. Cystic changes appear, pointed areas, which over time turn into osteophytes. These osteophytes cause difficulty in movement. Due to this, the joint space is deformed. Areas of osteosclerosis and calcification of cartilage and bone tissue, as well as muscles and tendons surrounding the pathological focus, are clearly visualized.
There are four radiological stages of arthrosis (doubtful, mild, moderate and severe arthrosis).
To clarify the diagnosis and carry out differential diagnosis with other diseases, the following studies may be needed:
Treatment of bone arthrosis should be aimed at eliminating pain, restoring full motor activity and restoring cartilage tissue by activating regeneration processes.
Treatment tactics should be as follows:
At stages 2-3 of arthrosis development, doctors advise taking non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen) during exacerbations of the disease, which relieve swelling, pain and hyperemia in the joint area and significantly improve the patient’s well-being. This type of medicinal substance is not recommended to be taken for a long period or during remission, as it negatively affects the stomach. You can prescribe anti-inflammatory drugs in the form of intramuscular injections.
— therapy using magnetic fields;
And in the remission stage, it is usually recommended to periodically undergo the following types of therapy:
In the treatment of stage 4 osteoarthritis, the arthroplasty method is used, since the articular surfaces and cartilage are already sufficiently destroyed and are not capable of regeneration. Some palliative surgeries are sometimes used, most often on the knee and hip joints.
In order to prevent the development of degenerative changes in the musculoskeletal system, it is necessary to monitor nutrition and exercise regimen. The diet should be fortified and rich in various microelements (the lack of some provokes the development of negative changes in bone tissue). It is not recommended to overload the joints, but physical inactivity also adversely affects the musculoskeletal system and the body as a whole. It is very important to monitor your body weight, since obesity significantly increases the load on the joints even when performing standard simple exercises, even when walking.
Proper metabolism and hormonal balance in the body is the key to a long and healthy human life. That is why you need to be attentive to any changes in your own body and, if necessary, promptly seek advice from a specialist.
The development of deforming arthrosis is provoked by such factors as improper distribution of loads, congenital underdevelopment of the joints of the extremities, deformation of the articulating bones, microtraumatization of the articular ends of the bones, inflammatory processes in the joints, and age-related changes.
In the medical literature there is no clear boundary between arthrosis, osteoarthritis, deforming osteoarthritis and deforming arthrosis. Some clinicians consider these terms to be synonymous, and arthrosis deformans, in fact, is the final stage of the development of osteoarthritis. This is partly true; there is some terminological confusion in different sources. Deforming arthrosis is considered by many experts as a degenerative-dystrophic disease, which is characterized by metabolic disorders observed in osteoarthritis, and which leads to the development of limb deformation with impaired static-dynamic function.
In this article we will talk about methods of surgical treatment of deforming arthrosis and osteoarthritis. We will understand when surgical intervention is necessary, what problems it solves, and why there is no need to be afraid of surgery for degenerative diseases, when this is the only possible solution to the problem.
In cases where conservative therapy is not effective enough and cannot prevent the development and progression of the disease, it is necessary to decide on the choice of surgical treatment. The decision on the need and extent of surgical intervention is made by an orthopedic surgeon in inpatient orthopedic departments.
Operations on joints in operative orthopedics occupy one of the leading places, which is due to the anatomical and functional characteristics of the joints, their slight “vulnerability” in various diseases leading to structural disorders of the articular apparatus. The synovium is very sensitive to infection, so sterility is of utmost importance. Access to joints is strictly anatomical, sparing periarticular formations and ligamentous apparatus, since violation of their integrity can lead to an unsatisfactory result in the form of joint instability. The choice of immobilization (immobilization) of a joint should be optimal, since excessively prolonged immobilization leads to irreversible changes in the elements of the joint and periarticular tissues.
It is natural for the doctor to expect the patient’s joint function to be restored as a result of surgery. However, as you know, you cannot always count on this. A dilemma often arises: to achieve stability and painlessness of the joint at the expense of loss of movement, or to maintain movement at the expense of loss of stability. In these cases, the old rule of orthopedics is followed: for the lower limb, first of all, stability and painlessness, and then mobility, and for the upper limb, first, painless mobility, and then stability.
Surgical treatment methods include: arthroscopic interventions, corrective osteotomy, joint chondroplasty, joint arthroplasty, synovectomy, arthrodesis and joint replacement. In addition, new methods of surgical treatment are being developed - transplantation of cartilage or its cells.
Joint trauma is often an indication for surgical treatment, since it serves as a factor that provokes damage to the articular cartilage. Microtraumas and increased physical activity, which cause long-term persistent pain and synovitis, create conditions for the development of degenerative and dystrophic processes in the joint. In the absence of adequate treatment, joint instability develops, accompanied by constant trauma to the articular cartilage during movement and progression of deformity.
