OsteoarthritisArthrosis is the most common form of joint disease, affecting around seven million people in Germany. Many patients suffer from the symptoms of osteoarthritis in several joints at the same time. To prevent the disease from taking too serious a course, it is important for an orthopedist to initiate the appropriate therapy in good time.
What does arthrosis mean?
Typical for the disease is that the cartilage layer of the joints becomes thinner and thinner. The cartilage, the elastic and protective joint region, covers the joint-forming parts with a protective layer of varying thickness depending on the load and strain. In a healthy state, the cartilage layer acts as a shock absorber in the event of sudden or hard movements, allowing for smooth movement. As osteoarthritis progresses, the cartilage continues to dissolve and eventually dissolves completely, causing the two ends of the bones to rub against each other without protection. This leads to changes and hardening in the bone tie. Movements are becoming more restricted. In the end they are possible only under partly strong pain.
The Arthrose occurs in many cases in the joints of the hand and fingers as well as at the knee and hip joint. However, all other joints can also be affected. If you suspect the presence of the disease, you should make an appointment in our orthopedic consultation hours.
Which causes lead to arthrosis?
The exact circumstances are not exactly clarified until today. Possible triggers include:
– An older age is considered a risk factor for the development of arthrosis. The reason for this is that the elasticity and load-bearing capacity of the articular cartilage decrease significantly during aging. However, pathological changes in the joints are also being found more and more frequently in younger people.
– In addition, injuries and accidents are among the most frequent causes. The smallest cracks or irregularities in the area of the ligaments and tendons are already sufficient to negatively influence the structure of the cartilage. Also, a long-term overuse or misuse. Excessive body weight is one of the typical triggers of osteoarthritis. Both can lead to overstressing of the joints.
– Since studies have shown that arthritic changes occur more frequently among family members, a genetic component cannot be ruled out.
– Congenital malpositions also promote the development of arthrosis due to the accompanying one-sided body strain. In sufferers, one side of the body usually has to bear significantly more weight, so the breakdown of joint cartilage can often be accelerated.
The origin of the disease to a single cause, is usually not possible. Nowadays it is amed that different factors play a role.
What are the symptoms of osteoarthritis?
Osteoarthritis is often accompanied by painful inflammation in the joint and swelling. However, the disease can also occur without accompanying signs of inflammation. It often begins with stiffness-. Feelings of tension in the corresponding joint. Typical are also the start-up pains. This means that they are violent at the beginning of a movement and slowly decrease with increasing load. As the disease progresses, pain on exertion develops. Later to a permanent pain with a movement restriction. This results from the disturbed friction behavior of the roughened joint surfaces and the increasing destruction of the cartilage layer.
The more the disease progresses, the greater the pain, especially under stress. A noticeable overheating is characteristic. Damp and cold weather intensifies the complaints. When pain at rest occurs, an inflammatory process often takes place in the joint. In this case, the body tries to break down the tie and cellular debris that results from joint destruction. The enzymes released additionally attack the pre-damaged cartilage. Cause an inflammatory reaction in the joint. This is called "activated arthrosis" spoken.
Further symptoms are cracking and grinding noises when moving the respective joint as well as muscle tension around the joint. The further the wear progresses, the more intense the symptoms become. In this case the pain occurs more frequently. Also at rest on. The joint's ability to move decreases more and more.
How does an orthopedist diagnose osteoarthritis??
First of all, the anamnesis, that is, the detailed consultation, always takes place. Here, the orthopedist should learn every detail, even if it seems unimportant, for example, a strange feeling in the joint, unusual noises when moving or pain that occurs only under load. This makes it easier for the orthopedist to make the diagnosis. Initiate suitable therapy more quickly.
Ultrasound
Sonographic diagnostics provide precise indications of swelling conditions in the joint. In the hand of the practiced user, the bony joint partners can be recognized. Their form can already show the joint congruency in the ultrasound image. The consequence of a chronic inflammatory change, the thickened joint capsule, can be estimated.
