Osteoarthritis

Many people suffer from osteoarthritis, particularly in old age. Osteoarthritis pain is caused by wear and tear and a dwindling cartilage layer. The joints become inflamed.

The cartilage serves as a protective layer between the ends of the bones to prevent them from rubbing against each other and is also a shock absorber that distributes the load evenly across the joints. As a result of wear and tear and incorrect loading, the cartilage becomes damaged and disappears more and more. The result is increasing pain, for example shoulder pain or knee pain. The joint becomes stiffer and therefore less mobile. The osteoarthritis pain leads to the adoption of a protective posture. This only exacerbates the condition, as the cartilage is less well supplied with blood and loses its protective function. In addition, other joints are put under unfavorable strain.

Osteoarthritis usually only develops at an advanced age, but it can also be diagnosed earlier. Joints that are constantly subjected to high stress and heavy loads are particularly susceptible to cartilage damage. The knee joint is therefore most frequently affected by osteoarthritis, followed by the hip, shoulder, finger and toe joints.

Causes of osteoarthritis

There are many causes of osteoarthritis. In addition to the ageing process, common risk factors include

• Excess weight due to excessive strain
• Misalignments such as knock knees or bow legs due to incorrect loading
• Osteoarthritis following an accident or injury
• Other diseases such as rheumatism, diabetes or gout

The greatest risk of osteoarthritis is a lack of regular exercise. Good muscular stabilization and good coordination skills are therefore important to maintain the joint and prevent osteoarthritis.

Symptoms: How does osteoarthritis manifest itself?

Osteoarthritis develops gradually and usually begins before those affected notice the first symptoms. The first symptoms are pain on exertion and increasingly restricted movement. The cartilage is less able to distribute pressure. As the disease progresses, the cartilage is damaged further and the space between the bones becomes smaller. Swelling occurs, which increases the circumference of the joint. In a later stage of osteoarthritis, pain also occurs at rest and initial pain after a period of rest. In the final stage of the disease, bony outgrowths form as the bones rub against each other, causing unbearable pain and the joint becomes stiff.

Diagnosis of osteoarthritis - what now?

A detailed medical history is required to determine osteoarthritis and the corresponding stage. To do this, the specialist analyzes the medical history (accidents, injuries) and whether any joint problems are already known in the family. The doctor will also check the gait pattern and mobility as well as whether there is any swelling in the joint.

X-rays and ultrasound provide further information on the stage of osteoarthritis. X-rays reveal any changes in the joint space and whether bone has formed at the joint.

An ultrasound also shows capsules and muscles, which makes inflammation of the joint mucosa and joint capsules visible. The early stages of osteoarthritis are already visible in an MRI scan, as soft tissue such as cartilage and structures of the joint capsule, tendons, ligaments and muscles are clearly visible.

Therapy: How is osteoarthritis treated?

Physiotherapy and other conservative measures such as painkillers alleviate the pain of osteoarthritis and halt its progression. However, osteoarthritis cannot be cured as the cartilage does not regenerate.

The decisive factor for treatment is how far the osteoarthritis has progressed. The cause must be treated first, for example by correcting misalignments such as bow legs or knock-knees. For mild forms of osteoarthritis, joint-preserving procedures with arthroscopic artholysis can be used. This restores the mobility of the joint. Another arthroscopic procedure is cartilage cell transplantation. The doctor inserts the patient's own, cultivated cartilage cells. However, this is only possible if the cartilage damage is still minor.

In severe forms of osteoarthritis, it is no longer possible to successfully preserve the joint. The only option here is an artificial joint. This procedure is very frequently used for osteoarthritis, primarily in older patients, as the durability of endoprostheses is limited. Our specialists for artificial joint replacement at the Sportklinik Hellersen provide detailed advice on the various options for osteoarthritis and when an artificial joint is necessary.