Osteoarthritis, also known as calcification..

OSTEOARTHRITIS; IS CALCIFICATION A FORCED FATE?

What is Osteoarthritis?

Our bodies wear out as we get older, and time changes our bodies without us even realizing it. Few people truly respect their health from their youth. Sometimes our living conditions are harsh and we work with physical strength, and sometimes we strain our bodies unnecessarily. The disease, popularly known as arthritis and called osteoarthritis in the medical literature, is most obviously the disease of abused bodies.

One in every 5 women and one in every 10 men over the age of 60 develop osteoarthritis. This disease comes to mind in our patients, especially knee, hip, waist, back and hand pain, which usually occurs with aging. Difficulty walking due to knee and hip pain, lower back pain that increases with standing, pain at the base of the thumb and the development of bone protrusions in the fingers are the issues our patients complain about the most. Although prosthetic surgeries are the last point of treatment for osteoarthritis today, the correct treatments that can be given to patients should be determined and especially preventive medicine should be implemented until this treatment method is reached.

The most important reason for the development of osteoarthritis is mechanical problems. Our joints are sensitive to overload. Excessive load, or constant performance of certain movements throughout life, causes the joints to begin to wear out. With age, the self-repair and renewal abilities of cartilage decrease. Conditions that cause calcification today:

1.Increasing age;The risk of osteoarthritis increases more significantly every year over the age of 60.

2.Excess weight;The load that each body carries more than its ideal weight increases this risk even more. On the other hand, while the load exerted by the weight is less on the hip, it is much more noticeable on the knee. I think one of the most important factors here is the way we walk. As a result of wrong footing habits, the knee joint is exposed to trauma with every step, outside of the natural posture. Such traumas cause the cartilage structure to become edematous over time. As this situation continues, A constant repair effort occurs in the cartilage, which triggers osteoarthritis in the future. If two women of the same weight who spend their lives in the field and in a house without stairs are compared, the negative effects of uncontrolled stepping on the ground as a result of continuous work in the field can be better understood. On the other hand, it should not be forgotten that osteoarthritis can also develop in a thin person.

3.Being a woman;The effect of hormonal balance and estrogen deficiency that changes with age on the cartilage structure. It is thought to be.

4.Joint damaging traumas;What I mean here are blows to the knee. Events such as jumping from high places and falling should be understood.

5.One leg being more than 1cm longer than the other;A small and incomprehensible leg difference, always short It will cause trauma to the leg. Maybe years will pass before such a small difference is noticed and the person will develop osteoarthritis.

6.Genetic features;The fact is that 11 genes are thought to be related to calcification. However, this effect was found to be extremely weak. Joints need to be handled differently in terms of arthritis. For example, the genetic predisposition for "erosive osteoarthritis", which we will call damaged hand arthritis, is different and more pronounced than that of the knee and hip. There is a relationship between the condition of such patients' hands and the possibility of the patient's hand being in a similar shape, which is especially true for women.

They can be listed as follows. The most prominent of these factors are age and weight.

How do we understand that the disease has developed?

The belief for years was that this disease was a non-inflammatory rheumatism. However, in my belief and in the light of the latest data, it shows that the disease also includes a rheumatic reaction of its own. This difference in understanding brings osteoarthritis closer to the class of treatable diseases.

The first step in diagnosing this disease is to listen to the complaint thoroughly. We need to know in which joint or joints there is pain and at what time of the day these pains occur.In osteoarthritis;

Pain increases with movement.

Pain decreases when you rest. Painless in the morning getting up and the pain increases during the day.

Stairs, folding the knee during prayer, sitting down to eat, and using the classic toilet especially increase knee pain.

Changes in the hip joint progress more slowly than in the knee.

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Manual work and dealing with cold water also increase hand pain

Pain increases with standing, especially in the waist and knees.

During diagnosis

A good conversation with the patient and subsequent examination is the first step

Simple films of the complained area are seen

Ultrasonography, which is used by experts in the field and now especially in all rheumatology clinics, is also helpful and simple in diagnosis. It is a test.

If necessary, advanced imaging tests are requested (MRI or tomography)

Rarely, it is necessary to carefully distinguish it from other inflammatory rheumatism

Taking a film. It guides us. Deteriorated joint structures, narrowing and damage are understood here. If a patient over the age of 60 is not considering surgery, MRI is an extremely unnecessary examination.

My comments about treatment methods

Early diagnosis is the first and most important step in treatment. . Because if osteoarthritis treatment is not started early, effective treatment is very difficult after permanent changes occur.

The most effective treatment method is to eliminate the factor that strains the joint. This factor is weight loss, as the most common form of osteoarthritis is in the knee joint. Making sports a part of life from adolescence is also an important form of preventive medicine.

Lifestyle changes should be made. When making this plan, different recommendations are made depending on which joint is affected. For example, someone with knee osteoarthritis should avoid stairs, and someone with hand osteoarthritis should avoid hand knitting or manual cleaning work.

Surgery is a bit confusing. It is still not clear whether arthroscopic surgeries performed on the knee joint have any benefits, and scientific articles tell us that there are no convincing results on this subject. Corrective surgeries, that is, surgeries without prosthetics, can only be successful in very special hands and in selected cases. There are serious fears for prosthetic surgery. At this point, our patients, who are often elderly, have Having additional diseases such as high blood pressure prevents the doctor from performing surgery. It is known that prostheses have a certain lifespan, and if a prosthesis is to be placed, the patient is asked to come for surgery at an older age. However, no matter how old we are, we want to live a quality life and enjoy life. While it is possible to eliminate the knee pain that keeps us out of bed at night with surgery at the age of 50, telling the patient to do this surgery when he is older means asking the patient to live his life with poor quality. At this point, I always try to ask myself this question and say what I would like if it were me. I think it would be wrong not to perform surgery on an 80-year-old and lively person just because of his age.

To date, a painkillers-based treatment approach has always been adopted in the drug treatment of osteoarthritis. However, someone who constantly takes painkillers will have less ability to maintain their joint in the correct position. While there is increasing evidence that osteoarthritis is also a partially inflammatory rheumatic disease, the effort to use only painkillers to treat this disease is an inadequate treatment approach. However, there are no drugs that can be considered a definitive solution in this regard, and different treatment methods are emerging based on physicians' own experiences. It is controversial whether hyaluronic acid and glycosaminoglycan, which have been increasing recently and are described as cartilage enhancers, are really effective or not, but they can be beneficial in the right cases.

Intra-articular cortisone application can be tried 1-2 times on the knee. However, frequently repeated injections will also increase the rate of damage to the knee cartilage.

Cartilage transplants, growth hormone inhibitor drugs, and stem cell treatments have not yet provided satisfactory results.

The main treatment method for osteoarthritis of the shoulder joint and spine. It is exercise.

PRP treatment, which is popularly called stem cell treatment but has nothing to do with stem cells in its real sense, has become increasingly common, which our patients have been asking about with more curiosity lately. My personal opinion on this issue is that this method is ineffective and the study results do not indicate a good result in this regard.

Let's not forget that hand osteoarthritis should be evaluated differently.

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