Osteoarthritis – symptoms – diagnosis – treatment
The most common form of arthritis is osteoarthritis, which involves the wear and tear of the cartilage that covers the bone in the area where two bones meet. It usually occurs in the fingers, hip and knee, and the pain it causes can become unbearable.
“It is mainly of the degenerative type (age deterioration), is called primary and occurs in patients over 60 years of age. There is osteoarthritis that develops in patients with congenital problems (congenital malformations), post-traumatic osteoarthritis, secondary to autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.) as well as diseases that cause osteonecrosis of the femoral head“, explains Dr. Ioannis Vailas, Doctor of the School of Medicine of the University of Athens, Director of Orthopedic Surgery, Metropolitan Hospital.
1. What symptoms does osteoarthritis cause?
• Pain in the anterior hip area that may radiate to the knee or even the buttock.
• Stiffness (restriction of range of motion) and especially after prolonged immobility of the joint.
• Lameness, which increases with walking and intensity of pain.
• Difficulty walking.
• An early symptom reported by the patient is difficulty putting on his sock.
2. What tests are needed to diagnose the condition?
The history, the clinical examination is a necessary condition for the selection of tests. A simple X-ray is often enough to make the diagnosis, while in complex cases, further investigation with other tests (hematology, CT, MRI) is needed.
3. How does the disease progress?
The progression of osteoarthritis is not predictable. In a large percentage of patients, the course of the disease is slow and is usually treated conservatively. There is a small percentage of patients in whom it develops rapidly with worsening symptoms and unresponsiveness to conservative treatment (drugs, physical therapy, hydrotherapy).
It should be noted that the radiological image of osteoarthritis does not go hand in hand with the manifested symptoms of the condition, i.e. an x-ray with obvious arthritic changes does not have corresponding symptoms, while an x-ray of a patient showing mild arthritis may have particularly strong symptoms.
4. How is it treated?
There is no causal drug treatment for osteoarthritis, only symptomatic treatment.
There are treatments with painkillers, anti-inflammatories that have even more side effects and should be used with caution and for a short period of time, while there are conflicting studies for taking glucosamine sulfate and chondroitin sulfate.
Intra-articular injections of stem cells or hyaluronic acid are performed only in selected cases. Rest, restriction of walking, weight loss, use of bacteria, muscle strengthening exercises in the hip area as well as swimming help to deal with the condition.
5. When is surgical treatment necessary?
When symptomatic conservative treatment (drugs, physical therapy, swimming, weight loss, rest) has no effect and there is severe symptomatology resulting in poor quality of daily life, surgery provides the definitive solution.
“The AMIS (minimally invasive) technique with the modern development of surgical tools excels many techniques having the following advantages:
The skin incision is small, the access is non-traumatic because we choose the normal path to the joint, between the muscles and tissues without cutting or detaching them. In this way, we do not cause surgical injuries and consequently the postoperative pain is significantly reduced, while there are no bleeding centers and no blood transfusion is needed.
In general, the pain is minimal, while the mobilization is very fast without limitations of hip movements as in other techniques where there is a risk of dislocation (e.g. the patient can sit in low seats).
Hospitalization time is short and ranges from 1-3 days. In conclusion, the AMIS total hip arthroplasty technique provides very good, immediate and long-term results and is superior to many other techniques”, concludes Dr. Vailas.
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