Arthrosis and the army - description of the disease, causes, types - knee, shoulder, hip joints, in which cases they are released from service

Arthrosis significantly worsens a person’s quality of life, depriving him of the joy of movement Arthrosis or osteoarthritis is one of the most common diseases of the musculoskeletal system. This is a degenerative-dystrophic pathology in which the cartilaginous basis of the joint is destroyed, deformation of the bone itself and degeneration of surrounding tissues occurs - the disease affects the ligamentous apparatus, menisci, and joint capsule. The joints most often affected are the lumbar and cervical spine, foot, and hand, but the most severe in terms of clinical manifestations are considered to be the pathologies of the “large” joints: ankle, knee, hip and shoulder.

Arthrosis is a wide group of pathologies with different etiologies, but having similar pathogenesis and clinical manifestations. This disease leads to a significant deterioration in the quality of life of patients and is one of the main causes of disability. For example, in the United States, about 7% of the population suffers from osteoarthritis. This problem is no less acute in our country.

Elderly people are especially often affected, although this disease is becoming “younger” every year. Therefore, the question often arises: are conscripts with arthrosis accepted into the army? It is difficult to answer in monosyllables, because the disease has many faces. It has many forms, several degrees and stages, pathologies of different joints have their own characteristics - therefore the decision to call in each case is made individually.

What is arthrosis

The etiology of this disease is not entirely clear to this day. It is believed that the pathology can develop under the influence of hereditary, metabolic or traumatic factors. In the joint, the normal processes of formation of cartilage cells of chondrocytes are disrupted, as a result of which the cartilage becomes thinner, loses its properties, and becomes fragile. Naturally, this immediately negatively affects the head of the bone that forms the joint. The structure and density of bone tissue changes, osteophytes appear - pathological growths that limit joint mobility.

This is how the joint becomes deformed. These processes can take years to develop.

There are risk factors that significantly increase the likelihood of developing pathology:

gender: men get sick several times less often than women;
age: more than 60% of cases occur in people over 65 years of age;
excess body weight;
excessive stress on the joints: professional athletes or people involved in heavy physical work often suffer from this pathology.
previous operations;
dysplasia;
inflammatory processes;
previous joint injuries;
hereditary predisposition.

There are primary and secondary arthrosis. If the cause of the disease cannot be determined, then this pathology is called idiopathic or primary arthrosis. Usually it is not accompanied by deviations in the functioning of other body systems. Secondary osteoarthritis has a distinct cause: metabolic disorders, traumatic exposure, degenerative or autoimmune disease, or inflammatory process.

The main symptom of arthrosis is pain in the joint, which increases with any movement or load and decreases with rest. As the pathology develops, the pain becomes constant and appears even at night. The mobility of the joint decreases; with any movement, a characteristic “dry” crunch occurs, indicating severe deformation of the joint. In addition to the general symptoms, each type of arthrosis has its own specific symptoms: for example, with coxarthrosis, pain is felt in the groin, knee, lower back and buttocks. The disease can be unilateral or bilateral.

There are four stages of the disease - they are determined using x-ray methods and often do not correspond to the severity of external symptoms. In addition, there are three degrees of development of the disease, each of which has its own characteristics. The third degree of arthrosis is considered the most severe; it is usually accompanied by complete loss of ability to work.

Arthrosis is one of the most common diseases of the musculoskeletal system.

Treatment methods for arthrosis can be divided into non-drug, drug and surgical. In the initial stages of the disease, chondroprotectors are very effective, improving the structure of cartilage tissue, as well as vitamin complexes. Non-steroidal anti-inflammatory drugs are used to relieve pain and inflammation. In addition, patients are prescribed special physical exercises, physiotherapy, massage, and cryotherapy. Severe stages of arthrosis usually require surgical intervention - in these cases endoprosthetics is performed. Today, hip and knee replacement surgeries are performed quite successfully and on a large scale.

Osteoarthritis is a serious disease with a chronic course that requires long-term and complex treatment. Moreover, the sooner it is started, the higher the chances of stopping destructive changes. Therefore, forget traditional methods and if pain in the joint occurs, consult a doctor immediately.

