Prevalence
Arthrosis is the most common joint disease.
According to Russian experts, 6.43% of Russians suffer from it. Men and women suffer from arthrosis equally often, but there is a slight predominance of men among young patients, and women among older patients. An exception to the general picture is arthrosis of the interphalangeal joints, which develops in women 10 times more often than in men. With age, the incidence increases sharply. Thus, according to studies, arthrosis is detected in 2% of people under 45 years of age, in 30% of people from 45 to 64 years of age and in 65-85% of people aged 65 years and older. Arthrosis of the knee, hip, shoulder and ankle joints has the greatest clinical significance due to its negative impact on the standard of living and ability to work of patients.
Causes
In some cases, the disease occurs for no apparent reason; such arthrosis is called idiopathic or primary.
There is also secondary arthrosis - developed as a result of some pathological process. The most common causes of secondary arthrosis:
• Injuries (fractures, meniscal injuries, ligament ruptures, dislocations, etc.).
• Dysplasia (congenital disorders of joint development).
• Degenerative-dystrophic processes (Perthes disease, osteochondritis dissecans).
• Diseases and conditions in which there is increased mobility of joints and weakness of the ligamentous apparatus.
• Hemophilia (arthrosis develops as a result of frequent hemarthrosis).
Risk factors for developing arthrosis include:
• Elderly age.
• Overweight
• Excessive stress on the joints or a specific joint.
• Surgical interventions on the joint,
• Hereditary predisposition (presence of arthrosis in close relatives).
• Endocrine imbalance in postmenopausal women.
• Neurodystrophic disorders in the cervical or lumbar spine (humeral hyperarthritis, iliopsoas syndrome).
• Repetitive microtrauma of the joint.
Who and when should not undergo dental implantation?
The list of contraindications to implantation is divided into two types: with absolute contraindications, implantation is completely excluded, with relative contraindications, the installation of implants and prostheses is possible, but after additional treatment. If the patient has the desire and readiness to correct the situation, all contraindications, except absolute ones, are surmountable. The main thing is not to hide problems from the doctor: to be completely open and prepared for the fact that you may have to wait a little if necessary.
ABSOLUTE CONTRAINDICATIONS
- unstable (decompensated) diabetes mellitus,
- pathologies of the cardiovascular and nervous systems,
- tuberculosis,
- increased tone of the masticatory muscles,
- diseases of the blood and hematopoietic organs (lymphogranulomatosis, leukemia, anemia, other problems with blood clotting),
- the presence of malignant tumors and conditions after radiation and drug therapy
- inadmissibility of anesthesia,
- aphthous stomatitis, lupus erythematosus, pemphigus, Sjogren's syndrome, Behçet's syndrome,
- diseases of the central nervous system,
- mental disorders and behavioral disorders,
- immunopathological diseases,
- dysfunction of the thyroid and parathyroid glands,
- rheumatic and rheumatoid processes, bone dysplasia1.
RELATIVE CONTRAINDICATIONS
- stabilized diabetes mellitus (treatment is carried out under the supervision of an endocrinologist),
- state of immunodeficiency of the body: HIV infection, AIDS, simply weakened immunity,
- presence of sexually transmitted diseases,
- low estrogen in women
- past drug use; smoking,
- inflammatory diseases of the oral cavity,
- periodontitis, periodontal disease, osteomyelitis or osteoporosis of the jaw,
- reduction in bone volume,
- bruxism and serious malocclusion pathologies,
- increased accumulation of dental plaque and the reluctance/impossibility of careful hygiene by the patient himself.
A temporary ban on the surgical stage of implantation in women is also imposed during the stages of pregnancy, lactation and menstruation; installation of implants is carried out with caution during menopause and other hormonal changes.
“Our goal is to help patients regain their health, give them the opportunity to smile openly and sincerely, eat any food and live without pain. This is why we never perform implantation on the first day - we prescribe tests and examinations, and, if necessary, refer us to specialized specialists.”
Bespalov Roman Dmitrievich, Maxillofacial surgeon, implantologist Experience over 25 years make an appointment
Gentle implantation in 1-3 days! Dental implantation with a minimum number of contraindications. For diabetes, for periodontitis, for bone atrophy!
