Dr. David López Capapé, specialist in Orthopedic Surgery and Sports Traumatology, defines osteoarthritis as a degenerative disease of the joints that affects the articular cartilage, a specialized tissue that favors the sliding and movement of the joints. The doctor states that it is a very common disease that develops in different joints, the most common being the hip, spine, knee and hands, although it can affect any other joint.
How is osteoarthritis diagnosed?
There is a popular belief that osteoarthritis appears in older people, but the cause of osteoarthritis is not age. What happens is that once the “wear and tear” begins in a joint there is a progression over time, which will depend on different factors. Clinically, this pathology is characterized by pain, inflammation and deformity of the joints.
Osteoarthritis can occur after an accident or trauma, so there are cases in which young people develop it. Meniscus, ligament and osteochondral injuries can be the origin of degenerative joint disease, whether they are intervened or not. Rheumatic diseases (arthritis) also favor the development of osteoarthritis. With the help of imaging tests (X-ray, ultrasound and MRI), it is now possible to make an early diagnosis in the initial stages and to start treatment to slow down the progression of the disease.
What treatments are used for osteoarthritis?
The earlier the treatments are started the better, and the treatment is chronic as is the disease. Among the measures to be included are
- Manual physiotherapeutic rehabilitation and rehabilitation with new technologies.
- Diet, weight control (especially in load-bearing joints such as the knee).
- Therapeutic and moderate exercise, adapted to the localization.
- Acupuncture
- Pharmacological treatments, chondroprotectors, phytotherapy
- Infiltrations of hyaluronic acid (viscosupplementation)
- Infiltrations with periarticular collagen, mesotherapy
- Infiltrations of growth factors (PRP), conditioned plasma (Orthokine, Goldic) or mesenchymal cells (fat, bone marrow or auricular cartilage).
- Prosthetic replacement surgery in the event that the joint is in very poor condition and all of the above measures fail to control pain. The hip and knee joints are the two most commonly implanted joints.
From the moment it is diagnosed it is important to carry out a multidisciplinary approach, including the above measures directed by an expert.
Is it recommended to practice sport once diagnosed with osteoarthritis?
The most conservative treatments of the disease take up the idea that it is necessary to prohibit the sport practice when we speak of osteoarthritis, nevertheless, it is important to adapt the sport and not to prohibit it.
Exercise is good but it is necessary to know how to modify it according to the location and the patient. Maintaining mobility and strength are the two objectives of exercise. There are also the psychological benefits of exercise, it is up to the patient to establish his or her preferences once informed. Osteoarthritis cannot currently be cured with any treatment, but it can be controlled or slowed down in its evolution, in addition to improving the symptoms. It is the patient, correctly informed by his physician, who must evaluate the cost-effectiveness of the different treatments.
In cases where osteoarthritis occurs in a load-bearing joint, sports that generate a high impact on the area, such as soccer or basketball, are not recommended (however, the swimming pool, cycling and the gym are very suitable). If the osteoarthritis is in the shoulder, it may be necessary to vary the exercises with weights, etc… In any case, it should always be kept in mind that it is better to keep the movement regulated than to do nothing, so the specialist in traumatology must find a way for the patient to continue practicing the sport he/she likes without damaging the joint.
What advice can be given to a person with osteoarthritis?
- The first thing is to understand that it is common and inevitable to develop osteoarthritis in some location and not to think that it is always a serious or disabling process.
- Maintain the practice of exercise as far as possible.
- Continue routine activities adapting them to the type of osteoarthritis.
- Eat a balanced diet and maintain an adequate weight.
- To go to a multidisciplinary team that at least includes doctors and physiotherapists, although other contributions may be useful.
- Understand that it is a process that will accompany us for the rest of our lives and that we can, with all the current means, control it, but that this control will be better the sooner and in a more complete way we approach it.