Consequences of not treating the disease

The consequences of the disease can be the most tragic. And we are talking here not just about those standard violations (destruction and deformation of the knee) that arise at each stage. With them, we think, everything is clear: if competent therapy is not started in a timely manner, a disappointing outcome is predetermined - the patient’s disability, which can occur quite quickly. But we would like to say a few words about the potential danger of the disease for other segments of the musculoskeletal system, in particular for the spinal column and other joints.

As we said above, the trouble with problems with joints is that if the work of one department is disrupted, then other areas, primarily the spine, are immediately involved in destructive processes.

Gonarthrosis, in 75% of cases it affects the medial (inner) part of the knee, is also a real aggressor for your spine - one of the most important and significant segments in the body. The disease creates additional stress on the vertebral elements, since it does not allow normal movement without adaptive postures. Thus, with advanced forms, the following serious problems may most likely be added to it:

radiculitis;
curvature of the vertebral axis;
intervertebral canal stenosis;
intervertebral hernia;
osteochondrosis;
vertebral instability.

Moreover, the listed ailments can provoke negative consequences in the future. And it is likely that, along with knee replacement, you will also be prescribed (before or after the main operation) another surgical intervention, but on the spine. We are sure that everyone has understood the essence of the problem. By the way, the same applies to other joints, most often the limbs. Due to the incapacity of the knee, they act as compensators for its functions, taking on too high loads, which is fraught with their rapid wear and, as a consequence, the same arthrosis in the near future.

Fortunately, synovitis can be successfully treated, unlike gonarthrosis.

It is impossible not to mention at the same time that sometimes synovitis appears against the background of gonarthrosis - an inflammatory process that affects the synovial membrane of the knee joint. As a result of synovitis, large volumes of joint fluid (synovium) accumulate in the articular cavity, which stagnates and literally puts pressure on the joint, pushing it out from all sides, which is why the knee area swells noticeably, local hyperemia and hyperthermia of the skin may appear, rise general body temperature. In addition, excess fluid can leak into the popliteal region, resulting in a popliteal hernia (Baker's cyst).

Thus, the main pathology plus its complications in the form of these diseases in combination will extremely aggravate the already unsatisfactory clinical picture. We have given only a few examples of consequences from a large list. We won’t scare you with other complications; you yourself must understand the seriousness of your problem and treat it with all the responsibility. In the end, what is at stake is your physical viability, which is the most valuable thing in life.

Study as much information as possible and visit only competent specialists.

Remember, restoring the biomechanics of the legs is not an easy process, often requiring high-tech surgery and then 3-4 months of rehabilitation. Therefore, seek medical help from professional specialists in a timely manner; only they will be able to diagnose any forms of the underlying pathology and associated complications, and then develop the most effective algorithm for treatment measures.

The army and arthrosis: are patients recruited for military service?

Joint diseases are covered under Article 65 of the Schedule of Diseases. The main attention is paid to the degree and nature of the pathology, wear of the cartilage plate, narrowing of the joint gap, and the presence of concomitant diseases (flat feet, osteochondrosis, spinal curvature) that aggravate the patient’s condition.

With arthrosis of the first degree, the conscript will most likely have to go to the army. Although, if a young person shows obvious signs of worsening of the disease, he may receive a delay for additional examination or treatment.

Military service involves severe physical exertion. Therefore, severe forms of arthrosis and the army are incompatible things

Arthrosis of the second degree is usually not accepted into the army, but a conscript may have problems due to the fact that doctors often do not distinguish it from the milder first degree. To receive a “non-conscript” category “B”, the pathology must be significantly pronounced: with joint deformation and a joint space width of no more than 4 mm.

With arthrosis of the third degree, almost complete destruction of the joint occurs - with such a pathology, the question of serving in the armed forces is simply not worth it. In this case, the location of the disease does not matter.

What guides the draft board?

In case of arthrosis of the foot or knee joint, the final decision on the possibility of conscription into the army is made by the draft commission. Military medical examination is carried out on the basis of the Government of the Russian Federation No. 565, the latest changes of which came into force in March 2017.

The document contains a division into 16 classes; the section on arthrosis of the foot, knee and spinal joints belongs to class 13. The content is organized according to the following principle:

serial number;
name of the disease;
category determining suitability for the army.

After each of the articles there is detailed information about the criteria based on which the verdict is made. According to the degree of suitability for service, there are 5 categories. Category A means full fitness, B - the existence of minor restrictions, C - exempts from the army and is included in the reserve, D - speaks of temporary unfitness, D - completely exempts from service.

