Osteoarthritis is a chronic joint disease where the cartilage of the joint is gradually destroyed.When cartilage is destroyed, changes in the bone that cartilage cover and in the joint capsule.However, this description is not entirely accurate, as with arthosis in the joint there are some inflammatory changes.In the English -speaking countries, "our" arthosis is called in most cases arthritis (arthrithis), ie.Inflammatory joint disease (it is suffix), while we are usually called arthritis, joint injuries in rheumatic diseases, infectious, cleansed joint damage, us sometimes, sometimes they have corrected this submission with another period: arhroso arthritis, but it is a series.
In modern scientific articles, the term osteoarthrosis is found more often (from the Greek words "osteo" - bones, "arthros" - joints, ie not -inflammatory disease of the joint and bones).And again, in the English -speaking countries, "our" ostosis -arthrosis osteoarthritis (osheoarthrithis), ie.Inflammatory disease of the joint and bone.
Often from patients we hear the question: "First, arthrosis was diagnosed with me, and now osteoarthritis is already writing. Is it really so bad?"In fact, arthrosis and arthritis are synonyms and your doctors talked about the same thing.
As we have already noticed in the beginning, with arthrosis (osteoarthrosis), cartilage is gradually destroyed and bones are gradually involved in the process.With osteoarthritis of the bone, a section of sclerosis (compression) occurs first as a result of loss of shock -dorming properties.Then there is point along the edges of the bone (exostosis), which is often mistakenly called "
salt deposits
"- In fact, with ordinary arthrosis, there are no salts of salts.With a further course of illness, the bone begins to bend, deform, cysts form in it: Often the disease is " - Faktisk er der med almindelig arthrose ingen salte af salte. Med et yderligere sygdomsforløb begynder knoglen at bøje, deform, cyster dannes i det: ofte er sygdommenDeforming arthrosis (osteoarthrosis).In old medical books you can sometimes find the term "crazy arthrosis", but now it is almost never used.
The exact causes of developing arthrosis were considered unknown for a long time, so there is another name for this disease - idiopathic arthrosis , ie.arthrosis that arose for unknown reasons or spontaneously.Of course, scientists no longer consider arthrosis a mystery, and the causes of its development are known.More about the causes of arthrosis, about what primary and secondary arthrosis is below.
Osteoarthritis more often affects the joints that experience maximum loads (hip, knee, ankle joints, hand with the joint).The osteoarthritis of the hip joint is called coxarthrosis (from the word "coxa" - hip), ankle joint - crurosteoarthritis ("cruuris" - lower leg), knee - gonarthrosis (“Gen” - Knee).In most cases, arthrosis affects both knee joints, while one of the joints may be more destroyed.In this case, the diagnosis sounds like a bilateral gonarthrosis with a predominant damage to the right (or left) knee joint.
Often it is not one, but several joints are affected by arthrosis, so they use a different expression - polyosteoarthrosis which means the defeat of three or more joints (two symmetrical, for example both knees and some others).In this case, the diagnosis usually reads as follows: Polyosteoarthrosis with a predominant damage to the knee joints (or one of them).
Why does arthrosis of the knee joint occur?
Osteoarthritis of the knee joint is different.Depending on the causes of its occurrence, primary and secondary arthrosis is separated.
Primary osteoarthritis of the knee joint
The articular cartilage is constantly destroyed and updated, and usually these processes are balanced.With age, the updating of the cartilage, and the destruction of cartilage, called the degradation process or degeneration, begins to prevail.
The process of synthesis and the destruction of cartilage is usually balanced.If degeneration begins to prevail, arthrosis of the knee joint begins
In most cases, the degeneration of cartilage occurs, that is, the development of arthrosis, after 45-50 years, but sometimes arthrosis can develop in 20 years.Fortunately, the development of arthrosis at such a young age is extremely rare.
People are prone to arthrosis of the knee joint to a greater or lesser extent.As a rule, if arthrosis occurs, then just at the age of 40-60, and if at the age of 60 there is no arthrosis, it will probably no longer be, or rather, arthrosis will be insignificant (certain degenerative changes in the knee joint exist for all elderly, but they are expressed differently).On arthrosis, but not all of them feel their knees as problematic.This is especially true for men who often already "severe" arthrosis do not show themselves or cause minimal disadvantage.
Primary arthrosis occurs spontaneously, ieWithout starting factors, it is therefore called idiopathic as we talked about earlier.
So we have already found that age is one of the most important factors that determine the development of arthrosis as the processes of cartilage degeneration begin to prevail with age.Every fourth person over 55 is suffering from arthrosis of the knee joints.But we also noticed that with age arthrosis does not develop in everyone.So there are other reasons.Before we show them, we notice that there is no main cause.The arthritis of the knee joint develops in terms of causes, while some play a major role, while others - less.
Floor. More often women suffer from the knee joint of women.The exact causes of this are unknown, but you can try to explain the following reasons.On average, women's life expectancy is greater than in men, and therefore the average older woman will more express degenerative processes.In addition, the body weight of women is slightly higher on average.The size of the bone in women is smaller than in men, and together with a higher body weight, this leads to a higher pressure in the knee joint and consequently more intense mechanical destruction of cartilage.In the overwhelming majority of cases in women, arthrosis begins to occur after the cessation of menstruation, and possibly determines estrogen's lack of the development of arthrosis.Note that attempts to treat arthrosis of the knee joint in women after menopause of estrogens are obviously implemented, but so far they are not successful.