Laboratory values
Certain laboratory parameters can increase and help to differentiate between mechanical, inflammatory or metabolic arthrosis.
X-ray
The most important instrument for the determination of arthrosis is the X-ray image. This enables the orthopedist to secure the diagnosis. If possible, the images should be taken with weight on the body to better assess the extent of degenerative joint stress.
Magnetic resonance imaging
Magnetic resonance imaging (MRI) is an informative procedure for further deciphering osteoarthritis. In particular, soft tie damage in the joint (tendons, ligaments, capsule, cartilage thickness and extent of cartilage damage) can be well assessed. In the case of advanced arthrosis, MRI does not necessarily provide any further necessary insight. Accordingly, MRI should not be used indiscriminately as the first imaging procedure. However, the complete diagnosis of a joint always includes X-ray imaging and ultrasound application.
Arthroscopy
In rare cases, an arthroscopy (arthroscopy of the joint) must be performed to ensure the diagnosis through tie samples of the inner structures of the joint.
Therapy of arthrosis
The orthopedist is the contact person for all joint complaints, so that he also initiates the appropriate treatment in the case of arthrosis. These include conservative. Surgical measures.
Medication
If the cartilage of the joint is not yet severely damaged, medications are prescribed, often nonsteroidal anti-inflammatory drugs (NSAIDs)or selective Cox-2 inhibitors. This will alleviate the pain. Inflammation symptoms reduced. At the same time, the ability to move is also improved in this way. If the above-mentioned substances do not bring sufficient improvement, intra-articular infiltrations can provide relief. Here, the active ingredient used is injected directly into the affected joint. Extreme care should be taken. By using sterile materials, sufficiently long disinfection, as much silence as possible during the procedure and application at the most suitable place of the respective joint, the concomitant risks can be minimized.
Physiotherapy and exercise
Physiotherapy is another component in the treatment of osteoarthritis. Physiotherapeutic exercises can improve the mobility of the joints and also relieve pain. Physiotherapy strengthens the muscles. Tension can be relieved by massage. In addition, the blood circulation is promoted. Dressings, bandages, soft shoe soles, and crutches relieve prere on the joints. For effective treatment of osteoarthritis, the orthopedist will also recommend regular exercise, such as swimming, walking on flat terrain and cycling.
Physical therapy
Heat applications, natural mud mud, infrared light, electrotherapy or specific applications in the water bath can relieve pain in osteoarthritis. Acute complaints such as swelling, on the other hand, tend to be improved with cooling applications.
Replacement of the joint fluid
Synthetic replacement of synovial fluid is used with good results, especially in cases of osteoarthritis of the knee. Here, joint fluid is injected directly into the joint space. In the case of mild and moderate arthrosis, long-term symptom-free intervals can also be achieved.
Operative joint-preserving measures
Surgical measures are the last resort, if the initiated treatment methods do not bring the desired success.
– The orthopedist usually has to perform the arthroscopy on an outpatient basis. During the less invasive procedure, the joint is cleaned, rinsed and the cartilage is smoothed. The indication should be extremely cautious in case of degeneratively altered joints. Recent studies could not prove any advantage over other non-surgical measures in the medium and long term.
– In an adjustment operation, the joint axis is changed by a corrective intervention in such a way that the degeneratively changed part of the joint is moved out of the load zone, resulting in a lower overall wear situation for the joint. In particular at the knee and the hip such corrective osteotomies are used.
Joint-preserving and gentle strategies should be at the forefront of osteoarthritis therapy. In most cases, the use of several suitable therapeutic approaches can significantly improve the symptoms for a long time and dramatically increase individual mobility.
How does osteoarthritis progress?
While the severe pain initially occurs only during exertion, it later becomes apparent even at rest. Musculature declines as a result of sparing, cartilage damage up to and including complete wear and tear can be detected over large areas. As a result, the joint space becomes increasingly thinner. As osteoarthritis progresses, mobility becomes more limited and painful. Bone density may decrease and joint swelling, redness, hyperthermia and increasing deformation of the joint may be observed.