Orthopedics Traumatology Treatment in Turkey

Orthopedics Traumatology Treatment in Turkey

Definition of Osteoarthritis

Osteoarthritis “a degenerative joint disease” is known as calcification. This is the most common joint disease in people over 50 years of age, and osteoarthritis can affect any joint in the body.

The most commonly affected joints are the hands, hips, knees and spine where calcification causes deterioration of the structure of the articular cartilage and as a result causes changes in the tissue of the bones below the articular cartilage. Tumors of the bones and protrusions at the edge of the joint disrupt the normal structure of the joints, resulting in restricted movement and pain.

Calculation is a (harmful) degenerative joint disease that mainly affects articular cartilage, as well as ligaments and essential bones. Over time, degradation of these structures leads to pain and reduced movements of the joints.

While previously thought to be a natural consequence of aging, it has recently been thought to occur with the interaction of many factors such as joint structure, genetics, mechanical forces and other ligament damage within the knee.

Recurrence of Osteoarthritis and Risk Factors

Degenerative arthritis is the most common joint disease and is one of the ten most often disabling diseases in developing countries, associated with aging and beginning after age 40. Calcification of the joints, especially of the knees and hands, is more common and severe, especially in women.
Women are at a higher risk of infection, especially after menopause. Studies have shown that hormones have a positive effect on cartilage tissue. Mostly painful joints are often sensitive to weather conditions.

Low temperature and lower atmospheric pressure can increase the severity of patients’ pain as it lowers a person’s pain threshold, which in turn explains how people predict rain and why joint pain is associated with moisture.

People at Risk of Osteoarthritis:

  • Those over the age of sixty
  • Those who are overweight
  • People who have recovered from joint diseases
  • People who have suffered joint injuries
  • Those who have undergone joint surgery
  • Those with congenital joint diseases

The risk of osteoporosis (calcification of the joints) is higher in those who work on their joints excessively and for a long time.

Reasons for Osteoarthritis

It is not known exactly why some joints are affected, however there are some factors that increase the risk of osteoporosis, and it is including:

  • Age
  • Genetic factors
  • Wear and Tear (Mechanical factors)
  • Other diseases affecting bones and joints

Age : Calcification is a disease that can affect those of middle or advanced age, and according to studies, it is a rare disease before the age of forty. With age, changes occur in the meniscus, and therefore its durability decreases. Therefore, the incidence of calcification increases with age. Women are more likely to develop calcification than men but the cause is not yet known.

Genetic factors:  The components of cartilage are identified as genetic. For this reason, it is now known that genetic factors play a role, especially in hand calcification.

Wear and Tear ( Mechanical factors): Repeated minor traumas that

occur over the years degrade joint endurance and cause cartilage destruction,

leading to calcification, especially in overweight people, so the development of calcification in joints such as the knee depends on it.

Other diseases affecting bones and joints: Diseases such as gout, rheumatoid arthritis, neuropathy, diabetes, Paget’s disease, septic arthritis, and congenital hip dislocation all of the above increase the risk of calcification.

Symptoms of Osteoarthritis

Symptoms of calcification usually develop slowly and can become severe at any time and symptoms may include:

  • Pain
  • Sclerosis
  • Restriction of joint movements

Pain : The most common complaint in people with osteoarthritis is pain, initially pain occurring during movement or later in the day and resolves by getting some rest but with advanced articular cartilage abnormalities and erosion, pain may also occur at rest.

Sclerosis: Occidents in the morning or after a long period of inactivity but does not last for long, rarely lasting more than 15 minutes

Restriction of joint movements: It can be seen in the advanced stages of the disease and can reach levels of disruption of daily life functions. The joint may appear swollen due to bony protrusions, however true swelling and high temperature rarely appear and despite their extreme rarity, deformities can be seen.

Osteoarthritis is a progressive disease. Although complaints decrease or pass from time to time, problems may continue to increase over the years.

How to diagnose Osteoarthritis?

Patients with pain, stiffness and swelling in the joints should consult a doctor.

