Posttraumatic arthrosis

Post-traumatic arthrosis

Posttraumatic arthrosis

Post-traumatic arthrosis is a degenerative-dystrophic joint injury that occurs after traumatic injury. It develops more often after intra-articular fractures, but it can also occur after injuries of soft-tissue elements of the joint( ligaments, meniscuses, etc.).Is manifested by pain, restriction of movements and deformation of the joint. The diagnosis is made on the basis of anamnesis, clinical data, radiography, CT, MRI, ultrasound, arthroscopy and other studies. Treatment is often conservative, with significant destruction of the joint is endoprosthetics.

Post-traumatic arthrosis

Post-traumatic arthrosis is one of the varieties of secondary arthrosis, that is, arthrosis, which has arisen against the background of previous changes in the joint. In orthopedics and traumatology is a fairly common pathology, can develop at any age. More often other forms of arthrosis are detected in young, physically active patients. According to various data, the probability of arthrosis after a joint injury is from 15 to 60%.It can affect any joints, however, the post-traumatic arthroses of large joints of the lower extremities have the greatest clinical significance, both due to the widespread prevalence and due to the influence on the activity and performance of patients.

Causes of development of post-traumatic arthrosis

The main reasons for the development of posttraumatic arthrosis are violation of congruence of articular surfaces, deterioration of blood supply to various joint structures and prolonged immobilization. This form of arthrosis very often occurs after intra-articular fractures with displacement. So, arthrosis of the knee joint often develops after fractures of the condyles of the hip and condyles of the tibia, arthrosis of the elbow joint - after overconscious fractures and fractures of the ray head, etc.

Another fairly common cause of posttraumatic arthrosis is the rupture of the capsular-ligament apparatus. For example, arthrosis of the ankle joint may occur after rupture of the intercostal syndesmosis, arthrosis of the knee joint - after the damage of the cruciate ligaments, etc. Often in the history of patients suffering from post-traumatic arthrosis, a combination of the listed lesions is revealed, for example, a three-ligament fracture with a rupture of intercleral syndesmosis.

The likelihood of developing this form of arthrosis increases dramatically with improper or untimely treatment, which results in even minor anatomical defects that are not corrected. For example, if the joints of the ankle joint change its location only by 1 mm, the load begins to be distributed not over the entire surface of the articular cartilage, but only 30-40% of their total area. This leads to a constant significant overload of certain areas of the joint and causes a rapid destruction of the cartilage.

Continuous immobilization can provoke the development of posttraumatic arthrosis, both with intraarticular and extraarticular injuries. In conditions of prolonged immobility, blood circulation deteriorates and venous-lymphatic outflow in the joint region is disturbed. The muscles are shortened, the elasticity of the soft tissue structures is reduced, and sometimes the changes become irreversible.

A variety of posttraumatic arthrosis is arthrosis after surgical interventions. Despite the fact that surgery is often the best or the only way to restore the configuration and function of the joint, surgical intervention alone always entails additional traumatization of the tissues. In the future, scar tissue forms in the area of ​​incised tissues, which negatively affects the work and blood supply of the joint. In addition, in some cases, during the operation, it is necessary to remove the damaged or severely damaged elements of the joint due to trauma, and this entails a violation of congruence of the joint surfaces.

Symptoms of post-traumatic arthrosis

In the initial stages, there is a crunch and minor or moderate pain, worse with movements. In rest, pain syndrome, as a rule, is absent. A characteristic sign of arthrosis is the "starting pain" - the onset of pain and the transient stiffness of the joint during the first movements after a period of rest. Later, the pain becomes more intense, it occurs not only with exercise, but also at rest - "on the weather" or at night. The amount of movement in the joint is limited.

Usually there is an alternation of exacerbations and remissions. During an exacerbation the joint becomes edematous, synovitis is possible. Because of constant pain, chronic reflex spasm of limb muscles is formed, sometimes muscle contractures develop. At rest patients are concerned about discomfort, pain and muscle cramps. The joint is gradually deformed. Because of the pain and limitation of movements, lameness occurs. At later stages the joint is bent, roughly deformed, subluxations and contractures are noted.

At visual inspection at early stages of change are not revealed. The shape and configuration of the joint is not violated( if there is no previous deformation due to traumatic injury).The volume of movements depends on the nature of the trauma and the quality of rehabilitation measures. In the following there is a worsening of deformation and an increasing limitation of movements. Palpation is painful, with palpation in a number of cases, thickenings and irregularities along the edge of the joint space are determined. There may be curvature of the limb axis and joint instability. With synovitis in the joint, fluctuation is determined.

Diagnosis of post-traumatic arthrosis

The diagnosis is based on anamnesis( previous trauma), clinical manifestations and radiographic findings of the joint. On the radiographs, dystrophic changes are revealed: flattening and deformation of the joint site, narrowing of the joint gap, osteophytes, subchondral osteosclerosis and cyst formations. With subluxation, there is a violation of the limb axis and irregularity of the joint space.

If necessary, more accurately assess the condition of dense structures designate CT of the joint. If it is required to detect pathological changes from the soft tissue side, the patient is referred to the MRI of the joint. In a number of cases, it is advisable to perform arthroscopy - a modern therapeutic and diagnostic technique that allows you to visually assess the condition of cartilage, ligaments, meniscuses, etc. This procedure is especially often used in the diagnosis of posttraumatic arthrosis of the knee joint.

Treatment of post-traumatic arthrosis

Treatment is performed by orthopedists and traumatologists. The main goals of the treatment are to eliminate or reduce the pain syndrome, restore function and prevent further destruction of the joint. Complex therapy is carried out, including NSAIDs of local and general action, chondroprotectors, exercise therapy, massage, thermal procedures( ozocerite, paraffin), electrophoresis with novocaine, shock wave therapy, laser therapy, phonophoresis of corticosteroids, UHF, etc. In intensivepains and pronounced inflammation perform therapeutic blockade with glucocorticosteroids( diprospan, hydrocortisone).When spasms of muscles are prescribed antispasmodics.