Weight. Of course, the greater the body weight, the greater the load is transferred to our knee joint.In addition, obesity reduces physical activity and leads to the weakness of the hip muscles.For a more active synthesis of cartilage, movements (without excess pressure) are needed, and with a sedentary lifestyle, the processes of cartridge of cartilage begin to prevail.The hip muscles are important stabilizers of the knee joint, and with the weakness of these muscles the movement in the knee joint becomes more painted, which accelerates the destruction of the cartilage.In general, these processes can be described as a vicious circle: the greater the body weight, the faster the knee joint is destroyed, the greater the pain, the more difficult it is to move, which in turn leads to excess body weight.
Vicio
On the other hand, only arthrosis of the knee joint only develops among complete people - those who have no obesity can also suffer from arthrosis.Again, this is because arthrosis has no reason.
Heredity. It has long been noticed that arthrosis of the knee joints is a "family" disease.If you have arthrosis or your parents, the probability of this disease is unfortunately high with you.Researchers have discovered many gene functions responsible for, for example, the individual features of the structure of the main cartridge in the cartilage - collagen, but unfortunately these discoveries have no practical significance so far because we cannot affect the prevention or treatment of arthrosis.There is evidence that the inheritance of arthrosis is transmitted along the female line, which partly explains their great tendency to this disease.
Primary arthrosis of the knee joint occurs not only for a reason, but only by their entirety.At the same time, arthrosis of the knee joint is to some degree in almost all people over 60 years old, but the severity of arthrosis is very different and not always arthrosis found on radiography manifests.In fact, it is even more difficult: no pain in the knee joint of an elderly person or, in addition, at the age of 40-60, will be accompanied by changes in radiographing characteristics for arthrosis.
For example, scientists have found that 76% of the elderly with complaints about pain in the knees of X -ray found arthrosis. That is, no pain in the knee joint of an older person is necessarily arthrosis of the knee joint.At the same time, among all older people with arthrosis of the knee joints found on x -rays, only 81% will make complaints about pain. That is, not always existing arthosis hurts.
Strictly speaking, there is no mandatory connection of the severity of pain with the severity of the arthrosis of the knee joint on the X -ray.It happens that the changes on the X -ray photo are completely insignificant, and the pain is strong, and it happens the other way around: The collection is completely destroyed on the X -ray, and a person can cycle, engage in yoga, work as a malarus and such cases we encounter almost every day.
The blue arrow marked the outer part of the joint and the orange - the interior of the joint.Be aware of how already the gap between the bones is from the inside: cartilage is not visible on the X -ray, and it is this hole that means cartilage.In this case, there is virtually no cartilage left on the inside of the knee joint, and the bone is already rubbed on the bone.
With gradual wear of cartilage from the inside of the knee joint, the leg begins to bend.Since osteoarthritis often affects both knee joints, it is, it is bilateral, both legs begin to become twisted, and an O-shaped foot deformation occurs (varied deformation).
Less common (in about 10% of cases) the external parts of the joint of arthrosis begins, and in this case the X-shaped (valgus) deformation begins.
Mindre almindeligt (i cirka 10% af tilfældene) påvirkes de eksterne dele af leddet af arthrose, og i dette tilfælde begynder den X-formede (valgus) deformation.
With curvature, of course, the load on the internal (with O-shaped) or external (with X-shaped) deformation variants increases even more, and arthrosis will develop faster and irrevocably.
Osteoarthritis can begin not only in the inner or external section, but also between the knee (patella) and the femoral furrows.This option is called patello-phomoral arthrosis, and it usually occurs due to tilt, subluxation of a pattern, lateral hyperpression syndrome As a separate article is dedicated to our website or after breach of patella , which you can also read about in a separate article.
Secondary arthrosis of the knee joint
osteoarthritis of the knee joint can also develop due to any specific causes, in this case called arthrosis secondary.Now we will briefly talk about the possibilities of secondary arthrosis.
Post -traumatic arthrosis of the knee joint. The damage to the knee joint, of course, does not add a joint of health, and almost everyone somehow increases the risk of arthrosis.Unfortunately, any person with the space in the meniscus has ever had the likelihood of developing arthrosis ever.If a medial (internal) meniscus is damaged, arthosis will rather develop in the interior of the knee joint.And consequently, if the external meniscus bursts, arthosis will develop in the external link in the joint.Note that the breach of meniscus does not always necessarily lead to arthrosis, the likelihood of its development Auls.Of course, the more the meniscus is damaged, the higher the risk of arthrosis.
Another reason for the development of arthrosis of the knee joint is a breach of ligaments, such as a fracture of the front cruciate ligament.As a result of the fracture of the ligament of the joint, instability can occur, which will of course lead to damage to the cartilage and the development of arthrosis.Of course, cartilage damage depends on the degree of instability, which may be different.
A much heavier damage to the knee joint is a fracture of the tibials in the tibia or the fracture of the femur holes if the fracture line enters the articular surface, then such a breaking intra -articular is called.Almost any intra -articular rupture is accompanied by a displacement of fragments, thus changing the shape of the articular surface.The step that appears as a result of the shift inevitably leads to progressive destruction of the cartilage and the appearance of arthrosis.Of course, the heavier a fracture, the greater the intra -articular fracture of the fragments, the more cartilage is damaged and the risk of arthos is higher.After the heavy multi -horned fractures of the tibial condyles, Arthrosis develops in almost 100% of cases, even despite the perfectly performed osteosynthesis surgery (eliminating bones and fastening with screws, plates, etc.)