Arthritis

Symptoms and treatments of osteoarthritis

Definition

Osteoarthritis is a chronic impairment of the joint in connection with irreversible wear of the cartilage, which progressively leads to degradation of the articular surfaces causing pain, stiffening and deformation of the osteoarthritic joint.

Evolution

Gradually, the cartilage will lose its qualities of suppleness and slip. The rest of the joint can then gradually degrade with a greater secretion of synovial fluid, bone deformations such as osteophytes (bone beaks) and progressive muscular melting in relation to the loss of progressive function of the joint.

Causes

The causes of osteoarthritis are multiple. This may involve early degradation of the cartilage. Genetic factors have been found to explain the onset of osteoarthritis in relatively young people with no previous history, with rapid onset of osteoarthritis in many joints or same family.
But most often it is a fairly natural phenomenon of wear and tear that can be accelerated by overweight, repetitive movements, repeated micro trauma during sporting or professional life, or deformation of the joint due to an ancient fracture.
Osteoarthritis may be favored by age, overweight, intensive and prolonged activities in the context of sport and work, trauma, but also lack of physical activity and muscle wasting.
Primary osteoarthritis affects people who do not have a particular risk factor and secondary osteoarthritis for which there is a particular mechanical or medical cause.

Locations

The most affected joints are those of the spine, the knee, the hip and the ankle, which support the weight of the body and are therefore subjected to high stresses.
But all joints can be reached and especially the shoulder, wrist and joints of the hand and fingers.

Clinical signs

The most suggestive clinical signs of osteoarthritis are :

• Pain (especially during mobilization or climate change)
• Stiffness occurring especially after a period of immobility or on waking
• Cracking during mobilization
• Swelling of the joint which may evoke synovial fluid effusion and associated inflammation.

Diagnosis

The diagnosis is usually quite easy.
The interrogation identifies persistent pain and risk factors.
Examination regains stiffness, cracking, deformity and swelling.
X-rays show articular pinching and osteophytes (parrot beaks).
The CT-scan may be useful at a beginning stage or for a more accurate assessment.

Medical treatment

▪ Prevention : Weight loss, joint economy while maintaining regular activity.
▪ Analgesia, anti-inflammatory medications.
▪ Injection of corticosteroids, viscosupplementation or platelets

The Bordeaux-Merignac Sport Clinic implements all of these treatments and participates in preventive actions

Surgical treatment

Surgical treatment is implemented in the event of failure of medical treatment when osteoarthritis is severe. It consists mainly of the placement of prostheses to replace the worn joint.

The Bordeaux-Merignac Sport Clinic has a long experience of this prosthetic replacement surgery for 20 years with currently more than 700 prostheses per year.

Surgeons are hyper-specialized in the pathology of a single joint.
A multidisciplinary approach to ERAS (Enhanced Recovery After Surgery) was instituted within the clinic to optimize the quality and speed of the results obtained.

The entire medical and paramedical teams are mobilized around the supervision of the clinic for this priority objective

Outpatient care can be proposed to selected patients.

Numerous national and international publications highlight the progress made in the field of prosthetic surgery in our institution.