Surgical interventions can be performed to restore the configuration and stability of the joint, as well as in cases where the articular surfaces are substantially destroyed and must be replaced by an endoprosthesis. During the operation, osteotomy, osteosynthesis with the use of various metal structures( nails, screws, plates, spokes, etc.), plastic ligaments using the patient's own tissues and artificial materials can be performed.

Operative interventions are performed in the orthopedic or trauma departments, in a planned manner, after an appropriate examination. In most cases, a general anesthesia is used. Both open access operations and the use of sparing arthroscopic techniques are possible. In the postoperative period, prescribe antibiotic therapy, exercise therapy, physiotherapy and massage. After the removal of the joints patients are discharged to outpatient care and carry out rehabilitation measures.

The effect of surgery depends on the nature, severity and duration of the injury, as well as the severity of secondary arthrosis changes. It should be borne in mind that in a number of cases the full restoration of joint function is impossible. With severe advanced arthrosis, the only way to return the patient to work capacity is endoprosthetics. If the endoprosthesis is not indicated for some reason, in some cases, arthrodesis is performed - fixing the joint in a functionally advantageous position.

krasotaimedicina.ru

Post-traumatic osteoarthritis and its treatment

Posttraumatic arthrosis is not a primary disease and is due to predisposing factors. This disease can develop at any age and does not depend on degenerative changes in cartilage tissue due to aging. Especially often, arthrosis affects large joints of the lower extremities in athletes, who neglect pre-preparation before the load.

Posttraumatic deforming arthrosis is used to consider the problem of people with excess weight. However, it is not. Among the main causes of secondary or post-traumatic osteoarthritis are:

  • Joint injuries with tearing and stretching of soft tissues. Especially if inflammatory processes begin in the injured tissues.
  • Frequent inflammatory diseases of the upper respiratory tract( tonsillitis, influenza, acute respiratory infections).
  • Metabolic disorders.
  • Overweight.
  • Diseases of the endocrine system, as a result of which the cartilage and bone tissue change their structure, become thinner. With this pathological condition, the risk of fractures increases.

Post-traumatic arthrosis of knee joint

Trauma can become a trigger mechanism for mechanical destruction of hyaline cartilage, which lining articular surfaces. Meniscus rupture is the main cause of arthrosis of the knee joint. Meniscus is a fibrous-fibrous cartilage. His injuries and injuries usually develop in everyday life.

The deformed part of the meniscus begins to injure the joint surface. This is because the fibrous fibrous cartilage of the meniscus is much denser than the hyaline cartilage of the joint. As a result, the mechanical destruction of the latter occurs. This process can last 3-4 years. As a result, the hyaline cartilage is completely destroyed. This leads to arthrosis to the extent that there is a need for endoprosthetics of the knee joint.

Post-traumatic arthrosis of the knee joint is manifested by pain, stiffness, swelling. When moving in the affected joint, a characteristic crunch arises. If the patient does not consult a doctor, there is a restriction of joint functions, curvature of the lower extremity, as well as muscle atrophy.

Consequences of an ankle injury

The main causes of arthrosis of the ankle joint are a violation of the blood supply of articular cartilage. Even minor injuries can damage the blood vessels that provide the joint with nutrients. As a result of trophic disturbances, the internal structure of the joint bag is disrupted, the production of synovial fluid is reduced, and the friction of the joint surfaces increases.

ankle joint

When the circulation of blood affects the muscles and nerves. As a result, there is a decrease in tone and impaired transmission of nerve impulses to the brain. Thus, the muscle tissue remains uncontrolled by the nervous system. This can trigger the onset of post-traumatic arthrosis.

Post-traumatic arthrosis of the shoulder joint

Also you can read:
aching knees
Symptoms of gonarthrosis

The disease is caused not only by injuries, but also by exorbitant physical stress on the joint. It is for this reason that people who work with heavy physical labor and athletes fall into the risk group. It takes several years after the injury, before the symptoms of the disease begin to appear.

The pain syndrome appears after the appearance of bone growths in the joint. The main symptoms of posttraumatic arthrosis of the shoulder joint include a decrease in muscle trophism and numbness in the arms. One of the striking symptoms is aching pain in the shoulder and shoulder area and the difficulty of removing the arm behind the back.

Treatment of

Treatment of posttraumatic arthrosis is a complex approach. Assign activities aimed at reducing oxygen starvation of tissues. This is achieved through the activation of local and general blood circulation. As a result, venous stasis and swelling of the tissues decrease. Improvement of blood circulation in tissues leads to restoration of regulation of water-salt metabolism, normalization of metabolism in cartilaginous tissue.

Physical exercises strengthen the muscles surrounding the joint, and ensure its stabilization and unloading. Dosed exercises in combination with massage and other methods of physiotherapy lead to adaptation of the body and the injured joint to stresses.

During the exacerbation of the disease, treatment is aimed at reducing pain, relaxing the muscles that are in the tonus. Within a few days, the patient is recommended a sparing motor regimen. With pronounced pain in the last stages of the illness, bed rest is prescribed.

For pain relief, pain relievers and non-steroidal anti-inflammatory drugs are used. To provide nutrients to the cartilaginous tissue, chondroprotectors are given in the form of tablets and external agents.

The use of hydrogen sulphide and radon baths is effective in the treatment of posttraumatic arthrosis. The course of balneotherapy helps to reduce pain for a long period of time. Mud baths are prescribed for the same purposes. Conservative treatment and exercise therapy in the initial stages of the disease can be effective. If the patient turned to a doctor with a neglected form of arthrosis, they suggest surgery. When does posttraumatic arthrosis occur? People often injure joints while playing sports Injuries to the joints and vertebrae do not pass unnoticed for the body. Post-traumatic arthrosis is a direct result of mechanical tissue damage. The traumatic nature of diseases of joints, muscles, bones is largely due to the damage they have received.

