Deforming osteoarthritis: symptoms, treatment, complications
The content of the article:
- DOA forms
- Symptoms of deforming osteoarthritis
- Diagnosis of the disease
-
Treatment of deforming osteoarthritis
- Drug therapy
- Surgical treatments
- Helper methods
- Complications of DOA
- Video
Deforming osteoarthritis (DOA, in the English language literature referred to as osteoarthritis) is a common joint disease that develops as a result of prolonged exposure to various factors that gradually destabilize the processes of cartilage restoration. DOA belongs to the group of degenerative-dystrophic diseases of the connective tissue.
Professional athletes are at risk of developing DOA
Unable to fully recover, the cartilage gradually becomes thinner, loses its former elasticity and rigidity, and its surface becomes rough, covered with microcracks. The area of the bone on which the cartilage is attached is exposed, osteophytes grow on its surface, and as the disease develops, all joint tissues are affected.
The most at risk of osteoarthritis are the elderly, overweight (especially in relation to the knee joints), women during menopause, workers in occupations where knee bending is often necessary, professional athletes and patients with hereditary collagen type II deficiency.
As the disease progresses, cartilage tissue changes
Clinically, DOA manifests itself as pain during movement (arthralgia), decreased joint mobility, deformity, and crepitus (crunching).
DOA forms
There are two forms of deforming osteoarthritis:
- primary: the disease occurs in healthy cartilage (for unknown reasons);
- secondary: destruction develops against the background of obvious cartilage defects provoked by trauma, chronic inflammatory process, aseptic necrosis of bone tissue, hormonal or metabolic diseases, obesity, the consequences of arthritis.
Symptoms of deforming osteoarthritis
For all types of DOA, regardless of the rate of development of cartilage degeneration, the leading signs of the disease are pains of various types and intensities in the affected joints. First of all, the so-called support groups are susceptible to the disease: knee (gonarthrosis), hip (coxarthrosis), spine and small interphalangeal joints of the hands and feet.
Pain syndrome options:
| Arthralgia type | Cause of occurrence | Clinical features |
| Mechanical pain | Lack of amortization qualities of the cartilage and subchondral region | They are present during the load on the affected joint, they reach their maximum in the second half of the day, their intensity decreases after a long rest |
| Starting pains | Development of reactive synovitis (inflammation of the articular membrane and the presence of effusion in it) | They are most pronounced at the beginning of the load (up to 20 minutes) and gradually subside as they move |
| Pain caused by tendobursitis and periarthrosis | Accession of inflammation of the tendons that support the joint | Observed during movements that involve these tendons |
| Night pains |
Caused by venous congestion in the subchondral layer of the periosteum, involvement of the bone marrow in the process |
Occur at night and gradually disappear in the morning when walking |
Also, pain is accompanied by the involvement of the joint capsule in the degenerative process, reflex spasm of the adjacent muscles and the block of the articular mouse (tissues of the free area of the destroyed cartilage) in the inter-articular gap.
As a result of the proliferation of osteophytes, the range of motion is limited
Other symptoms:
- crepitus;
- limitation of the range of motion (caused by the growth of osteophytes and muscle spasm);
- gradual and irreversible deformation of the joint.
Diagnosis of the disease
If you suspect degenerative diseases of the musculoskeletal system, you should consult a rheumatologist. The doctor can diagnose DOA if the patient has a triad of signs:
- complaints of pain;
- changes on the radiograph;
- visual signs of joint deformity.
Radiography is a widely available, objective way of diagnosing and assessing the effect of treatment with DOA.
X-ray is an objective way to diagnose pathology
X-ray signs of arthrosis:
- narrowing of the joint space (the dark space between two bones on an x-ray);
- subchondral sclerosis (compaction of the bony area on which the cartilage is attached);
- osteophytes - bony processes that change the contact area and the contour of the articular surfaces;
- cystic remodeling of bone tissue;
- increased density (ossification) of adjacent tissues.
Additional research methods make it possible to more accurately determine the stage of the disease, the degree of joint damage, and select an adequate therapy. These include:
- arthroscopy with targeted biopsy of the synovium and cartilage;
- analysis of synovial fluid;
- Ultrasound (the best method for visualizing articular cartilage);
- MRI, CT, scintigraphy (performed for differential diagnosis or in the preoperative period).
Treatment of deforming osteoarthritis
DOA is characterized by gradual development with periods of exacerbation and attenuation of clinical manifestations. The disease progresses regardless of the treatment, there is never a reverse development of degenerative changes. All treatment methods are aimed at reducing the degree of discomfort and maximizing the patient's physical activity.
There are two approaches to the treatment of this disease - conservative and radical. Both are aimed at preventing the development of disability and improving the patient's quality of life.
Drug therapy
This approach to the treatment of a patient with DOA consists of prescribing symptomatic and structurally modulating drugs.
With DOA, drugs with symptomatic and structural-modulating action are used
Symptomatic drugs are used to reduce pain and inflammation. These include:
- non-steroidal anti-inflammatory drugs: preference is given to selective COX-2 blockers;
- hydrolytic enzymes: systemic enzyme therapy;
- glucocorticosteroids: intra-articular administration of prolonged forms, no more than 4 times a year.
The use of the following means is shown:
- glucosamine sulfate by injection;
- chondroitin sulfate tablets;
- interleukin-1 inhibitors;
- hyaluronic acid injections.
Local therapy of the disease is carried out in case of development of periarthritis:
- infiltration of painful areas of soft tissues with glucocorticosteroids with anesthetics;
- application of anti-inflammatory ointments;
- phonophoresis of hydrocortisone and other methods of physiotherapy.
Surgical treatments
The type of orthopedic surgery differs depending on the X-ray stage of osteoarthritis.
The type of orthopedic surgery is determined by the stage of the disease
On the I – II st. it is recommended to carry out corrective osteotomies: removal of areas that interfere with movement in full or in which there are signs of malignant degeneration. This method is effective in 90% of cases. The duration of the functioning of the prosthesis exceeds 10-15 years.
At III – IV st. held:
- total arthroplasty: replacement of an artificial joint;
- arthrodesis: complete immobilization of the joint in a functionally advantageous position by removing the articular surfaces with subsequent fusion of the bones.
Helper methods
How helper methods are used:
- physiotherapy;
- physiotherapy;
- spa treatment: hydrogen sulfide, mud and mineral baths are especially useful.
Complications of DOA
One of the most frequent complications of pathology is secondary reactive synovitis.
A long course of deforming osteoarthritis can lead to a number of other consequences:
- spontaneous hemarthrosis: sudden hemorrhage inside the articular cavity;
- ankylosis: complete lack of mobility in the joint;
- osteonecrosis of the femoral processes;
- external subluxation of the patella.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
