The deforming osteoarthrosis
Contents:
see also:
Description:
The deforming osteoarthrosis - a chronic degenerative disease of joints which cornerstone the degeneration of a joint cartilage with subsequent change of bone joint surfaces, development of regional osteophytes, deformation of a joint, and also development of moderately expressed synovitis is.
Distinguish primary and secondary deforming osteoarthrosis. Primary deforming osteoarthrosis develops in a cartilage healthy before under the influence of its excessive loading. At the secondary deforming osteoarthrosis there is a degeneration of already previously changed joint cartilage.
Symptoms of the Deforming osteoarthrosis:
About 10% of the population are ill an osteoarthrosis, women at the age of 40-60 years are more often, after 60 years the disease occurs practically at 100% of people. The main and general signs for the deforming osteoarthrosis of any localization is the following:
- Joint pains of mechanical type, arise at load of a joint, it is more by the evening, calm down at rest and at night. Pains are caused by trabecular microfractures, a bone venous staz and intra medullary hypertensia, irritation of surrounding fabrics osteophytes, a spasm of circumarticular muscles. At development of venous staz in subchondral department the dull "vascular" aches arising at night and disappearing at morning activity are possible.
The "starting" joint pains appearing at the first steps of the patient, then disappearing and again arising at the proceeding loading. Can be a sign of a reactive synovitis. Development of a synovitis is followed by strengthening of pain, a joint swelling.
- Periodic "jamming" of a joint ("blockade" pain) - the sudden sharp joint pain at the slightest movement caused by joint "mouse" - infringement of a piece of a nekrotizirovanny cartilage between joint surfaces. Pain disappears at the certain movement leading to removal of "mouse" from a joint surface.
- Crepitation at the movements in a joint.
- The permanent deformation of joints caused by bone changes.
- Rather small restriction of mobility of joints, except for coxofemoral.
- Existence in the anamnesis of a mechanical overload of a joint or injury, inflammatory or metabolic diseases of joints.
- Existence at the patient of disturbances of a statics, neuroendocrinal diseases, disturbances of local blood circulation, arthrosis at parents.
The reasons of the Deforming osteoarthrosis:
The reasons of primary osteoarthrosis are finally not known. The major estimated factors of development of primary osteoarthrosis are:
- discrepancy between mechanical load of an articulate cartilage and its opportunity to resist this influence;
- the genetic predisposition which is expressed, in particular, in decline in the ability of a cartilage to resist to mechanical influences.
In development of primary osteoarthrosis the large role is played by interaction of the external and internal contributing factors.
The external factors promoting development of primary osteoarthrosis of an injury and joint microtraumatization; functional overload of a joint (professional, household, sports); hyper mobility of joints; unbalanced food; intoxications and professional harm (nitrates, salts of heavy metals, herbicides, etc.); abuse and intoxication of alcohol; the postponed viral infections.
The internal factors contributing to development of primary osteoarthrosis: the defects of a structure of a musculoskeletal system and disturbance of a statics leading to change of congruence of joint surfaces (flat-footedness, a dysplasia, genu varum, genu valgum, backbone scoliosis); excess body weight; endocrine disturbances; disturbances of the general and local circulation; the accompanying chronic diseases, including the previous arthritises.
Are the main reasons for secondary osteoarthroses: joint injuries, endocrine diseases (diabetes mellitus, acromegalia, etc.); metabolic disturbances (hemochromatosis, ochronosis, gout), other diseases of bones of joints (pseudorheumatism, infectious arthritises and other inflammatory diseases of joints, aseptic necroses of bones.
Treatment of the Deforming osteoarthrosis:
The existing methods of treatment of the deforming osteoarthrosis can be broken into 3 big groups:
1. Non-drug treatment.
Joint gymnastics, LFK, decrease in body weight at obesity. Short-term rest and an additional support when walking in case of a coxarthrosis and a gonartroz. To avoid overcooling.
Physical therapy: magnetotherapy; electro-, фонофорез bischofite hydrocortisone; ozokerite/paraffin in the absence of a synovitis.
2. Drug treatment.
Basic therapy.
Nonsteroid analgetics.
Treatment of a synovitis.
3. Surgical treatment.