Damage to the spine and articular tissue leads to the appearance in humans of a whole range of diseases that are similar in their posttraumatic nature and are by no means always predictable in terms of the severity of the consequences. Prevention of the occurrence of post-traumatic complications and treatment of diseases with this specificity is one of the most urgent issues of modern medicine .It is necessary to know: posttraumatic arthrosis, like similar diseases, is chronic.


The main symptoms of the disease

This type of disease affects the knee joint most often, the treatment of which requires a whole complex of medical, physiotherapeutic, orthopedic measures.

For posttraumatic arthrosis, three stages are noted. The first person has pain only with considerable physical exertion. In the second stage, arthrosis of the knee joint makes us aware of ourselves as the first signs of limited movement, during which the patient feels pain. At this stage, posttraumatic arthrosis of the knee joint is characterized by painful symptoms, which take place only in a state of prolonged dormancy of the body. In the articular tissue there is a crunch, a person has changes in the functioning of the spine - a symptomatic symptom that has osteochondrosis. The third stage of joint destruction is the complete limitation of their mobility. Lateral deformation of the axis at the level of the joint is a sign indicating that posttraumatic arthrosis of the knee joint has passed to the third stage.

The main causes of joint destruction

The main causes of joint destruction

Arthrosis of the ankle also has a similar property. The pain symptom of both diseases leads to the appearance of muscle contractions of the extremities. Osteoarthritis of the knee joint becomes the cause of deformation of the joint tissues, the destructive processes in them are aggravated because of the human endocrine system problems.

In addition to these symptoms, characteristic of many degenerative-dystrophic joint diseases, arthrosis of the knee joint is characterized by the presence of edema of tissues in the area where the disease develops. When a patient has post-traumatic arthrosis of the ankle joint, the above feature is certainly present. An increased local body temperature will indicate problems in the joint tissues. It is also observed if posttraumatic arthrosis of the hip or other leg develops.

Osteoarthritis of the ankle and other joints develops more dynamically if the patient does not regulate his physical activities. This factor is one of the reasons why osteochondrosis is developing rapidly.


Factors provoking disease progression

If a person regularly traumatizes the same area of ​​the body, this entails destructive changes in the tissues. One of the proof of this is posttraumatic gonarthrosis. The stronger the degree of injury, the more dynamically developing the disease, which is right-sided, left-sided or bilateral. Posttraumatic gonarthrosis is usually bilateral. It belongs to the category of secondary diseases that are not genetically conditioned, which does not exclude a hereditary predisposition of the organism to specific degenerative-dystrophic changes in tissues.

Comparison of healthy and aching joints

Comparison of healthy and aching joint

Knee joint gonarthrosis develops in three stages. One of its signs is progressive lameness. It is inherent in people who have a post-traumatic synovitis of the knee site. The presence of the first disease will indicate a specific articular crunch. Initially, a person experiences just uncomfortable sensations where the gonarthrosis of the knee joint develops. They after a while are replaced by pronounced pain symptoms. The patient feels pains mainly at night. This is observed if the ankle arthrosis progresses. With gonarthrosis, disability occurs in the third stage of the disease, when a deformed leg and a significant decrease in the quality of functioning of the limbs are observed in the suffering person. Gonarthrosis of the knee joint in the first stage is not distinguished by the presence of external deformation at the knee, it arises later.

Knee joint gonarthrosis belongs to the category of ailments, which significantly worsen people's health during the weather change. This quality has and posttraumatic osteoporosis.

Osteoporosis is treated quite effectively with the use of conservative methods. Compliance with diet and gentle treatment are mandatory. Osteoporosis usually passes without severe consequences if conservative therapy measures are taken in a timely manner.


Other post-traumatic diseases

In trauma, ligaments of the joint most often suffer

The joints of the joint

are most often affected in a variety of ways. The posttraumatic synovitis of the knee joint is also a common diagnosis. With it, inflammatory processes affect the articular membrane. In the region of the affected joint, a special watery liquid, synovium, accumulates because of which the synovitis of the knee joint has its name. The synovitis of the knee joint is able to develop against the background of gonarthrosis and arise due to:

  • ligament damage;
  • fractures of the joint bones;
  • pathology of blood vessels.

Hemorrhage and disruption of meniscus work - among the factors that cause synovitis of the knee joint. The disease also occurs due to unsuccessful landing on the legs during the jumps. Allergies, neurogenic diseases, endocrine disorders often provoke a synovitis of the knee joint, and it develops against the backdrop of these ailments.

Endocrine changes in the body can accompany arthrosis of the ankle joint. This disease is typical mainly of older people, whose articular tissues are most susceptible to degenerative changes. Osteoarthritis of the ankle is often called a woman's disease, since they are mostly affected by women. High heels and uncomfortable, traumatic shoes are one of the reasons why women develop arthrosis of the hip joint. The latter is one of the most complex degenerative-dystrophic joint diseases, when it is possible to preserve the mobility of the limbs only by surgical intervention. Osteoarthritis of the hip joint is characterized by constant pain:

  • in the thigh;
  • in the knee;
  • in the groin areas.

Osteoarthritis of the hip joint is the cause of stiffness and stiffness of movements, with this disease the affected leg begins to shorten. Osteoarthritis of the hip joint is the cause of lameness and dystrophy of the hip muscles, leading to disability. A hystogram is capable of detecting hip arthrosis in time, which is able to detect bony growths of

The absence of a cartilaginous lining in the joint leads to its destruction

. The absence of a cartilaginous lining in the joint leads to its destruction

both on the inner and outer edges of the swivel. This type of diagnosis can detect a person and post-traumatic arthritis. Its leading cause is multiple mechanical damage to the joint capsule and cartilage.

