Osteoarthritis is manifested primarily by pain and limitation in everyday functioning. It often makes it impossible to work or pursue a hobby, thus worsening the quality of life. Therefore, treatment should be started as early as possible.

Contents:

  1. Osteoarthritis - diagnosis
  2. Osteoarthritis - Pain Relief
  3. Osteoarthritis - rehabilitation treatments
  4. Osteoarthritis - joint repair
  5. Osteoarthritis - cartilage reconstruction

Osteoarthritisstarts off discreetly. Over time, pain occurs when carrying heavy objects, after prolonged walking, and in the morning or after resting, the joints become stiff. It takes several minutes to start them. As the lesions progress, the joint becomes deformed: bone spurs (osteophytes) form on the edges of the articular surfaces, and there is also joint exudate due to the development of inflammation caused by damage to the joint surfaces. However, the most troublesome is the restriction of the range of joint mobility and the pain.

Osteoarthritis - diagnosis

If symptoms persist or worsen, see a specialist. The orthopedist will conduct an interview, examine the joint and check the range of its mobility, and order an imaging test (X-ray, ultrasound or magnetic resonance imaging) to confirm the diagnosis. If he suspects an inflammatory disease of the joints such as rheumatoid arthritis, he will also need a blood test for this. The therapy is selected individually, incl. depending on age, severity of symptoms and advancement of changes. Treatment includes various therapeutic methods and aims to alleviate or remove pain, maintain joint function, and slow down degenerative changes. It is important to have a proper lifestyle and lose unnecessary kilograms, which also helps to relieve ailments.

Osteoarthritis - Pain Relief

In the fight against pain, paracetamol (especially in the early stages of the disease) and non-steroidal anti-inflammatory drugs (NSAIDs) are used. The latter, however, should not be taken for a long time due to side effects, such as gastrointestinal bleeding, kidney damage.However, you can use topical ointments or gels containing NSAIDs.

Viscosupplementation gives very good results - administering hyaluronic acid directly to the joint (in the form of injections), which is the main component of the synovial fluid. The substance increases the viscosity of the synovial fluid, which reduces friction in the joint and improves its mobility.

Hyaluronic acid also has an analgesic and anti-inflammatory effect. The effect is a significant alleviation of symptoms for a long time (depending on the type of preparation - up to a year). Evidence for the effectiveness of oral chondroitin, hyaluronic acid, and collagen supplements in the treatment of osteoarthritis is still lacking. Only in the case of glucosamine sulphate it has been shown that it can reduce joint pain and improve the functioning of patients.

Osteoarthritis - rehabilitation treatments

Systematic exercises (kinesiotherapy) are an essential element in the treatment of all rheumatic diseases, which allow you to stay fit for longer. Depending on the severity of the disease, the doctor issues a referral to individual or group classes. The set of exercises selected by the physiotherapist must also be performed at home.

Gymnastics increases the range of motion in the joint, reduces pain and strengthens the muscles responsible for its stabilization. In the case of degenerative changes, exercises in the swimming pool are also recommended, because the water relieves the joints.

The treatment is supplemented with physiotherapy treatments, such as cryotherapy, magnetotherapy, ultrasounds or laser therapy, which relax the muscles and relieve pain, but do not heal the joint.

Osteoarthritis - joint repair

Currently, arthroscopic methods of treating joints (minimally invasive surgery) are developing dynamically, with which not only large joints, such as the knee, shoulder and hip joints can be operated, but also smaller ones - ankle joint, elbow or wrist.

In the case of the knee, two small cuts are usually made. The end of the video track is inserted through one, which allows, after filling the joint cavity with physiological saline, to see exactly all intra-articular structures and articular surfaces on the screen. Through the second cut, special tools are introduced that allow, inter alia, for the removal of damaged fragments of menisci and the preparation of foci of cartilage damage (e.g. making the so-called microfractures).

Currently, modern techniques for the repair of cartilage (such as collagen membranes) and menisci (modern tools for suturing menisci and implants to replace or create conditions for the reconstruction of damaged cartilage) are being used on an increasing scale.fragment).

Under arthroscopy, you can also perform ligament reconstruction (in case of joint instability), treatment of intra-articular fractures (to make sure that the joint surface has been optimally reconstructed).

In the hip joint, arthroscopy is most often performed in the case of the so-called femo-acetabular conflict (repeated abnormal contact between the acetabular edge and the proximal femoral end).

A fragment of the femoral neck can be removed from a few small incisions, the damaged labrum can be prepared and the conflicting part of the acetabular roof can be removed.

Such a procedure can significantly slow down degenerative changes. It is worth mentioning the corrective osteotomies used in the case of valgus or varus disorder of the legs. Such a situation causes large overloads in only one compartment of the knee joint, and consequently a much faster development of degenerative changes in this limited area.

The procedure consists in cutting the tibia or femur (i.e. osteotomy) and after correcting the axis of the limb with stable fixation with implants, it transfers the loads to the he althy compartments of the knee, improving the comfort of functioning and postponing the need to implant an endoprosthesis for several or several years.

Osteoarthritis - cartilage reconstruction

In the treatment of degenerative disease, stem cells have been used for several years to help rebuild cartilage defects and, under certain conditions, can transform into cartilage tissue and / or affect the formation of cartilage scar.

During the procedure, cells from the patient are usually used, which undergo a process of concentration. The suspension obtained in this way is administered directly to the joint with a needle or soaked in collagen matrices placed in the bed of the prepared cartilage defect. The procedure is not reimbursed by the National He alth Fund, privately it costs several thousand zlotys.

Worth knowing

When the previous methods of treatment fail, implantation of an artificial joint (arthroplasty, arthroplasty) remains. It is better to perform such a procedure as late as possible, because our activity decreases with age and, consequently, the overload transmitted by the implant as well.

Knee arthroplasty: what is this operation and what are its effects?

Hip and knee endoprosthesis. Types of endoprostheses available in Poland

It is worth postponing the decision to perform an endoprosthesis with smaller procedures performed earlier (such as an osteotomy). During the operation, the damaged joint (most often the hip or knee joint) is removed in its entirety oronly the destroyed compartment, and in its place an endoprosthesis made of metal and polyethylene is placed (but in hip arthroplasty, joints of ceramic-polyethylene, ceramic-ceramic or metal-metal surfaces are often found).

Ideally, the joint can be put on weight a few days after the surgery, but sometimes you have to wait 6-8 weeks. Unfortunately, implantation of a prosthesis is a serious procedure with the risk of postoperative complications, as well as later complications, such as loosening, periprosthetic fractures, infection, which may require another surgery.

Therefore, this method of treatment is used as a last resort. Endoprosthesoplasty is performed under the National He alth Fund, but you have to wait up to three years for the operation. In private clinics, the procedure costs from several thousand zlotys.

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Category:

Geriatrics