Operations at various stages of the arthrosis process are one of the components in the system of complex treatment of patients in order to improve the quality of life of a patient suffering from osteoarthritis or deforming arthrosis. It should be noted that surgical treatment is not considered a panacea or complete relief from the disease, but only as one of the stages in a long-term system of treatment and rehabilitation.
Previously, clinical examination and radiography of the joint were considered the most common methods for diagnosing joint diseases. Clinical and radiological findings revealed: narrowing of the joint space, the appearance of subchondral sclerosis, the presence of osteophytes, joint instability, deformation of the articular ends of the bones. However, other symptoms indicating the causes of disease progression and intra-articular changes are not detected by clinical and radiological methods. To plan modern surgical treatments, the orthopedic surgeon needs additional information. Therefore, in these cases, arthroscopy is an important research method.
Arthroscopy is an endoscopic technique designed for visual and tactile examination of the internal structures of the joint, studying the surface structure of cartilage and clarifying the diagnosis using targeted biopsy (sampling material for research).
This method allows not only to resolve the issue of choosing a treatment method, but also to perform surgical manipulations directly during arthroscopy using arthroscopic instruments.
During arthroscopy in an operating room under general anesthesia, a light source, an endoscope (video camera) and arthroscopic instruments are introduced into the joint cavity through small incisions to perform diagnostic and therapeutic procedures. It should be noted that this type of surgical treatment is minimally invasive, that is, minimally traumatic to the joint tissue.
Arthroscopic examination helps to most accurately establish the stage of the arthrosis process, assess in detail the condition of the synovial membrane, determine the color and structure of the cartilage, its elasticity, softening, depth and size of fiber disintegration. Thanks to the presence of a video monitoring system for manipulations in the joint cavity, it is possible, without a large incision and opening of the joint, to perform synovectomy (removal of the altered synovial membrane), removal of the damaged meniscus, cartilaginous loose bodies, osteophytes (marginal bone growths), and restoration of intra-articular ligaments.
It is also possible to wash the joint cavity (lavage), administer drugs (chondroprotectors) and transplant (transplant) cartilage or its cells directly into the lesion. After the operation itself, a video recording remains, which allows you to monitor the quality of the arthroscopy performed.
For diagnostic purposes, arthrosis copy is used in the following cases:
For therapeutic purposes, arthroscopic manipulations are performed:
In general, arthroscopic surgery must solve three problems.
One of the reasons for the progression of degenerative changes in the joint is a violation of the limb axis, which leads to significant overload of the articular surfaces.
Reconstructive operations help eliminate deformation or significantly reduce it, which allows you to restore normal biomechanical relationships of articular structures and improve the function of the joint and limb as a whole.
These operations include: corrective osteotomy, osteoplastic and osteomyoplastic operations, arthroplasty, surgical correction of the anatomical length and axis of the limbs, as well as treatment of congenital and static deformities of the spine and feet.
Surgery itself does not completely eliminate the disease. Long-term staged treatment is necessary to slow down the pathological process in the joint. After surgery, it is necessary to use drugs with chondroprotective and chondromodulating effects, as well as a course of physiotherapeutic and sanatorium procedures.
Restoring painless mobility in the joints and the ability to support the limb is one of the pressing issues in traumatology and orthopedics. Endoprosthetics, which has become a new stage in solving this problem, is the replacement of a destroyed joint with an artificial one. Its high effectiveness lies in the fact that the patient immediately gets rid of pain, lameness, pathological attitudes and shortening of the limb, and lost movements in the joint are restored. If the changes in the affected joint are so pronounced that arthroscopic interventions and corrective osteotomy cannot give a good result, a complete replacement of the joint with an endoprosthesis (artificial joint) is required.
Indications for endoprosthetics are severe violations of static-dynamic function and severe pain. Endoprosthetics should be resorted to when stage 2-3 of deforming arthrosis is detected; pronounced changes in the joint, including complete damage to the articular cartilage, multiple osteophytes, dysplastic arthrosis of the 2nd-3rd stage, fibrous ankylosis of the joint with pathological alignment of the limb, rheumatoid polyarthritis of the 2nd-3rd stage, false joints of the femoral neck.
Today, various companies around the world produce many different designs of endoprostheses from various materials. The most common designs are made of titanium, cobalt-chromium, cobalt-chromium-molybdenum alloys or ceramics with polyethylene bushings. Thus, friction pairs metal - polyethylene or ceramics - polyethylene are the most common.
The success of the operation largely depends not only on its technically correct implementation and choice of endoprosthesis, compliance with the motor regime, but also on the condition of the bone tissue. Therefore, after joint replacement, in order to prevent osteoporosis and instability of endoprosthetic components, drugs that restore the structure of bone tissue should be used.