Women of advanced age are the most numerous at risk because they are most often diagnosed with post-traumatic arthritis. The disease can be accompanied by minor hemorrhages in the joint cavity. Arthritis of the knee joint, like the ankle, characterizes the swelling of the joint tissue. The ache and sensation of crunch will indicate arthritis of the knee joint.

The pain syndrome will begin to be observed in the restricted mobile, affected by the destructive changes of the site. Arthritis of the ankle has similar signs. Sometimes patients complain of pain in the area of ​​the finger.


Treatment of post-traumatic arthritis

If the inflammatory process starts in the human body, high fever and chills will indicate arthritis of the knee joint. At an early stage, his diagnosis is very difficult, therefore, when getting injured, you should immediately consult a doctor to prescribe procedures that can prevent arthritis of the knee joint. In the fight against the disease helps:

  • exercise therapy;
  • swimming;
  • physiotherapy procedures.
Water gymnastics is a gentle way to strengthen the joints They are prescribed for those who have arthritis of the ankle joint and are diagnosed at the first stage. The latter disease is successfully treated with the use of acupuncture, laser and manual therapy, the use of biologically active additives.

Arthritis of the ankle is able to prevent the use of biologically active additives in food, stimulating the development of joint tissues. The most effective method of treatment in the late stages of development is endoprosthetics, it is able to restore the mobility of the limbs of people who have arthritis of the ankle joint. The strategy to combat the disease largely depends on the degree of tissue damage and overall health of a person. The most difficult posttraumatic arthritis of the ankle is treated in the elderly, professional athletes and those whose work is associated with increased physical exertion.

These factors make it difficult to treat patients who have posttraumatic osteochondrosis. The chances of its occurrence are greatest for those who have:

  • excessive weight;
  • is engaged in heavy physical labor;
  • does not eat properly.

Osteochondrosis can aggravate the stresses and impairments of metabolic-dystrophic processes suffered by a person. Trauma in the neck disrupts blood circulation, and prerequisites arise to develop osteochondrosis. Especially dynamic is the progression of the disease during menstrual cycle disorders in women. Osteochondrosis is the result of a sedentary lifestyle, which does not contribute to strengthening tissues and the body's resistance to various diseases.

At the last stage of the disease, a deforming osteochondrosis develops in a person, modern medicine can only be combated with surgical intervention methods.

MoiSustav.ru

Posttraumatic arthrosis

Posttraumatic arthrosis

Posttraumatic arthrosis is a degenerative-dystrophic joint injury that has arisen after its traumatic injury. It often develops after intra-articular fractures, but it can also occur after injuries of soft-tissue elements of the joint( ligaments, meniscuses, etc.).Is manifested by pain, restriction of movements and deformation of the joint. The diagnosis is made on the basis of anamnesis, clinical data, radiography, CT, MRI, ultrasound, arthroscopy and other studies. Treatment is often conservative, with significant destruction of the joint is endoprosthetics.

Posttraumatic arthrosis

Posttraumatic arthrosis is one of the varieties of secondary arthrosis, that is, arthrosis, which has arisen against the background of previous changes in the joint. In orthopedics and traumatology is a fairly common pathology, can develop at any age. More often other forms of arthrosis are detected in young, physically active patients. According to various data, the probability of arthrosis after a joint injury is from 15 to 60%.It can affect any joints, however, the post-traumatic arthroses of large joints of the lower extremities have the greatest clinical significance, both due to the widespread prevalence and the effect on the activity and performance of patients.

Causes of development of post-traumatic arthrosis

The main reasons for the development of posttraumatic arthrosis are violation of congruence of articular surfaces, deterioration of blood supply to various joint structures and prolonged immobilization. This form of arthrosis very often occurs after intra-articular fractures with displacement. So, arthrosis of the knee joint often develops after fractures of the condyles of the hip and condyles of the tibia, arthrosis of the elbow joint - after overconscious fractures and fractures of the ray head, etc.

Another fairly common cause of posttraumatic arthrosis is the rupture of the capsular-ligament apparatus. For example, arthrosis of the ankle joint may occur after rupture of the intercostal syndesmosis, arthrosis of the knee joint - after the damage of the cruciate ligaments, etc. Often in the history of patients suffering from post-traumatic arthrosis, a combination of the listed lesions is revealed, for example, a three-ligament fracture with a rupture of intercleral syndesmosis.

The likelihood of developing this form of arthrosis increases dramatically with incorrect or untimely treatment, which results in even minor unresolved anatomical defects. For example, if the joints of the ankle joint change its location only by 1 mm, the load begins to be distributed not over the entire surface of the articular cartilage, but only 30-40% of their total area. This leads to a constant significant overload of certain areas of the joint and causes a rapid destruction of the cartilage.

Prolonged immobilization can provoke the development of posttraumatic arthrosis, both with intraarticular and extraarticular lesions. In conditions of prolonged immobility, blood circulation deteriorates and venous-lymphatic outflow in the joint region is disturbed. The muscles are shortened, the elasticity of the soft tissue structures is reduced, and sometimes the changes become irreversible.

A variety of posttraumatic arthrosis is arthrosis after surgical interventions. Despite the fact that surgery is often the best or the only way to restore the configuration and function of the joint, surgical intervention alone always entails additional traumatization of the tissues. In the future, scar tissue forms in the area of ​​incised tissues, which negatively affects the work and blood supply of the joint. In addition, in some cases, during the operation, it is necessary to remove the damaged or severely damaged elements of the joint due to trauma, and this entails a violation of congruence of the joint surfaces.