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Temporary restrictions also include situations when a patient is recovering from cancer treatment (radiation or chemotherapy), if the patient does not have the opportunity to postpone participation in any extreme competitions associated with an increased risk of injury to the maxillofacial area, or if there is a need to leave the city for for a long time immediately after implantation, installation of dental implants - in the first days it is important to be under the supervision of doctors.
The listed contraindications primarily relate to two-stage implantation with delayed loading, but one-stage protocols have much fewer restrictions. But this does not mean at all that the service life of the implants will be shorter - for example, basal implants are recommended2 for installation in the presence of acute and generalized periodontitis, with pronounced bone tissue atrophy, if the patient smokes a lot. That is, solutions can almost always be found.
Pathogenesis
Arthrosis is a polyetiological disease, which, regardless of the specific causes of its occurrence, is based on a violation of the normal formation and restoration of cartilage tissue cells.
Normally, articular cartilage is smooth and elastic. This allows the articular surfaces to move freely relative to each other, provides the necessary shock absorption and thereby reduces the load on the adjacent structures (bones, ligaments, muscles and capsule). With arthrosis, the cartilage becomes rough, and the articular surfaces begin to “cling” to each other during movements. The cartilage becomes more and more disintegrated. Small pieces are separated from it, which fall into the joint cavity and move freely in the joint fluid, injuring the synovial membrane. Small foci of calcification appear in the superficial zones of the cartilage. Areas of ossification appear in the deep layers. In the central zone, cysts are formed, communicating with the joint cavity, around which, due to the pressure of the intra-articular fluid, ossification zones also form.
Can arthrosis cause fever?
With arthrosis there may be a fever. According to various estimates, an increase in the thermometer reading occurs in 5-35% of clinical cases.
Arthrosis itself cannot provoke fever. This is a sign indicating the development of complications and third-party processes. A reaction to treatment is also possible. List of possible causes of fever:
- Incorrect diagnosis. Arthrosis is a slow, indolent degeneration of cartilage tissue. Periods of exacerbations are not typical; if they occur, they are not noticeable to the patient. An increase in temperature is typical for arthritis, which necessitates a revision of the diagnosis and additional examination of the patient.
- Attachment of complications. Factors in the development of arthrosis are metabolic in nature, that is, they are associated with metabolism. Additional causes are arthritis of the autoimmune (rheumatoid) and infectious types. Often both processes—arthritis and arthrosis—run in parallel. The first calls the second. But the opposite happens extremely rarely. In such a situation, the body temperature rises as a result of arthritis, but not non-inflammatory joint degeneration.
- Response to treatment. The use of drugs to which the patient is allergic has a similar effect. The reaction does not develop overnight. Since the drug is applied topically (usually as an ointment, gel or cream), significant concentration is required on the affected area. The active component penetrates the bloodstream. The following are possible options. An intense immune response provokes an increase in temperature indicators. But not higher than 37.5 degrees Celsius.
- Physiotherapy also plays a role. With a parallel course of arthritis and arthrosis, especially if both are in the latent phase, the body’s first reaction to intervention is inflammation. Hence the fever. After a few days she disappears on her own.
- It's also possible it's just a coincidence. Colds and infectious pathologies, especially chronic ones, give pronounced exacerbations with an increase in thermometer readings. They can be mistakenly associated with an orthopedic disease.
Temperature in arthritis and arthrosis must be differentiated. Against the background of the first, it occurs in 75% of cases (especially with rheumatoid, infectious, gouty types). With the second, such a symptom is rare.
Differences between arthrosis and arthritis
In another article on temperaturka.com, read in detail about how temperature manifests itself in arthritis.
Pain syndrome
Pain is the most constant symptom of arthrosis. The most striking signs of pain with arthrosis are the connection with physical activity and the weather, night pain, starting pain and sudden sharp pain in combination with joint blockade. With prolonged exercise (walking, running, standing), the pain intensifies and subsides with rest. The cause of night pain in arthrosis is venous congestion, as well as increased intraosseous blood pressure. The pain also intensifies under the influence of unfavorable weather factors: high humidity, low temperature and high atmospheric pressure.
