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The osteoarthritis is a chronic disease characterized by wear and tear of the cartilage articulate. Articular cartilage is the shiny surface that lines bones where they join together (joint) to facilitate friction-free gliding. When this cartilage surface wears away, the bones rub once morest each other with movement, causing symptoms such as popping, swelling, pain, and stiffness.
Generally, it occurs in people over 55 years, although it can appear at an earlier age. Risk factors are previous trauma, being overweight or obese, and advanced age. With the aging of the general population and the increase in obesity, it is estimated that the incidence of osteoarthritis in the Spanish population will increase in the coming decades.
This is how the
Dr. Joaquín Moya-Angeler, specialist in Sports Traumatology and, more specifically, in knee and hip injuries. Dr. Moya-Angeler has a degree in Medicine from the University of Navarra. After five years of residency, he completed a three-year subspecialty in the United States, including a one-year stay at the Hospital for Special Surgery in New York, the best in the United States in Orthopedic Surgery for ten consecutive years.
Currently, he is a member of national and international scientific societies and, in the last year, he has promoted the development of a clinical trial at the Virgen de la Arrixaca Hospital to identify and prevent a knee deformity in neonates.
Diagnosis and treatment of osteoarthritis
The diagnosis is simple and is carried out in the consultation supported by some imaging test; usually X-rays, although sometimes an MRI is required to rule out other associated injuries.
The treatment It can be divided into three therapeutic steps that go from the least aggressive to the most aggressive.
The first step includes measures such as relative rest, limb elevation, weight loss, application of local cold, taking oral anti-inflammatories, using an anti-inflammatory ointment occasionally, using a cane and treatment with physiotherapy. Regular low-impact exercise such as strengthening exercises, walking on regular ground, and Tai Chi are also recommended.
In the second step is the treatment with
infiltrations, which consists of injecting a substance into a joint using an ultrasound machine, which makes it possible to guarantee and see that the medication is injected in the correct place. They can be divided into three categories. In the first place, infiltrations for pain control: in cases of intense acute pain not controlled with the measures of the first step, the most advisable thing is to perform an infiltration with a corticosteroid diluted in anesthetic. Second, infiltrations to improve joint lubrication: in cases of stiffness associated with mild or moderate pain, infiltrations with hyaluronic acid, a joint lubricant, can be beneficial. Finally, infiltrations with regenerative substances: stem cells or PRP. The regenerative medicine It consists of processing the patient’s blood to obtain plasma proteins whose function is to regenerate damaged tissue.
These infiltrations can sometimes be combined depending on the objective sought and are carried out in the consultation in a time of no more than thirty minutes.
Third, when previous treatments have failed, surgical treatment should be started. In these cases, the most effective treatment consists of a replacement of the worn joint by a
total knee replacement o de hips. Currently, this surgery is performed with the help of surgical navigators to ensure successful prosthesis placement. Long-term results are favorable with a 20-year implant survival of 90% and an improvement in function and pain in a high percentage of patients only 4-6 weeks following the operation.
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