Osteoarthritis

knee-osteoarthritis

       Degenerative changes of articular cartilage, which then cause changes in other parts of the joint (joint capsule, bone), and sooner or later it is characterized by pain and impaired joint function, called arthrosis, osteoarthrosis or osteoarthritis.

      Frequency – Due to the modern way of life, arthritis is today a major socio – medical problem, particularly in developing countries. Epidemiological studies have shown that in highly developed countries 50% of people older than 40 years on the joints can prove arthrosis change, but at this age usually clinically asymptomatic.

      The cause of the – Despite intensive research, the cause of the degenerative joint disease is still largely unknown. The aging process of tissues, many external factors, hormonal balance disorders and hereditary predisposition, the factors responsible for the emergence of arthrosis.

      Depending on the causes of degenerative joint disease, we distinguish between primary and secondary arthrosis. In primary arthrosis with normal load, a “weakness” of the cartilage of unknown origin. In secondary arthrosis, under normal cartilage overload, and can be the result of injury, congenital abnormalities of joints, metabolic and endocrine diseases, inflammation, etc.

      Clinical picture – Deformation of joints, crepitus – crackling when  joint moving, tenderness of creating areas of bone apposition, joint – instability due to frequent outpouring in the articular cavity, with reduced functional capacity of the joint.  Process of arthrosis can affect any joint, but usually are affected leg joints (hip, knee, ankle) and joints of the spine  as they are most loaded. First, there is a softening and thinning of the articular cartilage resulting narrowing joint space.

      This causes the surrounding reaction (subchondral) bone thickens  (sclerosed), creates new bone accumulations (osteophytes), and finally yields under load while bone cysts occur ie. cavities in the bone. As a result of the changes described, there are symptoms as pain, reduced mobility, reduced muscle tone and deterioration of the surrounding muscles and others. Symptoms of the disease progressing with time and intensity of degenerative changes joint contracture, a thickening of the joint.

      Diagnosis – In addition to the symptoms, the disease can be diagnosed on the basis of radiography. The characteristic radiologic changes in affected joints confirm the diagnosis, but it should be noted that radiological changes are not always correlate with clinical symptoms. In extremely rare cases the diagnosis can be used and other radiological tests (CT, NMR).

      Treatment – Unfortunately, changes in cartilage and bone are irreversible. Treatment consists in reducing pain and muscle spasm, improving function, prevention of contractures and training for activities of daily living. Treatment can be: drugs – antirheumatic , anti-inflammatory, miotonolitici, physiotherapy – hydrotherapy (enables movement in the wrist with a reduced load), kinesitherapy  (relieving exercises and then strengthen the stabilizer muscles of the joint) and electrotherapy (mainly analgesic).

      Surgical treatment (palliative, causal, arthroplasty, arthrodesis and experimental attempts to replace or regenerate cartilage).

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