Symptoms of post-traumatic arthrosis

In the initial stages, there is a crunch and minor or moderate pain, aggravated by movement. In rest, pain syndrome, as a rule, is absent. A characteristic sign of arthrosis is the "starting pain" - the onset of pain and the transient stiffness of the joint during the first movements after a period of rest. In the following, the pain becomes more intense, it occurs not only during exercise, but also at rest - "on the weather" or at night. The amount of movement in the joint is limited.

Usually there is an alternation of exacerbations and remissions. During an exacerbation the joint becomes edematous, synovitis is possible. Because of constant pain, chronic reflex spasm of limb muscles is formed, sometimes muscle contractures develop. At rest patients are concerned about discomfort, pain and muscle cramps. The joint is gradually deformed. Because of the pain and limitation of movements, lameness occurs. At later stages the joint is bent, roughly deformed, subluxations and contractures are noted.

At visual inspection at early stages of change are not revealed. The shape and configuration of the joint is not violated( if there is no previous deformation due to traumatic injury).The volume of movements depends on the nature of the trauma and the quality of rehabilitation measures. In the following there is a worsening of deformation and an increasing limitation of movements. Palpation is painful, with palpation in a number of cases, thickenings and irregularities along the edge of the joint space are determined. There may be curvature of the limb axis and joint instability. With synovitis in the joint, fluctuation is determined.

Diagnosis of post-traumatic arthrosis

The diagnosis is established based on anamnesis( previous injury), clinical manifestations and radiographic findings of the joint. On the radiographs, dystrophic changes are revealed: flattening and deformation of the articular site, narrowing of the joint gap, osteophytes, subchondral osteosclerosis and cyst formations. With subluxation, there is a violation of the limb axis and irregularity of the joint space.

If necessary, more accurately assess the condition of dense structures designate CT of the joint. If it is required to detect pathological changes from the soft tissue side, the patient is referred to the MRI of the joint. In a number of cases, it is advisable to perform arthroscopy - a modern therapeutic and diagnostic technique that allows you to visually assess the state of cartilage, ligaments, meniscuses, etc. This procedure is especially often used in the diagnosis of posttraumatic arthrosis of the knee joint.

Treatment of posttraumatic arthrosis

Treatment is performed by orthopedists and traumatologists. The main goals of the treatment are to eliminate or reduce the pain syndrome, restore function and prevent further destruction of the joint. Complex therapy is carried out, including NSAIDs of local and general action, chondroprotectors, exercise therapy, massage, thermal procedures( ozocerite, paraffin), electrophoresis with novocaine, shock wave therapy, laser therapy, phonophoresis of corticosteroids, UHF, etc. In intensivepains and pronounced inflammation perform therapeutic blockade with glucocorticosteroids( diprospan, hydrocortisone).When spasms of muscles are prescribed antispasmodics.

Surgical interventions can be carried out to restore the configuration and stability of the joint, as well as in cases where the articular surfaces are substantially destroyed and must be replaced with an endoprosthesis. During the operation, osteotomy, osteosynthesis with the use of various metal structures( nails, screws, plates, spokes, etc.), plastic ligaments using the patient's own tissues and artificial materials can be performed.

Operative interventions are performed in the orthopedic or trauma departments, in a planned manner, after an appropriate examination. In most cases, a general anesthesia is used. Both open access operations and the use of sparing arthroscopic techniques are possible. In the postoperative period, prescribe antibiotic therapy, exercise therapy, physiotherapy and massage. After the removal of the joints patients are discharged to outpatient care and carry out rehabilitation measures.

The effect of surgical intervention depends on the nature, severity and duration of the injury, as well as the severity of secondary arthrosis changes. It should be borne in mind that in a number of cases the full restoration of joint function is impossible. With severe advanced arthrosis, the only way to return the patient to work capacity is endoprosthetics. If the endoprosthesis is not indicated for some reason, in some cases, arthrodesis is performed - fixing the joint in a functionally advantageous position.

krasotaimedicina.ru

Post-traumatic arthrosis: symptoms, prevention and treatment

A person is arranged in such a way that his whole life consists of a continuous movement, but it is the movement that constitutes a permanent danger to the joints. It lies in the possibility of obtaining joint tissues of injuries and overloads, which subsequently lead to the development of a very serious disease - arthrosis.

Depending on the cause, arthrosis is divided into primary and secondary. The causes of primary arthrosis can not be called reliable medicine is not yet valid, but the reasons for the secondary arthrosis are known precisely. Secondary arthrosis or post-traumatic can develop as a result of:

  • injuries of articular tissues, fractures or ruptures that led to the onset of inflammatory processes;
  • sprains and meniscus damage;
  • development in the body of inflammatory processes, including viral and infectious diseases( influenza, sore throats, etc.);
  • of endocrine system diseases;
  • problems with metabolism;
  • poor-quality or untimely treatment, which caused anatomical changes in the joint.

Secondary arthrosis, which is quite understandable for the above reasons, can occur in any person at any age. He is more exposed to people who lead an active lifestyle, engaged in sports and physical labor.

Symptoms of

Posttraumatic arthrosis can affect any joints, but most often suffer ulnar, ankle, knee. The first stage of arthrosis usually proceeds asymptomatically, only occasionally reminding oneself of some discomfort. Identify the disease at this stage can only be accidental, when conducting a medical examination.

In later stages, there are unpleasant sensations in the affected joint, the pains usually have the character of aching, dull, but can be sharp, episodic. The whole problem is that a person begins to experience pain in the late stages of arthrosis, when his treatment is already very difficult.

Prevention

An important moment in preventing the occurrence of secondary arthrosis is the timely access to a doctor and the installation of the correct diagnosis. Pay attention even to small tissue damage in the joints. Correctly prescribed medications will help to quickly restore periarticular tissues and eliminate inflammation, will help restore the functioning of blood vessels.

It is not superfluous to have an ultrasound or MRI that will help determine the condition of nerves, vessels and cartilage tissues.