Your doctor may order some tests to determine the exact cause of your complaint, including the following:

  • Direct radiography (X-ray film): X-rays of the joints help diagnose osteoporosis. However, the presence of calcification results in X-ray films does not mean that there will be complaints in this joint, nor does it indicate the seriousness of the complaints.
  • Blood Tests: There is no blood test to diagnose calcification, but some help to distinguish calcification from other rheumatic diseases.
  • Synovial fluid test: Joint fluid examination may be necessary and

useful in distinguishing calcification from other diseases, especially in patients with swollen joints

How to treat Osteoarthritis

Treatment is planned according to the stage and severity of the disease and the purpose of calcification treatment is:

  • Patient pain relief
  • Remove restrictions on movement and difficulties in daily life
  • Prevent disease progression

First Step: The first step in treatment is to educate the patient, as the patient must be made aware of the disease and heavy exercises and excessive use of the affected joint should be avoided. With weight loss, complaints related to calcification in overweight joints decrease. During periods of pain, the patient is recommended to rest with:

  • Regular exercise
  • Physiotherapy Treatment
  • Drug therapy
  • Intra-articular injections

Regular exercise: The muscles surrounding the joint are strengthened. Therefore, the load on the joint is reduced. However, your doctor should arrange the exercise program to be performed.

Physiotherapy Treatment:  Depending on your doctor’s recommendation, hot or cold treatments, pain relief treatments and deep heating treatments may be applied to the affected joint.

Drug therapy: Callixics and anti-inflammatory drugs are used under the supervision of a physician at certain periods of illness. The use of cartilage strengthening medications has also increased in recent years.

Intra-articular injections: If recommended by your specialist, injections of corticosteroids in the joint may be performed during periods of joint swelling. Additionally, medications that increase joint lubrication may be injected, and surgical treatment is recommended for patients who have not benefited from the treatments we have listed so far and whose illness is severely impaired by their daily living activities.

Symptoms of Degenerative Arthritis

Some of the most common symptoms associated with degenerative arthritis are:

  • Pain and stiffness in one or both joints
  • Cracking sound from the joint during movement
  • Joint enlargement and deformity
  • Swelling in some cases

Although calcification can occur in any joint, it is known that some joints most affected by the disease are the neck, waist, hips, fingers, knees, and toes, which are the most affected.

Diagnosis of Degenerative Arthritis

Calcification is diagnosed based on clinical and radiation results, as the history of the person with symptoms suggestive of calcification is taken by the specialist doctor, and a skeletal muscle examination is performed, and a radiological examination of the formed joint is performed and the necessary laboratory tests are performed, and it is verified whether the joint problem is caused by calcification or another cause.

If a definitive diagnosis cannot be made with these tests, or if another concomitant problem is suspected in addition to calcification in your joint, further tests may be needed. For example, MRI or nuclear medicine tests may be applied.

Treatment of Osteoarthritis

The goal of treatment for calcification is to reduce symptoms, prevent the development of disability, and increase quality of life Organic farming treatment should be tailored to an individual’s needs and lifestyle. Treatment begins with changes in daily life to protect joints. Exercise is important.

Weight loss will help in treatment as it will reduce the load on the joints as hot or cold applications, oral or topical medications, and alternative medicine and rehabilitation methods can be used to reduce pain.

Health spa treatment may be an option for pain relief but if these treatments fail, injections or surgical techniques for joints will help relieve pain and maintain daily life.

To protect your joints:

  • Try to stand up straight as the straight position protects the neck, waist, hip and knee joints.
  • Adjust seat heights so you don’t have to lean forward.
  • The low chair causes a heavy load on the knees and hips when sitting and waking up.
  • High chairs with armrests are preferred.
  • Lift weights off the ground and keep them close to you.
  • Bend your knees while picking up anything from the ground.

Treatment of degenerative arthritis with drugs

Although there is no pharmacological treatment to prevent arthritis or calcification, methods are being tried to slow joint damage or develop side effects. Medications used in the treatment of arthritis are given to support non-pharmacological treatment. A key component of the treatment of arthritis is pharmacotherapy because pharmacological treatment is more effective for pain relief when combined with non-pharmacological treatment.

  • Systemic drug therapies

Analgesics are the first choice of medication, including simple analgesics such as paracetamol and aspirin, which are highly effective in the beginning. Rheumatoid drugs (non-steroidal anti-inflammatory drugs) are also a good choice and control a patient’s pain in several stages. However, the side effects of these drugs on the stomach may cause problems with their use in the long term.

  • Intra-articular drug treatments

Fluid injected into a joint This method is injected into a joint, allowing bones to slide smoothly over another and absorb shock while transferring load to the joint. It is claimed that they increase cartilage formation in the joint. But there is no conclusive evidence of this yet.

  • Short-term effects

Hyaluronic acid does not have a quick pain relief effect but the results of a local reaction such as pain, increased temperature and slight swelling can be seen after the injection. These results usually do not last long and respond well when applying ice to them.

Knee overload, such as standing for long periods of time, running and lifting heavy objects, should be avoided during the first 48 hours after the injection.