About the signs and symptoms of arthrosis >>

Next to the letter, the commission assigns numbers from 1 to 4, which indicate the opportunity to serve in certain troops. The number 1 means special forces. When asking the question whether such troops with arthrosis of the foot or knee joint of the 1st degree are accepted into the army, the answer is negative. To be able to serve in them, you must have “ideal” health.

Gonarthrosis and conscription into the army

Will they be accepted into the army with arthrosis of the knee joint? This question is often asked, because gonarthrosis is a very common disease. Typically, this disease affects older women, but it also occurs in young men - in this case, the cause of the disease is usually injury. Excess weight or inflammation increases the risk of developing the disease. Gonarthrosis almost always develops after surgery to remove the meniscus.

The clinical picture of this disease is generally similar to other types of arthrosis. Stage 1 of the disease is accompanied by pain in the knee, which intensifies when walking or other activities. In the 2nd degree, a crunch appears in the joint, the pain intensifies, the knee increases in size and becomes deformed. The 3rd degree of gonarthrosis, in fact, turns the patient into a disabled person, actually immobilizing the limb - without a crutch or stick he can no longer move.

Different stages of arthrosis of the knee joint

Doctors at the military registration and enlistment office do not pay too much attention to the degree of the disease; they are more interested in the external manifestations of the pathology. A conscript with arthrosis of the knee joint may not go into the army if the disease has progressed to a deforming stage. If the width of the joint space is more than 4 mm, then they will take you into the army with gonarthrosis.

After surgery to remove the meniscus, a young man usually receives a six-month deferment. Then he undergoes a second examination, which decides his future fate.

Arthrosis of the ankle and emergency service

Ankle injuries can lead to the development of arthrosis of the talonavicular joint. Another common cause of this disease is excess weight. Arthrosis can also be a consequence of congenital pathologies, for example, dysplasia. The disease usually develops in older age, but it also occurs in young people.

The symptoms of the disease differ little from the clinical picture characteristic of osteoarthritis of other localizations: pain when walking, swelling of the foot, stiffness in movement. Usually, arthrosis of the first degree manifests itself poorly - pathological changes in the joint can only be detected using x-rays.

Arthrosis of the ankle joint

As practice shows, arthrosis of the talonavicular joint and the army are absolutely compatible concepts. The conditions for examining this disease are in many ways similar to the algorithm of actions for gonarthrosis. The commission pays the greatest attention to the degree of joint deformation and the width of the joint space. If it is more than 4 mm, then the conscript will most likely go to the army. To confirm the diagnosis, the person liable for military service must provide a report from an orthopedist or surgeon, as well as x-ray photos of the joint. This disease is covered under Article 68 of the Republic of Belarus.

Lesions of the hip joint: are they taken into the army?

Coxarthrosis is a severe lesion of the hip joint, which leads to muscle atrophy, impaired mobility of the lower extremities and disability. Once it occurs, the disease accompanies a person for the rest of his life, significantly worsening its quality.

The causes of primary coxarthrosis are unknown. It is believed that the predisposition to pathology is genetically determined; it is likely that the risk of developing the disease is increased by excessive physical activity, as well as excess weight. The secondary form of the disease usually occurs after infections, against the background of serious metabolic disorders or post-traumatic changes in the joint. Since coxarthrosis most often affects people over forty years of age, it is believed that age-related changes play an important role in the pathogenesis of the disease.

Primary coxarthrosis is often accompanied by damage to the knee joint and spinal column. The disease can be either unilateral or bilateral.

The symptoms of coxarthrosis depend on the cause and degree of the pathology, as well as on the individual characteristics of the patient. At the initial stage, the manifestations may be practically unnoticeable, but as the disease progresses, a person’s life turns into a real hell. Here are the main signs and symptoms of coxarthrosis:

Painful sensations at rest and during movement. With coxarthrosis, pain can be felt not only in the joint itself, but also spread to the abdomen, perineum, pubis and lower back;
The affected joint becomes sensitive to touch;
A feeling of “stiffness” in the joint, which is especially noticeable after waking up in the morning. This makes movement difficult;
Limited movement and loss of flexibility. In the later stages of arthrosis, the range of possible movements is significantly reduced;
The appearance of crunching and other unnatural sounds during movement;
Deformation of the joint and reduction in limb length;
Fatigue and muscle weakness;
Decrease and then complete loss of ability to work.