Basic principles of

treatment The treatment of posttraumatic arthrosis is a complex and long-lasting process, and a comprehensive approach to solving the problem gives greater effectiveness. The goal of the treatment is to stop, or slow down, the degenerative processes occurring in the joint tissues. Treatment of the first stage involves the appointment of a complex of special exercises to the patient, combined with unloading joints and rest.

In most cases, to obtain the desired result - the restoration of cartilaginous tissue - will take a course of hondoprotectors. Among them are oral medications( Arthro Complex, Arthra, Protecta, Teraflex), injections( Ostenil, Sinocrom), ointments and gels for topical application that include chondroitin and glucosamine, corticosteroids, plant extracts( "Horse Gel").

Among the non-medicinal methods of treatment of particular importance are massage, physiotherapy, manual therapy, shock wave therapy. If properly prescribed, they can have a good healing effect on the joints.

If a joint becomes swollen, the patient is advised to consult a rheumatologist. Treatment should be carried out under the supervision of a doctor. Do not self-medicate - its results can be very deplorable.

medicmagazin.ru

Post-traumatic and deforming arthrosis of the ankle: treatment and operation

Ankle joint carries the function of connecting the leg bone( tibia and tibia) with the talus of the foot. The movement of the joint occurs mainly along the frontal axis and provides flexion and extension of the foot, lateral movements are practically absent. That's why podvorachivanie foot in the side carries a strong pain and leads to serious damage in this area.

Arthrosis of the ankle is one of the most common ankle diseases. Osteoarthritis is the process of destruction of the joint tissue. This process is dystrophic-inflammatory and leads to a loss of cartilage elasticity and a disruption of the tissue structure. That leads to the death of some cartilage cells, and as a result - the formation of cracks on the surface, densification of bone tissue, the formation of cysts, ischemia, the growth of cartilage and ossification of it.

Consequences of the lack of treatment for arthrosis of the ankle joint - deformation of the joint and loss of functionality.

Classification and types of arthrosis of the ankle

Types of arthrosis:

  • Primary arthrosis. On healthy tissue, the process of degeneration begins as a result of excessive workload or trauma;
  • Secondary arthrosis. It develops in the case of chronic diseases such as diabetes, arthritis, etc.

Depending on the causes of the degenerative process, the following types of arthrosis exist:

  • Deforming - premature tissue aging, joint degeneration, impaired mobility of surfaces. U has abnormal gait, deformity of the joint is noticeable without additional studies.
  • Posttraumatic - the consequences of trauma, as a result the surface of the tissue becomes not an even tumor in the ankle area, acute pain.

Causes of arthrosis

Frequent injuries and a constant increased load on the ankle are the most common causes of arthrosis of the ankle joint. The main risk group is dancers, athletes, people with heightened weight and people spending a lot of time standing up.

As there are other factors of the disease:

  • Diseases, for example, diabetes, thyrotoxicosis and others;
  • Injuries;
  • Diseases causing inflammation of the joint tissue;
  • Dysplasia of tissues;
  • Hereditary predisposition.

Of course, women are at risk, often using high-heeled shoes. Due to the unnatural position of the foot, the load on the ankle significantly increases.

Clinical picture of

At the initial stage, the tissues begin to undergo changes, pains appear, the inflammatory reaction occurs only after excessive loads.

In the second stage there is a chronic inflammatory process, thinning of the cartilage, sclerotic changes on the bones. The pain becomes chronic, the mobility of the joint decreases, there is a constant puffiness, the probability of dislocations and injuries increases at times.

The third stage is characterized by a significant limitation in the mobility of the joint, bone deformation is visible even to the layman. Every movement brings a lot of pain.

Treatment of arthrosis of the ankle

In case of any pain in the ankle, consult a doctor. The specialist, diagnosing the post-traumatic arthrosis of the ankle in time, will reduce the pain syndrome, will help prevent the development of the disease.

Complex of measures for the diagnosis of arthrosis of the ankle:

travmpunkt.ru

Post-traumatic arthrosis is secondary degenerative-dystrophic changes in the joint, developing as a result of primary traumatic injury. In this case, the impact of the impact( injury) can occur not only in the cartilage and bone tissue of the joint, but also in the soft periarticular formations( for example, ligaments).The main symptomatology of posttraumatic arthrosis is pain, deformation and limitation of mobility in the affected joint.

Diagnostics is based on "classical" methods for orthopedics - general examination, collection of complaints and instrumental diagnostic studies.

Therapy depends on the severity of the lesion. More often medical treatment is used in combination with restorative measures( exercise therapy, physiotherapy, massage, etc.), according to indications, surgical intervention and plastic joint surgery are performed.

Posttraumatic arthrosis is more often detected in patients of a young age leading an active lifestyle. The "distribution" of the disease is approximately uniform between men and women.

The localization of the disease may be different, but more often large joints of the legs are affected( hip, knee, ankle).

If in time to consult a specialist, the forecast is usually favorable. But with severe lesions, only partial restoration of motor functions is possible, up to disability - disability.

In case of insufficient or untimely treatment, the disease is chronic: with frequent exacerbations and short periods of remission.

Causes of development of

The main and only reason for the development of posttraumatic arthrosis lies in the name of the disease: the occurrence of degenerative changes in the joint is caused by the trauma obtained earlier.

At any mechanical impact, there is a violation of the integrity of any structures, systems or organs of the human body.then not necessarily the violation of the skin with massive bleeding and protruding fragments of bones, as with open fractures. Often, with a slight impact, the microscopic blood vessels( capillaries) are affected, as a result of which the physiological processes of trophic tissue nutrition( nutrition) are broken and a pathology associated with the appearance of dystrophic changes appears.

It is this pattern that is typical for joint trauma. As a result of malnutrition and mechanical damage of the periarticular tissues( articular bag) in the joint cavity and its components, degenerative-dystrophic processes begin: the interarticulate cartilage becomes thinner, the joint elements are subjected to increased friction and, as a result, the joint surface is destroyed.

