Post-traumatic arthritis is characterized by a sharp deterioration in the condition of the body, problems with free movements in the damaged joint. The need for surgical correction of the articular apparatus depends on the time of treatment in medical institutions. The neglected forms of the disease provoke complete destruction of the joint and lead to operations on transplantation of an artificial apparatus.
General information about the disease
By post-traumatic arthritis is meant the development of an inflammatory reaction in joints that have undergone injuries.
An unpleasant complication can form in any of the articular apparatuses, regardless of their volume. Common localization of the pathological process is represented by a lesion:
- Fingers of the hands – the disease refers to the initial forms, in the future any bone structures of the hand can be involved in the process.
- Shoulder joint – the disease is more common in people who are professionally involved in sports or are engaged in work associated with the constant transfer of heavy objects.
- Elbow joint – pain syndrome with trauma in 10% of cases indicates the development of arthritis. The disease often develops after lesions of the radial bone.
- Knee articular apparatus – is formed under the influence of a fracture of the condyles of the thigh, tibia. These areas are often bruised.
- Ankle joint – pathology is formed due to a permanent dislocation or subluxation.
Continued disregard for the signs of a developing disease in some victims leads to serious complications. These include deforming arthritis, joint stiffness, septic lesion of the body.
The clinical manifestations of post-traumatic arthritis depend on the stage of the disease, represented by several successive stages:
Initial – the joint undergoes minor changes, patients complain of discomfort in the knee, ankle, rap >
The sources of development of post-traumatic arthritis include a violation of the integrity of the articulation structures: cartilage, bone tissue, capsule, ligamentous apparatus. The problem is directly related to bruises, fractures and dislocations. For the formation of the pathological process, it is necessary to reduce the protective functions of the body arising from problems with metabolism, certain systemic ailments.
Chronic infectious foci play a large role in the occurrence of post-traumatic arthritis. Pathogenic microflora in the body travels through the lymphatic and blood vessels. The main subgroup of the likelihood of developing the disease is elderly and elderly patients, children, people who are professionally involved in sports.
Inflammatory reaction is preceded by a violation of blood circulation, insufficient intake of useful substances, the penetration of infectious agents. Pathology can form against the background of hemorrhage in the joint cavity and lack of professional assistance. Post-traumatic arthritis is formed with constant repetitions of injuries, with single dislocations, fractures practically does not occur.
Confirmation of the disease is carried out by a variety of diagnostic procedures on the basis of the district clinic. The standard course includes:
- history taking – injury time, treatment options, clinical manifestations of complications;
- X-ray images – allow you to evaluate the deformation changes in the joint, to identify the narrowing of the joint spaces;
- arthroscopy – manipulation is used for diagnostic and therapeutic purposes, implies implementation in the joint;
- the study of joint fluid after puncture.
CT, MRI, ultrasound is recommended for insufficient information content of the above procedures. The techniques allow you to accurately determine the location of pathological foci, latent inflammation, hematoma, fluid accumulation.
Therapeutic measures imply an integrated approach to the problem, using medications, physiotherapeutic procedures, massage sessions, exercise therapy. In complex cases, patients are prescribed surgical correction.
Medicines and surgery
The key goal of therapy is to get rid of the ongoing inflammatory process in the articular apparatus. Conservative tactics in the treatment of post-traumatic arthritis include the use of several pharmacological subgroups of drugs:
- Antibacterial drugs – recommended for suppuration of the contents of the joint. Before the appointment, bacterial culture is carried out, with the help of which the type of pathogenic microflora and its resistance to antibiotics are determined. Injectable or tablet forms of drugs are used, the average duration of the course is 1-2 weeks. Therapy is carried out by minocycline, doxycycline, erythromycin.
- NSAIDs – help eliminate inflammation, swelling of tissues, reduce pain. Apply for 12-21 days: Nimesil, Kostral, Aponil, Mesulid, Aulin, Nimesan.
- Chondroprotectors – during therapy, activation of regenerative processes in cartilage tissues is necessary. The course differs in duration – from 1 to 3 months, treatment is carried out by Teraflex, Arthra, Dona, Kondronova.
- Vitamin therapy – multivitamin complexes help stabilize the immune system, make up for the deficiency of beneficial elements in the body. Specialists prescribe Osteomed, Vitrum Osteomag, Vitrum Calcium, Biocalcevit, Calcemin Advance.
The absence of positive dynamics, the preservation of the main symptoms leads to the need for surgery.
Common methods include puncture of the joint with subsequent pumping of the contents, washing with antiseptic solutions of the joint cavity, and the introduction of antibacterial drugs. Arthroscopy allows you to get rid of blood clots, articular mice in the articular apparatus. The procedure relates to minimally invasive techniques, does not require open intervention, is carried out by endoscopic equipment.
After stopping the inflammatory reactions, physiotherapeutic procedures are introduced into the therapy. With their help, impaired motor function is restored, complications are prevented. Common methods include magnetotherapy, electrophoresis, applications with paraffin, laser therapy. Treatment is carried out 10 consecutive days, if necessary, can be repeated several times a year.
Massage sessions allow you to restore blood circulation in damaged areas, improve the flow of nutrients and oxygen to the tissues. Manipulations are prescribed by the attending physician, take place once every 48 hours at the base of the clinic, hospital.
LFK – physical therapy classes begin under the constant supervision of an instructor. Over time, training becomes more complicated, increasing in time and number of approaches. With the help of regular training, an increase in the elasticity of the muscle, ligament-tendon apparatus is achieved, blood circulation and metabolic processes throughout the body are normalized.
Preventing the formation of post-traumatic arthritis implies the use of specialist recommendations in everyday life. Doctors note that prevention is necessary for people in the high-risk subgroup for complications after injuries.
To prevent the consequences, it is necessary to treat existing diseases of the endocrine, musculoskeletal system in a timely manner, and to deal with metabolic disturbances. Without exception, all patients with a history of a variety of bruises, dislocations, and fractures should periodically attend exercise therapy classes or conduct training at home.
Adequate motor, physical activity, normative mode of work and rest will help the immune system to function normally. Stably working protective mechanisms prevent the penetration of pathogenic microflora, its activity and further spread. Excess weight, excessive enthusiasm for alcohol, tobacco products, refusal to complete treatment and rehabilitation are direct suggestive factors for the formation of the disease. The exclusion of these conditions will help reduce the risk of developing the disease.
Post-traumatic arthritis occurs in cases of exclusion and is associated with chronic joint injuries. If primary symptoms occur, patients should immediately seek professional help and undergo the prescribed course of therapy. The duration of the disease, the development of its consequences depends on the speed of treatment.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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