Definition and classification of osteoarthrosis Osteoarthrosis is a disease that causes joint pain, enlargement, deformity, and impaired movement due to degeneration of joint cartilage, destruction of joint integrity, and formation of bony redundancies at the joint edges. Osteoarthrosis can be classified as primary (spontaneous) or secondary. In the former case, osteoarthrosis occurs with age and after wear and tear. In the latter case, there are various conditions that can serve as clear etiologies, such as trauma, metabolic diseases or gout. The name of osteoarthrosis is controversial because there is still disagreement about the nature and etiology of the disease. One school of thought believes that osteoarthrosis is a group of systemic inflammatory diseases with similar clinical and pathologic outcomes. Another school of thought supports the use of the name “osteoarthropathy” because the presence of inflammation is only one of its manifestations. The causes of osteoarthrosis, according to Ai Guo, are multifactorial, the most important of which is age. There is a not very scientific name for osteoarthrosis, called senile degenerative osteoarthrosis, which we used to explain to patients in a way that was intuitive and easy to understand. As the name implies, as we age, it causes wear and tear of joint cartilage, which induces osteoarthrosis. Surveys have found that the incidence increases with age, whether it is in the knee, hip or hand joints. For every 5 years of age, the incidence of osteoarthrosis in the knee joint increases by 20%, and the risk of osteoarthrosis in the hip joint over the age of 70 is 2.38 times higher than that of patients over the age of 50. Weight is also a factor in predisposing to osteoarthrosis. Patients who are heavier are more likely to develop osteoarthrosis because of obesity, which puts more weight on the joints and causes more wear and tear over the years, and weight causes a close relationship mainly with osteoarthrosis of the knee. There is also a relationship between the occurrence of osteoarthrosis and gender. The incidence of osteoarthrosis in women is higher than in men, mainly because of the secretion of estrogen, which can act directly on cartilage cells or protect cartilage by acting on bone or other tissues, but after menopause, women will stop the secretion of estrogen, so that the protective effect will stop, and the incidence will be higher than in men. The occurrence of osteoarthrosis is related to occupational activities. Patients who engage in heavy physical labor, often squatting or kneeling will increase the wear and tear between joints; textile workers, white-collar workers, and frequent computer users are prone to osteoarthrosis of the hand joints. Great trauma, damage to the meniscus also increases wear and tear. Of course there are other factors, like genetics, congenital deformities, metabolism, etc. Treatment of osteoarthrosis When talking about how osteoarthrosis is treated, Guo Ai says: It can be said that osteoarthrosis can be cured, or it cannot be cured. The reason why it is not curable is that, theoretically speaking, this disease can only be treated by drug intervention to relieve the symptoms and improve the function of the joints. Because the main cause of osteoarthrosis is aging and degeneration of the joints, the disease will develop as we age. Why do you think it can be cured again? Now there is a surgery called artificial joint replacement. The driving factor of osteoarthrosis is the wear and tear of the cartilage, and this surgery removes the cartilage and replaces it with an artificial prosthesis, so the basic life of the patient can be guaranteed after the successful implementation of this surgery. The overall treatment system for osteoarthritis is in the shape of a pyramid. The most advanced and patient-oriented treatment is the preventive treatment, where patients are educated about the causes of osteoarthritis and how to take care of themselves and treat the disease. The next level up is medication, and I think this level of the pyramid should include physical therapy. Physiotherapy includes body therapy, hot compresses, wax therapy, hot spring baths, etc. Through these treatments, we can achieve the purpose of relieving pain symptoms and slowing down the rate of disease development. The earliest and most commonly used painkillers are aspirin, acetaminophen, etc. These drugs have analgesic effects and are mainly used to improve the pain symptoms of patients. The next level up is the NSAIDs. There is a wide variety of NSAIDs, like Fotarim, Fenbid, Piroxicam, etc. These drugs have anti-inflammatory effects in addition to analgesia. They are indicated for patients with more pronounced inflammation. However, these drugs can have some side effects in clinical practice. Patients feel most uncomfortable stomach, because it is irritating to the gastrointestinal tract, and long-term use of cardiovascular effects. For patients with severe acute arthritis, intra-articular glucocorticoid injections can be considered. Theoretically, the number of injections should not exceed three times a year because it will accelerate cartilage damage and blood sugar fluctuations. A higher level is the symptom control drugs, the most used is glucosamine, which is a physiological substance necessary for the biological metabolism of chondrocytes. Chondrocytes use glucosamine to synthesize large mucopolysaccharides, and these proteoglycans form an important part of the cartilage matrix, maintaining the form and function of cartilage together with type II collagen fibers, which can play a role in relieving the course of the disease. Another type of medication is injectable medications, the most commonly used being sodium vitamate, which can lubricate the joint, reduce friction, and act as a cushion to protect the cartilage. All of these medications are called conservative treatments. At the top of the pyramid, surgery is performed. If conservative treatment is ineffective, minimally invasive arthroscopic surgery can be performed in the early and middle stages, and osteotomy can be performed for deformities.