The mechanism of development of posttraumatic arthrosis can be different:

  1. Violation of the conformance of the forms( congruence) of articulating articular surfaces, deterioration of the trophism of the joint segments, prolonged limitation of motor functions. Such arthrosis, as a rule, develops against the background of intraarticular fracture, burdened with displacement of damaged bones.
  2. Injuries( ruptures and sprains) of the joint capsule, ligaments, meniscuses. For example, with the development of arthrosis of the ankle joint, there is an anamnesis of the intercellular joint( syndesmosis).

But often the development of secondary arthrosis begins after a combination of these injuries( fracture and ligament rupture simultaneously).

  1. Complications after surgery on the joint. As a result of the operation, traumatization of soft tissues and muscle fibers occurs with the subsequent development of scars. These seals interfere with the normal feeding of the joint elements, which leads to its secondary damage.

The second dangerous complication of surgical interventions is the scope of the operation. When removing the damaged joint elements( as a result of trauma), there is a violation of its geometry.

  1. Untimely or complete absence of treatment of primary joint damage due to trauma. Often the symptomatology with joint bruises is smoothed or absent altogether.then leads to the fact that the patient does not seek for qualified help, transfers the damage "on his legs" and as a result receives posttraumatic arthrosis with a full "set" of pathological changes in the joint.

Symptoms and degrees

The clinical picture of the disease largely depends on the location of the damaged joint. For example, in connection with the peculiarities of the anatomical structure, secondary arthrosis of the hip joint is characterized by swelling of the soft tissues.

But the main feature of the defeat of segments of the bone articulation is pain syndrome. At first, there is a dull, aching pain that occurs only with loads or movements and stops at rest. Over time, pain does not pass, and their intensity increases, there is a restriction of the motor function of the limb in the affected area( with the development of degenerative-dystrophic changes in bone tissue).

A characteristic feature of posttraumatic arthrosis is not only the nature of the pain( aching or acute), but the aggravation of the pain syndrome. As a rule, in patients, unpleasant sensations first appear after physical exertion or during sports activities. In the future, pain occurs with ordinary walking, lifting on foot on the stairs and eventually acquires a permanent character.

As the lesion progresses, the stages of exacerbation and remission are replaced by one another. In an acute period, there is swelling of the affected joint, possibly the accumulation of exudate due to the inflammatory process of the synovium( synovitis).Constant pains cause reflex muscle contractions and spasms. Even when the joints are immobilized, patients suffer from pain and muscle cramps.

There are 3 degrees of the development of the disease:

  • The first - the pain syndrome occurs only during the stresses, with the "work" of the joint there is a crunch. No visual changes are observed, the joint retains the usual shape( if the configuration of the bone joint has not been disturbed after the initial injury).Painful sensations appear on palpation.
  • The second - the pain syndrome becomes more intense, the sharp pain gets at the beginning of the movement( when moving from a static position to a dynamic load).In the morning hours there is stiffness, limited mobility."Crunchy" sounds are getting louder.

The joint joint deformations are defined: the presence of thickenings and the appearance of irregularities along its contour.

  • At the third degree the deformity of the affected joint is visualized, the pain syndrome does not pass even in a stationary state: the pain can intensify at night, and react "to the weather."The motor function is almost completely limited.

Diagnosis

When making a diagnosis, the doctor should pay special attention to the collection of anamnesis of the disease( Anamnesis morbi).If the patient has had injuries of the joint or the periarticular region in the past, there is a high probability of talking about post-traumatic arthritis. To confirm the diagnosis, a general examination, palpation( to determine the soreness), and analyze complaints voiced by the patient.

The final diagnosis is made after an examination of the area of ​​the joint. If necessary, the patient is recommended more accurate methods - computer and magnetic resonance imaging.

The radiological picture of secondary( traumatic) joint damage is divided into three stages:

  • The first stage is the appearance of bone growth along the edges, the presence of small areas of the cartilage tissue axis and the narrowing of the joint space.
  • The second stage - marginal bony proliferation progresses, subchondral sclerosis of the end plate is noted and further narrowing of the joint gap.
  • Third stage - articular surfaces are deformed, enlarged and sclerized( due to bony growths), joint joint is practically absent. Subchondral necrosis with foci of radiological enlightenment in the form of cysts or small cavities is noted.

Treatment

Treatment is complex, includes medical therapy, physiotherapy methods, folk medicine, orthopedic support, and with indications - surgical intervention.

Conservative methods

In the treatment of posttraumatic arthrosis, therapy is applied, the main tasks of which are:

  • Reduction of the load on the damaged joint. Restrictions of movement in the joint should alternate with specially designed complexes of medical exercises, in the performance of which it should not be allowed to exacerbate the pain syndrome. Courses of exercise therapy are necessary in order to prevent atrophy of muscle fibers.

For patients with excess weight, a diet is provided.

  • Removing the pain syndrome and fighting the inflammatory process. Drug treatment consists of the administration of NSAIDs - to reduce pain and inflammation, chondroprotectors are prescribed to prevent joint destruction, as these drugs promote the regeneration of cartilaginous tissue.

Ointments and gels containing chondroitin and glucosamine are used in the form of applications. To alleviate unpleasant symptoms( especially in the initial stages of the disease) corticosteroid ointments of external use( as an anti-inflammatory agent) and preparations based on plant extracts are prescribed.

  • Restoration of motor function. To develop the affected joint, a complex of physiotherapeutic procedures( thermal warming), massage, acupuncture, manual and shock wave therapy, phonophoresis, etc. are used.

All these measures are necessary to improve the trophism of the affected area, restore normal circulation of atrophied muscle fibers, facilitatestate of the patient( by the removal or reduction of pain syndrome).

