Arthrosis (joint wear)

Description

Joints are not exempt from wear and tear. Painful, excessive wear and tear of the cartilage layer of joints is called osteoarthritis. Over time, bones, muscles, joint capsules and ligaments are also affected.

Most commonly affected are heavily used joints of:

• Spine
• Hip
• Knee
• Feet

To date, osteoarthritis cannot be cured. However, symptoms such as pain can be alleviated and the progression of wear and tear can be stopped.

If a joint is particularly severely affected by the disease, it can be replaced by an artificial joint (endoprosthesis).

Of all the diseases affecting joints, osteoarthritis is the most common worldwide. Almost everyone is affected sooner or later, mostly in the knee or hip joints.

The foundation for osteoarthritis is laid as soon as the cartilage of a joint is overloaded. In case of an already existing damage, even a normal load is sufficient.

The reason why some people are affected earlier (in some cases already in their youth) and some are not has not yet been adequately clarified. The main causes are still determined to be overload and many years of incorrect loading.

Possible risk factors:

• hereditary factors (especially in finger joints)
• Congenital deformities (e.g. knock knees, bow legs, hip dysplasia)
• Incorrectly healed injuries or operations (e.g. meniscus, cruciate ligament)
• Years of overstraining (e.g. competitive sports, overweight and heavy physical work)
• Metabolic diseases (e.g. diabetes mellitus)

The onset of osteoarthritis is not easy to recognise. There are rather inconspicuous complaints such as stiffness, sensitivity to the weather or an unsteady gait.

Starting pains are clearer warning signs. It is joint pain at the beginning of a movement, which decreases with continued movement.

As the wear and tear on the joints progresses, the complaints become more pronounced:

• Pain on impact (e.g. running downhill)
• overheated, reddened joints (inflammation due to worn material, activated arthrosis)
• Deformation of joints (up to immobility)
• pain at rest
• pain at night

How strong the pain is usually alternates in more or less pronounced phases.

Arthritic changes can be determined on the basis of an X-ray examination, as can the degree of wear.

Visible disease progress and the associated subjective sensation vary from patient to patient. Therefore, even mild arthrosis can cause severe pain.

Whether the mobility is limited is determined with the help of a physical examination.

Depending on the pain and possible restriction of movement, a treatment strategy is then determined.

Joints that are already worn out cannot be regenerated up to the present time. Therefore, early detection of the disease is extremely important.

Relieve the joints

The course of the disease can be positively influenced, e.g. by relieving the joints.

For this reason, overweight people should urgently reduce their body weight. With orthopaedic aids (hand cane, buffer heels, insoles), malpositions can be compensated for and complaints alleviated.

The nutritional status of the cartilage is improved by exercise without load (swimming, cycling at very low speeds), which counteracts the progression of wear and tear.

Physiotherapy and physical therapy also have positive effects. Massages, heat and cold treatment strengthen the musculature and thus protect the joints.

Drugs and medicines

Pain and inflammation can be alleviated by medication.

Pain therapy is divided into cortisone-containing and cortisone-free drugs (so-called non-steroidal anti-inflammatory drugs and COX-2 inhibitors). There is also the possibility of injecting cortisone directly into the joints (in particularly severe cases).

Some doctors recommend injecting hyaluronic acid into affected joints as synovial fluid. There are patients who respond very well to this after 3-6 injections and complaints improve between 6 and 12 months.

Furthermore, nutritional supplements are offered in many pharmacies and drugstores. These preparations are supposed to help build up cartilage with ingredients such as chondroitin sulfate and glucosamine sulfate. The effect has not yet been clearly proven, but some studies show a positive effect (stabilizing, alleviating pain), others show no effect.

Artificial joint

Patients with particularly pronounced arthrosis have the option of surgery. In this case, the damaged joint is replaced by a prosthesis (artificial joint) in the course of a surgical intervention. This is followed by a stay in hospital (up to 2 weeks) and physiotherapeutic training to build up muscles and learn how to use the new joint.

Depending on lifestyle, activity and stress on the prosthesis, it will remain functional for around 20 years or even longer. If necessary, it can be replaced.

Artificial tissue

Thanks to the rapid progress of biotechnology, it is now possible to grow cartilage tissue. The starting tissue is the body's own cartilage, which is artificially cultivated (tissue engineering) and implanted. However, the implantation must take place before the bone under the affected joint is damaged.

It is hoped that this will be particularly successful for knee joints in the future.

To date, damage to cartilage and bone material cannot be reversed.

Therapy is limited to alleviating discomfort and slowing down the progression of osteoarthritis. Despite the tendency towards a negative prognosis, every available therapy should be used.

In order to prevent arthrosis, it is above all necessary to avoid incorrect and excessive loading of joints. The correction of malpositions can sometimes be useful (surgery for knock-knees and bow-legs).

Losing unnecessary kilos is the best way to relieve your body.

Exercise strengthens muscles and cartilage. Sports that are particularly easy on the joints, such as swimming or cycling, are recommended to promote cartilage nutrition. Parallel to this, targeted muscle building training is recommended, which makes movements more secure and avoids one-sided strain.

Therefore, try to incorporate more movement into your daily routine. For example, you could do small purchases by bicycle, or prefer a short walk to the car.