Osteoarthritis of the hip joint is a chronic disease that develops over years, and sometimes decades. Therefore, severe forms of the disease are rarely diagnosed in young people of military age. The examination of the disease is carried out according to Article 65 of the Republic of Belarus.

Healthy and arthrotic hip joint

Young people with the first degree of arthrosis almost always go to serve. The second degree may be the basis for receiving a “non-conscription” category “B”, and the third is an almost guaranteed “white” ticket. However, the medical commission pays more attention to the manifestations of the disease than to its degree. Conscripts with deforming arthrosis and significant narrowing of the joint space are usually exempt from the army. The last factor largely determines the fitness category that the young man will receive - if it is less than 2 mm, then the conscript will be assigned category “D”.

Localizations and clinical forms

Any localization and form of arthrosis has serious complications, so you should not delay treatment.
See how easily the disease can be cured in 10-12 sessions.

Arthrosis develops mainly in the most loaded joints – the knee and hip. But after an injury or against the background of arthritis, degradation-dystrophic processes can progress in any joint.

Classification of osteoarthritis

There are several classifications. The most famous are:

Classification by etiology (reasons for development):
secondary – develop against the background of injuries and diseases.
Classification by clinical forms:
oligoosteoarthrosis – the number of affected joints is no more than two;
monoosteoarthrosis – damage to one joint;
in combination with osteochondrosis or osteoarthritis of the spine.
Classification by localization:
hip;
knee;
other.

Arthrosis of the lower extremities

Due to the high load, the legs suffer first of all:

Arthrosis of the hip joint (coxarthrosis) is the most severe. The structural features of the hip joint (deep joint cavity, narrow joint space) contribute to the rapid development of degenerative disorders involving muscles and ligaments. If inflammation occurs, the effect of partial or complete immobility develops. Often develops against the background of congenital dysplasia, dislocations, subluxations of the hip, osteochondropathy (aseptic necrosis of the femoral head - Perthes disease). Symptoms of arthrosis: pain initially appears only towards the end of the day, but gradually increases, worries all day, radiates to the groin and buttock area. To reduce pain during coxarthrosis, the patient holds the leg in a forced position, which makes it seem shorter than the healthy one. The pain syndrome is very strong, so patients often agree to endoprosthetics.
Arthrosis of the knee joint (gonarthrosis) - the most common. The knee withstands the highest loads and is injured, so gonarthrosis develops most often. Arthrosis of two joints is distinguished:
tibiofemoral arthrosis (femoral-tibial joint) - develops less frequently and is easier. The pain radiates down to the area of the lower leg and foot; Complete immobility with gonarthrosis rarely occurs. Prevention and timely treatment of arthrosis of the knee joint are very important - this will allow a person to live without pain. But even with an advanced disease, it is quite possible to relieve the patient from pain.
Ankle – a large load also falls on the ankle, which is why arthrosis often develops in it. He is also often injured and the degenerative process is post-traumatic in nature. It is also affected in reactive arthritis. Symptoms: the disease is asymptomatic for a long time, but then pain appears. First, during physical activity, and then constant, aching pain. Stiffness of movement after a long rest is also characteristic, which goes away within half an hour. Complete immobility of the ankle is rare and only if the underlying cause of the disease is a long-term inflammatory process.
Heel - arthrosis can develop in the area of the subtalar or talocalcaneal-navicular joints after injuries and diseases. They do not manifest themselves for a long time, then painful sensations in the heel begin to appear, gradually acquiring a constant painful character. Disability is rare.

