What is arthrosis?
Arthrosis is a degenerative joint disease, which most people will develop as they age. The disease is a result of excessive wear and tear on the joints and reduced replenishing of the cartilage matrix by the chondrocytes (cells of the cartilage).
In order to understand the disease, it is necessary to have knowledge about the structure of the joint. The joint typically contains two rounded ends of bone, each covered with articular cartilage. Articular cartilage has a smooth surface, which makes the bones move easier against each other and also act as a shock absorber, protecting the underlying bone from trauma. A synovial membrane, which forms a joint space for the two bone ends, and contains a synovial fluid that lubricates the joint cartilage, often encloses the joint. Furthermore, an outer capsule supports the joint.
What are the symptoms of arthrosis?
Because arthrosis is a progressive disease that slowly worsens, symptoms will also slowly become more and more debilitating.
At the beginning the patient show no symptoms but over time the patient will experience more and more of the following symptoms, which will become more and more severe:
- Pain: Pain in the joint during and after joint movement. As the disease progresses, the pain may be present even when resting and this can lead to sleep deprivation.
- Stiffness: This is especially felt after prolonged immobility of the joint, and therefore, the affected joints are stiff, especially in the morning. Over time stiffness may reduce the range of motion.
- Hardness: The joints may feel firm and form small bone growths from the joint edges.
What are the causes of arthrosis?
Most cases of arthrosis have no known cause. These cases are called primary arthrosis. When a specific cause of arthrosis is known, the disease is called secondary arthrosis.
Primary arthrosis is mostly related to the normal aging process. Through aging, the water content of the cartilage increases and the protein that maintains the cartilage is weakened, thus the cartilage erodes. Therefore, the ability to absorb shock and allow easy movements is gradually lost. The degree of replenishment by the chondrocytes are reduced too. The opposing joint surfaces becomes irregular, restricting of movement and causes pain and stiffness in the joint.
In some cases, all articular cartilage is lost and the bones end up sliding against each other. With time, this condition may cause inflammation in the joint. Inflammation of the articular cartilage can stimulate new bone growth, and this may worsen the ability of movement in the joint.
Secondary arthrosis is caused by other conditions, such as obesity, repetitive trauma or surgery in the joint, abnormal joint formation at birth (congenital malformations), diabetes, and other hormonal disorders.
Obesity is a major cause of arthrosis, because weight gain increases the load, which is put on the cartilage. Obesity and aging are common risk factors for arthrosis of the knees. Repeated trauma (injuries) to the joint components, such as joint ligaments, bones and cartilage, are believed to lead to early arthrosis of the knees.
Some people are born with abnormally formed joints (congenital abnormalities). These people are particularly vulnerable to mechanical wear and tear, causing early degeneration and loss of cartilage in the joints.
What are the treatments for arthrosis?
There are no medications for the progress of the disease, however, many of the symptoms associated with arthrosis can be treated with several medications. Paracetamol can relieve pain, while NSAIDs may help to reduce inflammation and relieve pain.
In addition, it is recommended to re-evaluate one’s lifestyle. For example, weight loss reduces joint load and increased exercise increases muscle mass, which is supporting the joint. Furthermore, the use of tools that absorb shock and reduce weight load, such as certain shoes, hiking sticks or support bands can relieve the joint of stress and weight. In addition, the advice of a physical therapist can useful as well as certain food supplements.
In some cases, surgery is necessary and this involves a new artificial joint.