After endoprosthetics, an individual rehabilitation program is developed taking into account the general physical condition, age of the patient, characteristics of wound healing, and the severity of osteoporosis.
The rehabilitation program includes four stages.
The first stage (2 weeks) includes passive dosed movements and activities aimed at restoring muscle strength.
The second stage (4 weeks) - increasing the intensity of muscle training (static and dynamic exercises), coordination exercises.
The third stage (3 months) - careful restoration of household and other skills, comprehensive rehabilitation treatment in a specialized rehabilitation department of the sanatorium.
At the fourth stage (after 3 months), more extensive restoration of functions occurs, including sports activities.
Arthrodesis operations are aimed at creating a motionless joint (ankylosis). The indication for surgery is severe deforming arthrosis, when it is not possible to use endoprosthetics. The principle of the operation boils down to opening the joint, economical resection of the articular ends and matching them in a functionally advantageous position. Such techniques make it possible to perform arthrodesis without opening the joint.
The goal of arthroplasty is to create a painless, mobile joint with severe joint contracture, bone and fibrous ankylosis. With the advent of joint replacement, interest in classical arthroplasty has decreased significantly. Nevertheless, this method of joint mobilization remains in the orthopedic surgeon’s arsenal to this day.
It should be noted that the operation is not an end in itself that satisfies the pride and well-being of the orthopedic surgeon, but one of the difficult stages in the treatment of degenerative-dystrophic diseases of the musculoskeletal system.
All joints of the body, despite their different structures, have many of the same structural elements. Any joint contains bones covered with cartilage, between the bones moving relative to each other there is a cavity containing intra-articular fluid, the cavity is covered with a synovial membrane, all this is covered by the articular membrane. To make movements, a joint contains muscles, ligaments, and tendons.
It is important to know! Doctors are shocked: “An effective and affordable remedy for ARTHROSIS exists. " Read more.
In cartilage tissue, like in any other tissue, processes of destruction and synthesis occur. Normally, these processes are balanced. Under certain conditions, the process of destruction can proceed faster than synthesis; in this case, the cartilage becomes thinner, the fluid content decreases, and its viscosity changes. Then the cartilage begins to deteriorate, the cavity narrows, bone tissue grows, and the surfaces of the bones begin to rub against each other. If you continue to do nothing, the situation worsens and the joints become deformed. People experience pain with any movement, joint mobility is significantly reduced, up to complete immobility. This is the pathogenesis of arthrosis. Synonyms: arthrosis deformans, osteoarthrosis.
The disease can affect any joint, both large and small. The most commonly affected joints are the knee (gonarthrosis), hip (coxarthrosis), interphalangeal (polyosteoarthrosis) and ankle joints. Since the spinal column consists of vertebrae that are connected by joints, arthrosis of the spine is possible - spondyloarthrosis. This classification is based on the joint in which the pathology develops.
Causes and factors contributing to the occurrence of the disease
The causes of arthrosis are varied and not fully understood. Since dystrophic and degenerative processes occur in the joint, everything that can provoke or contribute to this is the cause of deforming arthrosis. We can highlight:
Find out useful information about the disease from Elena Malysheva and her experts:
Factors provoking arthrosis deformans:
The largest group of patients is the elderly; three quarters of people over 65 years of age have this disease. With age, all tissues age, metabolic processes and blood circulation are disrupted, which leads to a lack of nutrition of the joints. Women get sick more often. This is due to disturbances in the body during menopause. If we talk about post-traumatic arthrosis, the majority in this group are men. They are the ones who are fond of extreme, traumatic sports, and work in areas where large and uneven loads are placed on the joints.
Don't miss the video in which surgeon Stanislav Georgievich Shkipin talks about the problem:
Inflammatory joint diseases - arthritis can be a trigger for deforming arthrosis, as well as chronic and endocrine diseases of the body. Improper nutrition, firstly, can provoke excess weight, and secondly, it does not contain enough elements necessary to nourish the joints. Excess body weight leads to additional stress on the joints. Smoking, excessive alcohol consumption, and drugs negatively affect all metabolic processes in the body, which means they worsen the condition of the joints. All of these factors can affect people of any age. It should be noted that recently many diseases have become much younger. This can be fully attributed to arthrosis. According to some authors, even twenty-year-old people suffer from arthrosis.
Arthrosis deformans is a long-term disease. The main symptoms of the disease are pain and joint deformation. However, the severity of these symptoms depends on the stage of the disease. Typically, arthrosis affects several asymmetrical joints at once.
In the first stage of the disease, mild pain is usually felt after physical activity or when the weather changes. It goes away after rest or after the end of the external factor. There are no restrictions on movements. Most often, a person simply does not pay attention to it.
