Viêm Khớp Thoái Hóa: Triệu Chứng và Điều Trị

Osteoarthritis is a common joint disease in Germany. It affects millions of people and causes cartilage degradation. Joint pain and restricted movement often affect the daily lives of those affected.

Osteoarthritis can be caused by age or injury. Finger, knee and hip joints are often affected. The risk increases with age: 90% of people over 65 have osteoarthritis.

Early signs are stiffness and swelling. Later, pain on exertion is added. This can develop into permanent pain.

Diagnosis is based on physical examinations and imaging procedures. Sometimes joint punctures are also necessary.

The treatment of osteoarthritis is varied. Exercise therapy and physiotherapy are the first priority. Medication can alleviate pain and inflammation.

In advanced stages, surgical procedures such as joint replacement can help.

Important findings

• Osteoarthritis affects up to 8 million people in Germany
• Women are more frequently affected than men
• Main symptoms: Start-up pain and pain on exertion, limited mobility
• Treatment includes exercise therapy, medication and surgery
• 70-80% of patients report relief through multimodal therapies

What is osteoarthritis

Osteoarthritis is the most common joint disease in Germany. It affects over 5 million people. It leads to cartilage degradation, pain and limited mobility.

Definition and basics of the joint disease

Osteoarthritis causes the joint structures to change slowly. The protective cartilage becomes thinner and rougher. This can cause inflammation and wear and tear.

Initially, often only a small area is affected. Over time, the damage spreads.

Affected joints and structures

Osteoarthritis can affect any joint. Knees, hips and hands are most commonly affected. According to the Robert Koch Institute, over 50% have knee osteoarthritis.

Around 25% suffer from hip osteoarthritis. The fingers are affected in a third of women and a seventh of men.

Difference between primary and secondary osteoarthritis

There are two types of osteoarthritis:

• Primary osteoarthritis: This is caused by ageing and natural wear and tear.
• Secondary osteoarthritis: This is caused by injuries or other diseases.

Both forms lead to degeneration of the joint cartilage. In the late stages, the cartilage is completely worn away. The bone becomes denser and harder.

Bony protrusions, so-called osteophytes, form. The joint widens and hurts when moving.

Triggers and risk factors

Osteoarthritis has many complex causes. Several factors contribute to this joint disease. Here we take a closer look at the most important risk factors.

Age-related changes

The risk of osteoarthritis increases with age. From the age of 55, women are affected more frequently. The cartilage wears out and renews itself more slowly.

This leads to increased stress on the joints. Regular exercise can counteract this.

Genetic predispositions

A familial predisposition can increase the risk of osteoarthritis. Certain genes influence cartilage structure and stability. Hereditary malalignment of the joints also favors osteoarthritis.

Overweight and joint stress

Being overweight is a major risk factor for osteoarthritis. Every extra kilo puts a lot of strain on the joints. Knees and hips in particular suffer as a result.

Losing weight can significantly reduce the strain on joints. A healthy diet and exercise can help.

Pre-existing conditions and injuries

Previous joint injuries or operations increase the risk of osteoarthritis. Chronic diseases such as diabetes or rheumatism can also affect cartilage health.

Injuries that have not healed often lead to incorrect loading. This can cause long-term joint damage.

Risk factor	Impact	Preventive measure
Age	Wear and tear of the cartilage	Regular exercise
Genetics	Increased susceptibility	Early prevention
Overweight	Increased joint stress	Weight reduction
Injuries	Permanent joint damage	Adequate healing

Disease progression and signs

Osteoarthritis often develops unnoticed. Initially, those affected feel slight stiffness in the joints. This occurs particularly after long periods of rest.

Over time, joints can swell. Pain is also experienced, initially only during exercise. Later, it can also occur during periods of rest.

Restricted movement is another characteristic. Joints lose mobility, which makes everyday life more difficult. Osteoarthritis of the knee makes climbing stairs more difficult, osteoarthritis of the hip makes putting on shoes more difficult.

Typical signs during the course of the disease:

• Morning stiffness of the joints
• Increasing joint pain during exercise
• Swelling and thickening of the joints
• Cracking or rubbing in the joint during movement
• Decreasing mobility and strength

The course of the disease can vary from person to person. Some have occasional complaints, others have constant pain. Early detection and timely treatment can have a positive influence on the course of the disease.

Diagnostic methods

Diagnosis of osteoarthritis requires a thorough examination. Doctors use various methods to diagnose the disease. They also rule out other possible causes.

Physical examination

The doctor asks detailed questions about pain and complaints. He palpates the joints and checks their function. He looks for swelling and restricted movement.

A gait and movement analysis can reveal disorders. The doctor looks for lumps in the finger joints. These examinations help with the initial assessment.

Imaging procedures

X-ray examinations show typical signs of osteoarthritis. These include joint space narrowing and bone spurs. MRI examinations make soft tissues such as tendons and cartilage visible.

CT scans are particularly suitable for visualizing bony structures. These procedures provide important information for the diagnosis.

Joint puncture and laboratory tests

A joint puncture can reveal inflammatory processes. Blood tests help to rule out other diseases. In the case of osteoarthritis, relevant blood tests are usually negative.

Diagnostic method	Field of application	Advantages
X-ray examination	Bony structures	Shows joint space narrowing
MRI	Soft tissue	Detailed visualization of cartilage
Joint puncture	synovial fluid	Detection of inflammation

The combination of these methods enables an accurate diagnosis of osteoarthritis. It helps to plan suitable treatment steps. Each method contributes important information to the overall diagnosis.