  • Long term effects

After a period of injection, there is a decrease in knee pain, since hyaluronic acid acts as an edema analgesic and painkiller, and also stimulates the body’s production and the effect can take an average of 6-9 months.

This method may not work for everyone plus it is very expensive. If the conventional treatment used is successful, this method should not be used, but injection therapy should be used when other methods do not work and delay the necessary surgery. This thing should be discussed with your doctor.

  • Intra-articular cortisone injections

In cases where there is swelling in the knee, intrajoint cortisone application two or three times can control the swelling and pain. Cortisone, applied up to two or three times in advanced calcifications, can temporarily control patients’ pain.

The application of cortisone accelerates the progress of calcification in light to medium calcifications. Again, more than 3 applications of cortisone caused localized loss of knee bones.

Overcoming Osteoarthritis pain

Pain is the main reason patients seek medical help. Overuse of NSAIDs may be misunderstood today. Appropriate doses of the analgesics administered are usually sufficient for most patients.

Symptoms of osteoporosis often appear as seizures, and if NSAIDs are to be used, the need for these medications should be regularly reassessed, especially in at-risk elderly patients. There is no convincing evidence to date that these drugs affect the development of osteoporosis in humans, but they are thought to accelerate progress (especially for endomethacin).

Topical NSAIDs have similar efficacy to oral compounds used for calcification patients but should be used more frequently, especially in people with fewer symptoms and easily accessible in infected joints due to less side effects.

However, significant doubts remain as to whether they have little superiority over Rubefacials (drugs that make the skin red and not bulging when applied). Capsicin can locally reduce pain in patients with osteoporosis and has very few side effects. Many other treatments for symptoms (some of which are alleged to have effects that preserve cartilage) are being investigated  Although there is great interest in the drug treatment of calcification, the actual place of these drugs in the treatment has not yet been revealed.

Medications modified for Osteoarthritis

There are conflicting methods of injecting corticosteroids into the joint for calcification, which is not complicated, and is not generally recommended. They do, however, have a place in patients with acute crystalline articular membrane inflammation, who are unsuitable or waiting for surgery.

Today, hyaluronic acid compounds are available and have similar roles to steroids within the joint, but have a longer duration of action. Similarly, the location of radioisotopic articular membrane ablation is unclear, while eitrium-90 injection is useful in some patients with calcification with persistent articular membrane inflammation of large joints.

Surgical treatment of degenerative arthritis:

The recent success of prosthetic joint replacement has led to significant progress in treating hip and knee arthritis. Although problems with money supply, waiting times, and the selection and review of prosthetics must be encountered, there is no doubt that such surgeries can change patients’ lives.

Other surgical methods (laparoscopic washing, bone cutting and joint proofing) may also be useful. Criteria for the procedure are uncertain and may include uncontrolled pain (especially nocturnal pain), severe dysfunction, and age.

Patients who do not respond to medical treatment who suffer from acute arthritis and whose daily lives are severely restricted by orthopedic physicians for surgical intervention must be assessed.

Degenerative Arthritis Laparoscopic

Laparoscopic, an interference method, is transferred to the screen by placing a camera through a small hole in the joint. Next, the operator performs the operation by watching on the screen with various surgical instruments inserted into the joint through a small hole.

In calcification operations, laparoscopic surgery is performed to clean and correct damaged cartilage and rupture of the meniscus in the knee.

This method is frequently used and relies on correcting the irregularity of the semicircular cartilage by shaving. There’s no new cartilage formation here. Treatment aims to reduce friction, corrosion, and pain only by smoothing surfaces. Although it is an easy technique, it is a very pleasant process.

Effect of psychological factors on Osteoarthritis

One of the most important contributing factors to the calcification treatment approach was the demonstration that the patient’s psychological state (anxiety, depression, social support) was an important determinant of symptomatic and functional diagnosis.

Providing social support, even if it’s a single phone call with a normal person, can relieve symptoms.

Perhaps the single most important help any therapist can provide is to emphasize that arthritis is not necessarily a progressive disease, and there is something that can be done and the patients should not be left alone.

Replacement of knee and hip joint for osteoarthritis patients

If there is no response to the alternative therapies listed above and knee or hip problems impair your standard of living, we can assure that the replacement of an artificial joint is necessary.

Artificial joints is the name given to the surgically placed material that takes over the function of an joint. The life of the artificial joint today extends from 20-25 years , the concept of standard of living is becoming more important rather than the age of the building.  However, other treatments should be tried to the fullest in people under the age of 55.


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