Osteoarthritis is no longer considered a consequence of aging with the development of degenerative changes in cartilage. The reason is not only destructive processes, but also reparative ones. In 1995, the disease osteoarthritis was defined as the result of mechanical and biological influences that disrupt the balance of degradation of the extracellular matrix of articular cartilage, synthesis of chondrocytes, and subchondral bone. What causes and factors provoke the development of osteoarthritis of the joints? What are the symptoms of osteoarthritis?
What factors provoke the development of osteoarthritis of the joint?
The progression of the disease can be triggered by various factors: developmental, genetic, traumatic and metabolic. In the pathological process in osteoarthritis, all tissues of the joint are always involved. Morphological, biochemical, biomechanical and molecular mechanisms of development of osteoarthrosis of the joint lead to significant softening, ulceration, fibrillation and loss of articular cartilage. There is a development of eburnation and sclerosis of the subchondral bone, as well as the formation of subchondral cysts and osteophytes.
Factors that lead to osteoarthritis of the joint:
- Genetic factors:
- Hereditary disorders of collagen II synthesis (Stickler syndrome).
- Impaired functioning of the collagen II gene.
- Belonging to a particular ethnic group.
- Pathology of the skin or joints of a hereditary nature.
- Non-genetic factors:
- Pathological diseases of the bones of an acquired or congenital nature.
- Surgical interventions on the joints.
- Decrease in the level of female sex hormones during menopause.
- Obesity or overweight.
- Old age.
- Environmental factors:
- Traumatization of the joint.
- Features of the profession associated with constant physical stress on the joints.
- Active leisure.
The most significant risk factor is age. Significantly increases the risk of developing osteoarthritis of the joint, the presence of overweight and obesity. Sports such as running do not lead to an increase in risk, as they produce an adequate biomechanical load on the joints. Hereditary factors play a role, especially in the development of generalized Heberden's nodules.
What is the mechanism of development of osteoarthritis of the joint?
It is still impossible to say unequivocally where the disorders initially appear in idiopathic osteoarthritis of the joint - in the subchondral bone or articular cartilage. In the joint, cartilage ensures the sliding of the articular surfaces during joint movement, as well as reducing the load under the action of mechanical factors.
This effect is due to the unique structure of cartilage tissue, where all chondrocytes are embedded in a matrix consisting of collagen and proteoglycan. Collagen type 2 is the main structural protein. Proteoglycans, represented by agrecan, are the second important component of cartilage. In normal articular cartilage, the processes of cartilage synthesis and degradation are in balance.
The cause of degenerative changes can be either increased catabolism or insufficient synthesis. This is confirmed by an increase in metalloproteinases in the cartilage from OA– enzymes that catalyze the degradation of collagen and proteoglycans. Their production is simulated by the action of interleukin 1. The role of inflammation in the development of osteoarthritis of the joint is ambiguous.
The main clinical manifestations of osteoarthritis of the joint
The main symptom that patients with osteoarthritis of the joint seek medical attention is pain. The pain appears sharply and increases with movement of the joint. The presence of pain at rest indicates a severe lesion. In this case, all components of the joint can be sources of pain: joint capsule, synovial membrane, periarticular ligaments and periarticular muscles, subchondral bone and periosteum.
At the same time, patients feel morning stiffness in the joint, its stiffness, instability when walking and impaired function of the joint itself. On examination, the following objective signs are found: crunching during movement, defiguration of bones, pain on palpation, swelling of the joints, limitation of the range of motion, displacement or deformity of the joint.
Osteoarthritis of the joint may not manifest itself for quite a long time. At the first signs of osteoarthritis of the joint, you should consult a doctor for the treatment of osteoarthritis.
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