WHAT IS OSTEOARTHRITIS?

The medical name of the disorder called calcification among the people is “osteoarthritis”. Although it is called as calcification among the people because the joint movements are difficult, there is actually no calcification in the joint. In healthy joints, the disease arises as a result of wear of the shiny and slippery cartilage structure covering the joint surface. Friction of worn joint surfaces increases and joint movements are limited. As wear increases by the time, deformities develop. Although, osteoarthritis can be seen in all joints, it is most common in the knee joint.

WHAT ARE THE REASONS FOR ARTHRITIS? WHO ARE UNDER THE RISK OF HAVING JOINT ARTHRIT?

The most common cause is aging. The joint, which has been used for years with age, got aged; so cartilage is being corroded.

Women are more prone to arthritis than men. In addition to the fact that; cartilage resistance is less in women, as a result of the hormonal effects of menopause, arthritis starts earlier in woman. Excessive weight, genetic factors, extremely heavy working conditions, over-compelling sporting activities are other reasons that cause premature corrosion of the joint. Apart from this, it may cause age-independent joint damage due to causes such as; joint traumas, previous joint surgeries, congenital joint diseases, rheumatic diseases, joint infections and various blood diseases.

WHAT ARE THE SYMPTOMS OF ARTHRITIS?

First of all, when the joint surfaces are rubbed against each other, sounds like crunching start to come out of the joints during movements. In the beginning of the problem, joint pain occurs while standing or walking for a long time, by the time pain gradually increases, even with less activities more pain begins to become. The walking distance is increasingly restricted.  Pains in the daytime also disturb in the night.  The painful rotations that occur during the year are prolonged, and even after a certain period of time, the pain becomes to continuous form. With increased friction, as a protection mechanism fluid is released into the joint cavity to reduce friction, which is seen by the patient as swelling of the joint. If the swelling increases too much, movement of the joint is restricted. In this case, there are no disadvantageousness on the removal of excess joint fluid. In the case of advanced arthritis, wear develops in the bones after the cartilage is worn, the shape of the joint is deformed, the legs are generally deformed inwards and sometimes outwards.

HOW TO BE DIAGNOSED?

Patients with advanced signs of calcification can only be diagnosed with X-rays. X-ray shows narrowing of the joint space, bone protrusions, deformity and misalignment of the joint. X-ray is normal in early stages of the disease where cartilage erosion is mild, the wear may be detected by MRI.

WHAT ARE THE TREATMENT OPTIONS?

No treatment in osteoarthrosis changes the natural course of the disease, because the event is actually the wear of the joint so the aging over the years. There is a period in which each treatment option will be beneficial and it will provide effect for a time. Therefore, patients should stay under the supervision of a physician and have to be examined at least every 6 months. Appropriate treatment should be chosen according to the patient, the extent and benefit of the treatment should be explained to the patient.

1. What can patients do to help to the treatment?
   1. diet and weight reduction
   2. Exercises and sporting activities which don’t force knee: such as walking, swimming and cycling.
   3. avoiding activities which the knee is bent such as crouching and uprising.
   4. applying cold when swelling in the knee and hot when there is only pain
   5. cane use in painful period

2. Drug treatments
   1. Painkillers
   2. glucosamine and chondroitin sulphate pills: intended to restore cartilage building blocks. They cannot bring back the completely lost cartilage, they can only provide pain relief and increase activity.
   3. Intraarticular injection treatments:
      1. Hyaluronic acid: reduce friction by increasing joint lubricity
      2. PRP: stimulates the healing of tissues in the joint, reduces edema.
      3. stem cell: provides healing of tissues in joints, which are not very deformed.

3. Physical therapy: does not cure the disease, it can provide relief from pain 

4. Surgical treatments
   1. Arthroscopic cleaning (closed surgeries): In the early period, cartilage fragments spilled into the joints and meniscus fragments stuck together can be removed and this removal can provide relief for several years.
   2. Bone correction surgeries: If there is deformity in the legs and half of the joint is affected, leg shape is corrected with bone incision and as the result; joint load distribution is equalized. It may provide relief to the patient for 5-10 years due to less burden will be placed on the deteriorated part.
   3. Joint prosthesis surgeries: Depending on the damage of the part of joint or all of the joint, partial (unicondilar) or total prothesis may be done. While the life of the partial prothesis are 8-10 years, the life of the total prothesis are 15-20 years.