General algorithm of treatment if the operation is not shown:

  1. Fighting the progression of the disease.
  2. Pain relief or reduction.
  3. Reduction in the phenomena of reactive synovitis.
  4. Correction of motion in the joint - preservation or improvement.

Operative intervention of

The effectiveness of treatment and the restoration of motor function largely depends on the degree of destruction of the joint tissues caused by degenerative processes.

Surgical intervention is used for significant joint surface lesions( endoprostheses are used for their replacement), "reconstruction" of the configuration and restoration of the stability of the damaged bone articulation.

For surgical repositioning, both fixing metal structures( plates, screws, etc.) are used, and the transplanted tissues of the patient themselves( to restore the ligamentous apparatus), as well as artificial materials( implants) are used.

Operations are usually performed under general anesthesia( "classical" methods with open access) and without the use of general anesthesia - minimally invasive arthroscopic techniques.

The postoperative period includes the use of complex conservative treatment:

  • medication - antibiotics;
  • physiotherapy;
  • exercise therapy;
  • massage.

Which doctor treats

If you have a history of joint trauma, after which the symptoms described above are observed, you should consult a specialist - orthopedic doctor. If there is swelling in the joints region, it will be superfluous to visit a rheumatologist to eliminate systemic diseases that also provoke joint damage.

If surgical treatment was performed in post-traumatic arthrosis, post-operative rehabilitation is a prerequisite. This will help doctors, rehabilitators and physiotherapists.

knigamedika.ru

How posttraumatic arthrosis of the ankle develops: treatment in a timely manner

Typically, traumatic injuries rarely pass without a trace. Even minor injuries always affect the nerves and blood vessels. As a consequence, blood circulation of articular tissues worsens, muscle tone decreases. All this provokes in the future the disease of the joint itself.

Causes in the name

Post-traumatic arthrosis of the ankle develops as a result of injuries sustained during an injury, especially if it has not been treated. The damage to the integrity of the blood vessels always present during trauma leads to a deterioration in the supply of nutrients to the joint, and damage to the joint bag leads to increased friction of the surfaces of the joint itself. As a result, the cartilage becomes thinner, its strength decreases, and it begins to slowly break down.

It is not necessary for the development of the disease that the injury was severe, even regular microtraining is enough. A feature of this joint is that while flexing and extending the foot and moving while in the frontal surface, it has a minimum amplitude of lateral movements. Therefore, even a slight tampering causes severe pain and can cause very serious damage. In the risk group of this disease, dancers, athletes, people who have to spend a lot of time on their feet, as well as all those who are overweight. I would like to note that lovers also go on high heels here.

Diagnosis and causes of the disease are established by X-ray and ultrasound, and magnetic resonance imaging and computer tomography are also used for diagnosis.

Symptoms of

Arthrosis of the ankle shows itself aching and blunt pains. The longer the disease lasts, the sharper and sharper the pain becomes. If at first they occur with physical exertion or after them, then the patient feels them after a period of rest. Such initial pains are explained by the fact that at the beginning of the movement the maximum load is on the affected joint. For the patient, it becomes problematic to descend the stairs. The probability of getting additional traumatic dislocations, bruises and strains increases, which further worsen the course of the already begun inflammatory process.

The affected joint begins to deform with time, a swelling occurs, and its mobility is limited. A characteristic sign of deformation is the crunch that is heard when moving. After a while, the deformation becomes pronounced, various curvatures are observed in the foot region. To move such patients are forced to use a cane or crutch.

Treatment: the effectiveness of the integrated approach

Post-traumatic arthrosis of the ankle, the treatment of which is aimed at the removal of pain and improvement of motor functions, is a disease requiring an integrated and versatile approach. At the first stage it is important to provide rest for the joint. Then it is necessary to undergo the medication prescribed by the doctor, which is often supplemented with electromagnetic therapy. In the recovery phase, spa treatment and balneotherapy are effective. It is advisable in this period to use massage, acupuncture, manual therapy.

From drugs prescribe anti-inflammatory and pain medications. Biostimulators, as well as chondroprotectors obtained from cartilage animals, are used to improve blood circulation and restore cartilaginous tissue functions.

To maximally relieve the aching joint, a restrictive diet is recommended to reduce weight.

In case of large destruction or ineffectiveness of conservative treatment, operative intervention is performed. As a rule, the patient is offered the least traumatic arthroscopic operation, consisting in the fact that by means of a special tool - an arthroscope, which is inserted through micro cuts, the growth of bones and tissues is removed. This method is characterized by efficacy, low traumatism, rapid recovery after surgery. Postoperative wounds heal in 2-3 days, and inflammation or complications of another kind after it are excluded. The mobility of the joint is restored almost completely after 5 weeks.

The prognosis in the early stages is favorable, with the advanced forms of the disease, the onset of disability is possible.

Thus, post-traumatic arthrosis of the ankle arises due to the inability of a weakened joint with the same force to withstand the usual loads. Beginning in the cartilage itself, this process often results in the destruction of the entire joint. The success of the treatment of this disease completely depends on its stage.

proartrit.ru

Treatment of joints

Treatment of jointsOsteoarthritisOsteoarthritis

Efficacy of hips in the hip joint with arthrosis Coxarthrosis is an inflammation of the hip joint. Such a lesion is capable of completely or partially destroying the binders of the joint bag. S...

Read More
Treatment of joints

Treatment of jointsOsteoarthritisOsteoarthritis

Reviews about the preparation for joints Fermatron Fermatron is a viscoelastic drug that is injected( injected) into the synovial cavity of the joint. Most often, this drug is used if a pers...

Read More
Treatment of joints

Treatment of jointsOsteoarthritisOsteoarthritis

Modern effective medications for arthrosis of the knee joint Osteoarthritis of the knee joint( gonarthrosis) does not affect life expectancy, but can seriously impair the quality of life due to...

Read More