Conservative treatment options

There are various conservative treatment methods for osteoarthritis. They are designed to relieve pain and improve joint function. These methods offer sufferers the opportunity to reduce their symptoms.

Exercise therapy and sport

Regular exercise is important for the treatment of osteoarthritis. Cycling and swimming are easy on the joints and are suitable. Jogging or sports with rapid changes of direction should be avoided.

If you are overweight, losing weight can reduce the strain on the joints. This can lead to a significant improvement in symptoms.

Physiotherapeutic measures

Physiotherapy plays an important role in the treatment of osteoarthritis. It includes techniques such as manual therapy, thermotherapy and hydrotherapy. The aim is to strengthen the muscles and reduce stress on the joints.

Orthopaedic aids such as supports or shoe adjustments can also help. They support the joints and improve mobility.

Drug therapy

Painkillers are often part of osteoarthritis treatment. Anti-inflammatory drugs (NSAIDs) such as Voltaren® or Ibuprofen® are frequently used. Cartilage preparations can also be helpful.

In some cases, cortisone injections are administered directly into the joint. A new option is autologous blood therapy (PRP), which can provide relief for months.

An individual therapy plan takes all aspects of conservative treatment into account. This allows those affected to benefit from the basic components of the therapy in everyday life. This leads to an improvement in quality of life.

Surgical interventions and modern procedures

Surgical interventions may be necessary in cases of advanced osteoarthritis. The choice between joint-preserving surgery and joint replacement depends on the degree of severity. Doctors take the condition of the joint into account.

Joint-preserving operations

Minimally invasive procedures such as arthroscopy offer good prospects of success for moderate cartilage damage. They enable faster regeneration and a lower risk of infection.

Correction of misalignments can be useful if cartilage loss is not too advanced. The aim of these procedures is to maintain natural joint function.

Joint replacement operations

If joint preservation is no longer possible, osteoarthritis surgery with joint replacement is an option. These operations are usually routine today.

In 2019, almost 245,000 artificial hip joints were implanted in Germany. In addition, 195,000 patients received knee joint endoprostheses. Total endoprostheses (TEP) are the largest surgical procedures.

Aftercare and rehabilitation

After the operation, intensive rehabilitation is crucial to the success of the treatment. Physiotherapy and adapted training strengthen the muscles and improve joint function.

A meta-analysis showed interesting results for hyaluronic acid treatments. Regular applications can delay a knee joint replacement by more than three years.

Intervention	Advantages	Special features
Arthroscopy	Rapid regeneration, low risk of infection	Suitable for moderate cartilage damage
Joint replacement	Significant pain relief, improved mobility	Frequently used for hips and knees, routine procedure
Joint puncture	Relief of the joint, pain reduction	Can help to improve mobility

Conclusion

Osteoarthritis affects around 5 million people in Germany. It is a common joint disease in older and younger people. Good osteoarthritis management significantly improves the quality of life of those affected.

Prevention starts with a healthy lifestyle. Joint-friendly exercise such as swimming or cycling strengthens the joints. A balanced diet with plenty of fruit and vegetables can have a positive effect on the course of the disease.

It is important to avoid being overweight, as this puts additional strain on the joints. Those affected have various treatment options to choose from.

Conservative methods include physiotherapy and pain medication. Surgical procedures such as joint replacement are another option. Modern technologies even allow for custom-made implants using 3D printing.

All measures are aimed at relieving pain and maintaining mobility. With the right management, those affected can remain active and improve their quality of life.

FAQ

What exactly is osteoarthritis?

Osteoarthritis is a common joint disease. It is caused by the breakdown of cartilage tissue. Osteoarthritis can occur as a result of age or injury and causes pain and restricted movement.

Which joints are most commonly affected by osteoarthritis?

Osteoarthritis usually affects the knees and hips. Finger joints, shoulders and the spine can also be affected.

What are the main risk factors for osteoarthritis?

The main risk factors include age and genetic predisposition. Obesity, injuries and excessive joint strain also play a role. Some pre-existing conditions can increase the risk.

What are the symptoms of osteoarthritis?

Osteoarthritis often begins with stiffness and occasional pain on exertion. Over time, permanent pain can occur. Mobility becomes increasingly restricted.

How is osteoarthritis diagnosed?

The diagnosis is made by physical examination and questioning the symptoms. Imaging procedures such as X-ray, CT or MRI are used. Sometimes joint punctures and laboratory tests are necessary.

What conservative treatment options are there for osteoarthritis?

Conservative treatments include exercise therapy, sport and physiotherapy. Medication can also help. Regular, joint-friendly exercise is particularly important for joint function.

When is surgery necessary for osteoarthritis?

Surgery is considered when conservative methods no longer help. This is often the case with advanced osteoarthritis. Severe pain and considerable functional limitations are typical signs.

Can osteoarthritis be prevented?

Complete prevention is not always possible. However, you can reduce the risk by adopting a healthy lifestyle. Regular exercise, weight control and a balanced diet are helpful.

How can I deal with osteoarthritis pain in everyday life?

Heat or cold applications can relieve osteoarthritis pain. Adapted movement exercises and ergonomic aids are useful. A good balance between activity and rest is important.

Are there alternative treatments for osteoarthritis?

Some sufferers report positive experiences with acupuncture or yoga. Special diets can also help. These methods should be discussed with your doctor.