Many people suffer from the joint disease osteoarthritis, especially in old age. Osteoarthritis is triggered by wear and tear and a dwindling cartilage layer. The joints become inflamed.
The cartilage serves as a protective layer between the ends of the bones so that they do not rub against each other and is also a shock absorber that distributes the load evenly across the joints. Due to wear and tear and incorrect loading, the cartilage takes damage and disappears more and more. The result is increasing pain, for example shoulder pain or knee pain. The joint becomes stiffer and therefore less mobile. The arthritis pain leads to the adoption of a protective posture. This only aggravates the condition, as the cartilage is less well supplied with blood and loses its protective function. In addition, other joints are put under unfavorable strain.
In most cases, osteoarthritis does not develop until older age, but earlier diagnosis of osteoarthritis is also possible. Joints that are constantly subjected to high stress and heavy loads are particularly susceptible to cartilage damage. The knee joint is therefore most frequently affected, followed by the hip, shoulder, finger and toe joints.
There are many causes of osteoarthritis. In addition to the aging process, common risk factors include:
- Excess weight due to excessive strain
- Malpositions such as knock-knees or bow-legs due to incorrect loading
- Arthrosis after an accident or injury
- other diseases such as rheumatism, diabetes or gout
The greatest risk for osteoarthritis is the lack of regular exercise. Good muscular stabilization and good coordination skills are therefore important to preserve the joint and prevent osteoarthritis.
Arthrosis develops insidiously and usually begins before those affected notice the first symptoms. The first symptoms are pain on exertion and increasing restrictions on movement of the affected joint. The cartilage is less able to distribute the pressure. If the disease progresses further, the cartilage is further severely damaged, reducing the distance between the bones. This increases the stress on the bones and inflammation is possible. Swelling develops, increasing the circumference of the joint. In a later stage of osteoarthritis, pain also occurs at rest and start-up pain after a period of rest. In the final stage of the disease, bony outgrowths also form due to the bones rubbing against each other, causing unbearable pain and the joint becomes stiff.
In order to determine arthrosis and the corresponding stage, it is first important to ask when the joint pain occurs and how it manifests itself. In a detailed medical history, occurring joint complaints in the family and previous accidents and injuries are considered. In addition, the doctor checks the gait pattern and mobility and whether there is any swelling at the joint.
Further information on the stage of arthrosis is provided by an X-ray or ultrasound, among other things. The X-ray shows a possible change in the joint space and whether bone has formed at the joint.
An ultrasound, on the other hand, also shows capsules and muscles and thus also makes inflammation of the joint mucosa and joint capsules visible. An MRI even reveals the early stages of osteoarthritis, as soft tissues such as cartilage and structures of the joint capsule, tendons, ligaments and muscles are clearly visible.
Physiotherapy and other conservative measures such as painkillers alleviate osteoarthritis pain and halt its progression. Osteoarthritis is not curable, however, because the cartilage does not form anew.
The decisive factor for treatment is how far the osteoarthritis has progressed. In order to first treat the cause, it is necessary, for example, to correct malpositions such as knock knees or bow legs. For mild forms of arthrosis, joint-preserving interventions with arthroscopic artholysis can be used. The mobility of the joint is thereby restored. Another arthroscopic procedure is cartilage cell transplantation. The physician inserts the patient's own, regenerated cartilage cells. However, the prerequisite is that the cartilage damage is still minor.
In severe forms of osteoarthritis, it is no longer possible to successfully preserve the joint. In this case, the only option is an artificial joint. This procedure is used very often in cases of arthrosis, primarily in older patients, since the durability of endoprostheses is limited. Our specialists for artificial joint replacement at the Hellersen Sports Clinic provide detailed advice on the various options for osteoarthritis and when an artificial joint is necessary.