Arthrosis of the upper extremities

Arthrosis in the joints of the hands develops less frequently. Main features of localizations in individual joints:

Arthrosis of the shoulder joint. It usually develops after injuries and against the background of microtrauma in weightlifters, as well as in people engaged in heavy physical work. Acromial (acromio-clavicular) arthrosis is a consequence of trauma and inflammatory processes. At first it goes unnoticed, but then pain appears in the upper part of the shoulder, radiating to the elbow and neck, stiffness of movements and crunching when moving. The pain can be permanent and debilitating. Sometimes accompanied by inflammation, which contributes to the progression of the disease. If left untreated, partial ankylosis develops. Read more about shoulder arthrosis here.
Elbow arthrosis - occurs rarely, mainly in miners, blacksmiths and workers of some other professions who deal with vibrating tools. Symptoms: pain in the elbow when bending and straightening the arm, stiffness after a long rest. If left untreated, there will be persistent dysfunction.
Arthrosis of the joints of the hand. Most often, the degenerative process develops in the carpometacarpal joint of the first finger, since it is usually subject to trauma during household work. It manifests itself as a periodically appearing dull soreness in the outer side of the palm, radiating to the thumb.
Arthrosis of the finger joints. Develops when performing small tasks (knitting, embroidery, sewing). In the distal (uppermost) interphalangeal joints, the pathological process manifests itself in the form of growths of bone tissue - Heberden's nodes; joint pain usually does not occur or they appear only occasionally, for example, when the weather changes. In the proximal interphalangeal joints, the disease manifests itself in the form of the same bone growths on the joints of the fingers located below - Bouchard's nodes.

Crunching in joints - when to worry

Intra-articular injections of hyaluronic acid

Arthrosis of the spine (vertebral)

In different parts of the spinal column, arthrosis manifests itself in the form of different symptoms:

Cervical uncovertebral arthrosis (cervical facet spondyloarthrosis) . Degenerative-dystrophic changes in small facet joints of the cervical vertebrae. Arthrosis of the joints of the cervical spine develops mainly in the second half of life in people who work for a long time in a stationary state with their heads bowed. It can also develop after injuries and against the background of chronic arthritis. It manifests itself in the form of headaches, dizziness, pain in the neck, radiating to the shoulder and crunching when moving. Decreased vision, hearing, and the appearance of high blood pressure (BP) are also possible. Since overgrown bone tissue can compress the vessels supplying the brain, the disease sometimes threatens the patient’s life. Requires long-term rehabilitation treatment.
Thoracic spondyloarthrosis (arthrosis of the joints of the thoracic spine). It is much less common than the cervical one. First, moderate and then quite severe pain in the spine appears, intensifying with coughing, sneezing and deep breathing. Sometimes the symptoms are similar to manifestations of diseases of the cardiovascular and respiratory systems. To correctly establish the diagnosis, additional examination is required. In the thoracic region there are also costovertebral joints, 2 of them on each rib (rib head and costotransverse). They can also develop degenerative-dystrophic processes, mainly in older women. The disease manifests itself as pain in the chest. If it lasts for a long time, it can cause severe complications from the cardiovascular and respiratory systems.
Lumbar spondyloarthrosis. It is a consequence of heavy physical labor and spinal injuries. Arthrosis of the joints of the lumbar spine manifests itself in the form of aching pain, aggravated by bending the body. Characterized by stiffness of movement after a long rest, a crunch in the back when bending over.
Sacrococcygeal spondyloarthrosis. Most often develops after injuries, for example, after a fall and injury to the tailbone. It manifests itself as pain, aggravated by sitting and prolonged walking. Requires long-term rehabilitation treatment.

Tissue changes in spondyloarthrosis

Arthrosis of the temporomandibular joint (TMJ)

The disease develops with chronic arthritis of the TMJ, malocclusion, absence of lateral teeth, and problems with prosthetics. There is a violation of blood circulation and metabolism in the TMJ area with the development of degenerative-dystrophic processes in it. Symptoms of arthrosis of this joint: aching pain in the lower jaw, stiffness and crunching when opening the mouth and chewing. The pain increases with changes in weather, as well as with the development of synovitis. The long course of the disease leads to the appearance of asymmetry: displacement of the jaw tissue to the affected side.

Arthrosis of the shoulder and elbow joints

Arthrosis of the shoulder joint is a fairly rare disease that usually affects older people. In young people, this disease is most often a consequence of injury or excessive physical exertion. Even a simple shoulder dislocation increases the risk of developing pathology. The clinical picture of arthrosis of the shoulder joint is generally similar to other diseases of this group. In addition to pain and unnatural sounds when moving, shoulder arthrosis is characterized by a decrease in the “mobility” of the limb. This is an important sign that is used to determine a conscript’s suitability for military service.