Further, pain begins to occur not only during movement, but also at rest. Its intensity increases. Stiffness in movements and signs of inflammation appear. Osteophytes begin to grow. When moving, a crunching sound may be heard in the joint. Sore joints may swell slightly. This is the second stage.
The third stage is characterized by an increase in all the symptoms of the second stage. Changes in the ligaments occur: they shorten and lose elasticity, which leads to contracture. The pathological process involves the muscles. They become shorter or stretch out, losing their ability to contract. The joints are noticeably deformed. Lumps may appear on some joints, such as the interphalangeal joints of the hands. Excruciating pain is felt almost constantly; a person may lose the ability to move the joint.
Even “advanced” ARTHROSIS can be cured at home! Just remember to apply this once a day.
Deforming arthrosis is an insidious disease. At the onset of the disease, clinical symptoms still hardly appear, but changes in the joint have already begun. The disease can only be determined by conducting a comprehensive examination. However, during this period, patients rarely consult a doctor, because the discomfort is mild.
Diagnostics requires an integrated approach. It includes a conversation and examination of the patient, the appointment of laboratory and instrumental tests: a detailed blood test, radiography, and, if necessary, MRI. Blood tests for arthrosis are most often normal. Changes corresponding to a certain stage of deforming arthrosis are visible in the photographs. Only a doctor can make a correct diagnosis based on the results of a comprehensive examination.
Treatment depends on the stage of the disease. There is no consensus among experts whether arthrosis deformans can be cured. If treatment is started in a timely manner, there is a high probability that the disease can be cured or stable remission can be achieved using conservative methods. If this is stage 3, conservative methods may not be able to do this; in these cases, they resort to replacing the joint or its individual components.
Treatment is aimed at eliminating symptoms and improving or restoring the condition of cartilage tissue. Usually, with arthrosis, a person goes to the doctor already experiencing severe pain. Therefore, the first task is to relieve pain. For this purpose, NSAIDs are prescribed, for example:
These are “first aid” drugs. Medicines quickly relieve pain, reduce swelling, and relieve inflammation. These drugs do not treat arthrosis because they do not affect the process of cartilage restoration. In addition, they have quite a lot of side effects. To minimize side effects, medications are often prescribed in the form of creams, ointments and gels for topical use. Voltaren gel, Fastum gel, Akrikhin relieve pain well. Now there are new generation NSAIDs, the side effects of which are minimized. Because they do not have a negative effect on cartilage, they are called NSAIDs for the treatment of joints. These include:
After the acute period has passed, treatment with chondroprotectors is prescribed. These drugs are capable of restoring cartilage tissue, but they have one feature: they need to be treated for a long time. Quite often used for treatment:
The drugs are available in various forms. At the first stage of deforming arthrosis, tablets and forms for external use are used: creams, ointments, gels. In later stages, the most effective form is intra-articular injections. Treatment must be comprehensive, therefore, during the period of remission, physiotherapy and exercise therapy are used. A good effect is achieved by using compresses made from Dimexide, Bishofite, and medical bile. They help improve metabolic processes in the joints, which helps restore the structure of cartilage tissue. Acupuncture and hirudotherapy are used for treatment. During the recovery period, the use of natural mud and mineral baths, sanatorium treatment is indicated.
Traditional medicine methods are also used. They are mainly aimed at relieving swelling, inflammation, and reducing pain. Beekeeping products have proven themselves well - honey, propolis. Infusions and decoctions of anti-inflammatory herbs calendula, birch leaves, willow bark. Horseradish and mustard are used as distractions.
There are many drugs and treatment methods, traditional and folk. Your task, after consulting with your doctor, is to choose the treatment that is right for you.
First of all, you need to balance your diet. Diet is the first step towards preventing arthrosis. It is recommended to consume sufficient amounts of protein and foods containing calcium. Fermented milk products meet these requirements. It is necessary to get enough vitamins; they are found in vegetables and fruits. Jellied meats, jellies, and jellied dishes are useful for arthrosis. It is recommended to eat more fish. It is preferable to steam fish and meat. It is worth paying attention to your drinking regime. It is necessary to drink enough clean, still water. It is advisable to drink water before every meal. Smoked meats, pickles, and sweets should be excluded from the menu.
Homeopathic doctor, herbalist and nutritionist Lyudmila Ermolenko paid special attention to the issue of nutrition for illness:
Lead an active lifestyle, do preventive exercises.
Deforming arthrosis is a formidable and insidious disease that can significantly worsen the quality of life, lead to disability and even complete immobility of diseased joints. If you are sick, only persistence and meticulous implementation of all the doctor’s recommendations will help you recover or achieve stable remission. You need to be attentive to your health not tomorrow, but today.
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