Osteoarthritis of the hip and knee joints
Osteoarthritis is a non-inflammatory degenerative joint lesion, usually occuring in middle and old age. It is marked by progressive destruction of the cartilage tissue of the joint and bones.
Osteoarthritis of large (hip and knee) joints often develops after 45-50 years of age.
Women suffer more often than men. Symptomatic (i.e. causing complaints) osteoarthritis affects 10-15% of people over the age of 63. Asymptomatic (not causing complaints) osteoarthritis is found by radiological imaging in 25-30% of people aged 63-69 years.
Risk factors
- gender - women suffer from this disease more often
- age - the incidence of osteoarthritis increases dramatically with age
- weight - obesity is a risk factor for osteoarthritis
- vitamin C deficiency
- osteoporosis
- history of joint injuries
- increased joint load (labour associated with lifting and moving weights)
- hereditary factors
- congenital malformations
Symptoms
Pain in the area of the affected joint. First, pain occurs only when loading the affected joint, then, in advanced cases, the pain is present at rest. The so-called "Starting pain" is specific for athritis - pain arising after a longer period of inactivity and gradually subsiding as physical activity increases. Morning "stiffness" is a characteristic symptom of osteoarthritis, it usually lasts no more than 10-15 minutes. Joint deformity, increased size and a limited range of motion in the joint, a decrease in the muscle mass of the affected limb are characteristic symptoms of an advanced joint lesion.
Treatment
Drug treatment – In order to reduce the symptoms of osteoarthritis a combination of paracetamol and non-steroidal anti-inflammatory drugs (ibumetin, diclofenac, etc.) is usually prescribed. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) can lead to damage to the gastric mucosa and toxic kidney damage.
- Injecting hormonal anti-inflammatory drugs into the joint cavity usually gives a good, but short-term effect.
- Intra-articular injection of hyaluronic acid preparations may in some cases reduce the severity of osteoarthritis symptoms.
The effectiveness of the so-called "chondroprotectors" - chondroitin and glucosamine - has no convincing evidence.
Non-drug treatment - regular long-term exercise , like walking, swimming, cycling is necessary to strengthen muscles and maintain joint mobility.
Weight Management - Weight loss usually results in decreased symptoms of osteoarthritis.
Conservative therapy is ineffective over the longer term. Total arthroplasty (endoprosthetics) is the “gold standard” in the treatment of advanced osteoarthritis. However, the prevalence of severe postoperative pain after arthroplasty is 5-8% for the hip joint and 10-15% for the knee joint. Minimally invasive treatments are used if medical and physiotherapeutic treatment does not give the expected result or there are contraindications to surgical treatment, for example, severe comorbidities. One of these treatment methods is the so-called. "denervation" of the joint. The essence of the procedure is that the nerve fibers that transmit pain from the affected joint are being destructed. This can be achieved in 2 ways - either by radio frequency destruction or by applying low temperatures - the so-called. cryodestruction. Pain in the affected joint subsides immediately after the procedure. The effect lasts for 6-8 months, after 6-8 months the nerve fibers begin to recover and pain in the affected joint may relapse. However, this does not happen in one day, and, if the pain is severe, the denervation procedure can be repeated.
Osteoarthritis of large (hip and knee) joints often develops after 45-50 years of age.
Women suffer more often than men. Symptomatic (i.e. causing complaints) osteoarthritis affects 10-15% of people over the age of 63. Asymptomatic (not causing complaints) osteoarthritis is found by radiological imaging in 25-30% of people aged 63-69 years.
Risk factors
- gender - women suffer from this disease more often
- age - the incidence of osteoarthritis increases dramatically with age
- weight - obesity is a risk factor for osteoarthritis
- vitamin C deficiency
- osteoporosis
- history of joint injuries
- increased joint load (labour associated with lifting and moving weights)
- hereditary factors
- congenital malformations
Symptoms
Pain in the area of the affected joint. First, pain occurs only when loading the affected joint, then, in advanced cases, the pain is present at rest. The so-called "Starting pain" is specific for athritis - pain arising after a longer period of inactivity and gradually subsiding as physical activity increases. Morning "stiffness" is a characteristic symptom of osteoarthritis, it usually lasts no more than 10-15 minutes. Joint deformity, increased size and a limited range of motion in the joint, a decrease in the muscle mass of the affected limb are characteristic symptoms of an advanced joint lesion.
Treatment
Drug treatment – In order to reduce the symptoms of osteoarthritis a combination of paracetamol and non-steroidal anti-inflammatory drugs (ibumetin, diclofenac, etc.) is usually prescribed. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) can lead to damage to the gastric mucosa and toxic kidney damage.
- Injecting hormonal anti-inflammatory drugs into the joint cavity usually gives a good, but short-term effect.
- Intra-articular injection of hyaluronic acid preparations may in some cases reduce the severity of osteoarthritis symptoms.
The effectiveness of the so-called "chondroprotectors" - chondroitin and glucosamine - has no convincing evidence.
Non-drug treatment - regular long-term exercise , like walking, swimming, cycling is necessary to strengthen muscles and maintain joint mobility.
Weight Management - Weight loss usually results in decreased symptoms of osteoarthritis.
Conservative therapy is ineffective over the longer term. Total arthroplasty (endoprosthetics) is the “gold standard” in the treatment of advanced osteoarthritis. However, the prevalence of severe postoperative pain after arthroplasty is 5-8% for the hip joint and 10-15% for the knee joint. Minimally invasive treatments are used if medical and physiotherapeutic treatment does not give the expected result or there are contraindications to surgical treatment, for example, severe comorbidities. One of these treatment methods is the so-called. "denervation" of the joint. The essence of the procedure is that the nerve fibers that transmit pain from the affected joint are being destructed. This can be achieved in 2 ways - either by radio frequency destruction or by applying low temperatures - the so-called. cryodestruction. Pain in the affected joint subsides immediately after the procedure. The effect lasts for 6-8 months, after 6-8 months the nerve fibers begin to recover and pain in the affected joint may relapse. However, this does not happen in one day, and, if the pain is severe, the denervation procedure can be repeated.