The most characteristic sign of arthrosis is starting pain - pain that occurs during the first movements after a state of rest and goes away while maintaining motor activity.
Symptoms
Arthrosis develops gradually, gradually. Initially, patients experience mild, short-term pain without clear localization, which intensifies with physical activity. In some cases, the first symptom is a crunching sound when moving. Many patients with arthrosis note a feeling of discomfort in the joint and transient stiffness during the first movements after a period of rest. Subsequently, the clinical picture is supplemented by night pain and pain due to the weather. Over time, the pain becomes more and more pronounced, and a noticeable limitation of movements occurs. Due to the increased load, the joint on the opposite side begins to hurt.
Periods of exacerbations alternate with remissions. Exacerbations of arthrosis often occur against the background of increased load. Due to pain, the muscles of the limb reflexively spasm, and muscle contractures can form. The crunching in the joint becomes more and more constant. At rest, muscle cramps and discomfort appear in the muscles and joints. Due to increasing joint deformation and severe pain, lameness occurs. In the later stages of arthrosis, the deformation becomes even more pronounced, the joint is bent, and movements in it are significantly limited or absent. Support is difficult; when moving, a patient with arthrosis has to use a cane or crutches.
Prevention
Whatever provokes the disease, it is advisable to notice the pathology in a timely manner. Otherwise, therapy will no longer help. If you feel even the slightest pain in the joints, difficulty walking or other movements, you should rush to the clinic. Don't forget that you need to see a doctor periodically. This way, it will be possible to timely detect not only arthrosis, but also other diseases that can manifest themselves much later, when it is too late to treat them.
Constantly train your own muscle corset, because the stronger the muscles on your legs, the lesser the load becomes transmitted to the cartilage of the hip and knee joints. Such activities will be an excellent prevention of arthrosis, and they will also help save you from arthritis. When a person does not take care of himself and does not follow the doctor’s recommendations, this causes extremely dangerous complications.
However, you should not be afraid of arthrosis. When a sick person undertakes professional treatment, even if it is performed at one of the advanced stages of the pathology, he is quite capable of alleviating his suffering. The most important thing is not to leave the progression of the disease uncontrolled for a minute. The doctor will certainly prescribe painkillers and instruct you on how to take the correct therapeutic course.
- Temperature during arthritis: what causes it and should it be brought down?
A person must remember that the disease will never defeat him if he systematically fights it. Even experiencing excruciating pain inside the hip joint, some women manage to safely give birth to heirs. Therefore, one should not panic, believing that life is lost. Let's take a closer look at how arthrosis is treated correctly?
Diagnostics
The diagnosis is made on the basis of characteristic clinical signs and the X-ray picture of arthrosis. Images of the diseased joint are taken (usually in two projections): for gonarthrosis - radiography of the knee joint, for coxarthrosis - radiography of the hip joint, etc. The X-ray picture of arthrosis consists of signs of dystrophic changes in the area of articular cartilage and adjacent bone. The joint space is narrowed, the bone platform is deformed and flattened, cyst-like formations, subchondral osteosclerosis and osteophytes are detected. In some cases, with arthrosis, signs of joint instability are found: curvature of the limb axis, subluxations.
Taking into account radiological signs, specialists in the field of orthopedics and traumatology distinguish the following stages of arthrosis (Kellgren-Lawrence classification):
• Stage 1 (doubtful arthrosis) – suspected narrowing of the joint space, osteophytes are absent or present in small quantities.
• Stage 2 (mild arthrosis) – suspected narrowing of the joint space, osteophytes are clearly visible.
• Stage 3 (moderate arthrosis) – obvious narrowing of the joint space, there are clearly defined osteophytes, bone deformities are possible.
• Stage 4 (severe arthrosis) – pronounced narrowing of the joint space, large osteophytes, pronounced bone deformities and osteosclerosis.
Sometimes x-rays are not enough to accurately assess the condition of the joint. To study the bone structures, a CT scan of the joint is performed, and an MRI of the joint is performed to assess the condition of the soft tissues.