Osteoarthritis / arthrosis

Osteoarthritis/arthrosis is a disease that affects the joints. It is the most common degenerative joint disease and also has an inflammatory component. When we talk about the joint, we mean the articular cartilage and the underlying bone – the subchondral bone – which together form a single unit. Cartilage has no blood vessels; it is nourished by the subchondral bone and the synovium.

Osteoarthritis also affects the edges of the bones and the joint capsule and, as a result, the muscles. The bones gradually become deformed, bony outgrowths (osteophytes) appear, and in the decompensated stage a joint effusion develops. The effusion needs to be aspirated (arthrocentesis), the inflammatory joint fluid drained and a medicine instilled that above all reduces the inflammatory component. In the quiet phase, viscosupplements such as Hyalgan, Synvisc and Synocrom should be given; these hyaluronic acid products differ in molecular weight and in the origin of the medicine itself (animal or biofermentation origin).

The medicines are given at weekly or monthly intervals, depending on the assessment of the cartilage and of the patient. If these measures are not sufficient, preoperative preparation begins, whether arthroscopy or a total or partial joint replacement is planned.

Offloading the joint with an orthosis, crutch or walking stick is sometimes necessary, as is proper gait training, which can be learned quickly and easily at Faktor Zdravlje Polyclinic.

Taking anti-inflammatory drugs (NSAIDs) and opioids to control pain and inflammation must be under strict medical supervision.

In the acute phase, physiotherapy consists mainly of static exercises and offloading exercises until the pain settles and the range of motion increases. We then move on to active or active-assisted exercises.

Procedures such as iontophoresis (the use of galvanic current) and sonophoresis (the use of ultrasound with a medicine) help achieve an active concentration of the medicine locally. Osteoarthritis affects the knees and hips, but also the hands and spine; the specific distribution of affected joints and entheses – the so-called joint pattern – points to an inflammatory, degenerative or metabolic disease of the bones and joints.

Newer technologies and preparations such as blood extracts and stem cells are modern treatment methods and are used at Faktor Zdravlje Polyclinic.