Arthrosis of the shoulder joint is a fairly rare disease. As a rule, it is a consequence of an injury.

This disease is also covered under Article 65 of the Republic of Belarus. A conscript can receive category “B” if two conditions are met: when the width of the joint space is reduced to 2-4 mm and a significant decrease in joint mobility. Moreover, the Schedule of Diseases clearly indicates the degrees of normal amplitude for flexion, extension and reduction.

Osteoarthritis of the elbow joint is even less common because it does not bear significant stress. This disease may be grounds for exemption from conscription if it is in a deforming stage with severe narrowing of the joint space.

Suitability categories

During the military medical commission, the conscript is assigned one of the fitness categories:

A – fit;
B – suitable with minor restrictions;
B – limited availability (not called up in peacetime);
G – temporarily fit (assigned until the end of the recovery period for conscripts who have undergone surgery);
D – not subject to conscription.

Read more about how categories of military fitness are determined here.

Spondyloarthrosis and emergency service

Spondyloarthrosis is a severe chronic disease in which destruction of the joints of the spine occurs. It is often accompanied by osteochondrosis and intervertebral hernia. Most often, the pathology affects the cervical (uncovertebral arthrosis) or lumbar spine. Spondyloarthrosis is usually diagnosed in older people, but it also occurs in young people.

The clinical picture of the disease depends on its location; a common symptom for all forms of the disease is pain. To these are added neurological manifestations specific to pathologies of different parts of the spine. For example, with cervical spondyloarthrosis, patients complain of frequent dizziness, tinnitus, and lack of coordination. Pathology of the thoracic vertebrae provokes numbness in the limbs, and localization of the pathology in the lower back causes pain in the legs, buttocks and discomfort when staying in one position for a long time.

The causes of the development of the disease are abnormalities in the structure of the vertebrae, acquired or congenital, metabolic disorders, curvature of the spine, injuries and excessive stress on the spine, flat feet, and excess weight.

The question of whether people with spondyloarthrosis are accepted into the army is difficult to answer in monosyllables. This disease usually occurs in combination with other pathologies of the spine: osteochondrosis, spondylosis, curvature of the spinal column. Doctors at the medical commission assess the general condition of the patient and the degree of dysfunction of the spine. They can be significant, moderate and insignificant. When determining the patient’s condition, the entire set of clinical and radiological signs is taken into account. For example, pain during physical activity is confirmed by repeated visits to medical institutions, which are reflected in the relevant documents.

With minor disorders of the spine, a young man can receive categories “B” or “B”; with moderate ones, he is assigned the “non-conscription” category “B”; with severe ones, he is declared completely unfit for military service and receives category “D”. To receive an exemption from service, a conscript must seriously prepare to pass the commission. He must collect a package of documents confirming his illness. Moreover, it is necessary that the conclusions in the medical record correspond to the wording adopted in the Schedule of Diseases, otherwise they may not be taken into account. If, before the start of the draft commission, a young man did not complain about diseases of the musculoskeletal system, then there is a high probability that he will go to serve in the army.

Signs and causes of the disease

Have you noticed any uncharacteristic sounds such as clicking, creaking or crunching in your knee when performing movements? Or maybe the leg in this section suddenly, after a simple walk or immediately after sleep, began to bother you with painful signs and/or stiffness? And after some time, did they go away on their own: in the first case - after rest, in the second - after 30-60 minutes, when the limbs had warmed up? But we ask all this for a reason, since these are the symptoms with a high degree of probability that can indicate gonarthrosis, at best stages 1-2.

The most important symptom of problems with the musculoskeletal system is pain. As long as it doesn't hurt, no one worries.

Important! If you do not pay attention to the problem in time, the pathological focus will reach an irreversible phase (stage 3-4), and conservative therapy will no longer be needed, you will have to undergo surgery. Often surgery is required already at stage 2, mainly for pathologies of rheumatoid origin.

So, if you have given an affirmative answer to at least one question, do not delay your visit to an orthopedic doctor and immediately undergo all the necessary examinations. After a thorough diagnosis, you will be individually prescribed the most effective treatment appropriate to the diagnosis. To make a diagnosis, it is usually sufficient to take an x-ray and test the biomechanical abilities of the knee area. Assessment of motor potential is carried out by performing certain movements of the limb with the help of a specialist and by the patient himself.

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