Osteoarthritis, also known as joint wear and tear , is a chronic disease characterized by degeneration of the cartilage and bone structure in the joints. "Arthron" is the Greek word for joint and the suffix "-osis" is usually used in medicine to describe chronic non-inflammatory diseases. With around five million people affected in Germany, osteoarthritis is the most common chronic disease of the musculoskeletal system.
It can affect individual joints, typically the knee or hip joint, as these are exposedto particular stress. However, joint arthrosis can also develop after accidents and bone fractures that involve the joint area. It would be correct to speak of monoarthrosis (mono = single) in the case of osteoarthritis of one joint and oligoarthrosis (oligo = few) in the case of 2 to 4 affected joints. However, this is rarely used so precisely in everyday clinical practice.
In medical terminology, the term polyarthrosis (ICD code M15) refers to osteoarthritis that occurs simultaneously in 5 or more joints.

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In humans, the joint surfaces are covered with a layer of cartilage . Although this is only a few millimetres thick, it plays a crucial role in the function of the joint. This network of cartilage cells and collagen fibers reduces friction between the joint surfaces and also acts as a natural shock absorber. Cartilage is also known as bradytrophic (poorly nourished) tissue, as it contains very few blood vessels. With increasing pressure on the cartilage, its nutrition deteriorates further, leading to osteoarthritis.
Osteoarthritis leads to a progressive breakdown of cartilage tissue, usually over years and decades, which is also referred to as "cartilage wear and tear".
In principle, osteoarthritis can affect any of the 100 or so joints in the human body. However, joints that are exposed to heavy loads on a daily basis are particularly susceptible.
The most important forms of osteoarthritis therefore include
The increasing wear and tear of the joint cartilage can have various causes. In principle, however, cartilage damage is preceded by a load that exceeds the joint's own load-bearing capacity. Due to the lack of blood supply, the cartilage is unable to repair and regenerate itself. Excess weight or an unusually high joint load, for example due to joint-straining work or competitive sport, can damage the cartilage, as can incorrect loading due to joint misalignment. For example, people with bow legs or knock-knees have a higher risk of osteoarthritis.
Metabolic diseases such as gout also promote cartilage damage. Injuries with cartilage damage or bone fractures that heal in an incorrect position are also risk factors for polyarthrosis.
Finally, rheumatism can also lead to polyarthrosis, often affecting the joints of the hand. Typically, patients with so-called rheumatoid arthrosis (= arthrosis caused by rheumatism) show increasing misalignment of the finger joints, so that the fingers often deviate outwards. This can lead to an increasing restriction of mobility and even loss of independence for the patient. However, as rheumatism frequently causes inflammatory attacks, it is often referred to as arthritis.
In some cases, no specific cause for the cartilage damage can be found. This is known as primary osteoarthritis. All other forms in which causes are known or can be found are referred to as secondary forms of osteoarthritis.

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In the early stages, joint wear and tear often causes no or only a few symptoms. Later on, patients complain of pain when they move the affected joints. Pain at rest is also possible, especially early in the morning after getting up. If the symptoms have improved after 1-2 hours, osteoarthritis is highly suspected. The arthritic joints feel stiff and their mobility is restricted. Noticeable resistance during joint movement and clearly audible cracking noises may also occur, depending on the stage of the disease. The further the osteoarthritis progresses, the more likely it is that abnormal joint positions will occur.
In contrast to arthritis, osteoarthritis is not primarily inflammatory. However, the arthritic joints can also become inflamed if they are acutely overloaded. A sudden swelling of the joints as well as overheating and reddening of the joints can indicate such an inflammation. This is referred to as "activated osteoarthritis", which is often observed in the hip joint. However, activated osteoarthritis can also occur in all other joints, for example in the knee joint, during inflammatory episodes and acute overload reactions.
As the damaged cartilage cannot be restored, the treatment of osteoarthritis serves solely to alleviate the symptoms. In addition, the therapeutic measures should stop or at least slow down the progressive wear and tear of the joint. In principle, osteoarthritis treatment can be divided into conservative and surgical treatment methods. Which therapy is suitable for treatment depends on the extent and exact localization of the polyarthritis.
What does conservative therapy involve?
- The most important component of conservative therapy is exercise. Swimming and cycling help to improve joint mobility and strengthen the muscles that support the joints. Less suitable are sports with abrupt movements or high loads such as soccer, boxing or tennis
- Crutches or orthoses can be prescribed to relieve pressure on the joints
- If you are overweight, you should reduce your weight to protect your joints
- In addition, physical treatment methods can alleviate the symptoms of polyarthritis. These include mud and mud packs as well as medicinal baths or irradiation with infrared light
- Special physiotherapy exercises and massages are also suitable for the conservative treatment of osteoarthritis
- If the pain is too severe, painkillers with active ingredients such as paracetamol or ibuprofen as well as pain-relieving ointments can also be prescribed and used. In addition, the pain-relieving application of a local anesthetic, which is injected into or near the painful joint, is also possible in principle. Hyaluronic acid injections are also sometimes used for conservative osteoarthritis treatment. Hyaluron is an endogenous substance and component of synovial fluid and is intended to improve the mobility of the joint. However, its effectiveness has not yet been clearly proven. Cortisone injections are also used, but sometimes have undesirable side effects.
Important: All procedures in which something is injected into the joint from the outside should be critically scrutinized and indicated, as there is always a risk of germs being introduced into the joint cavity.
What does surgical treatment look like?
Surgery to correct misalignments can be useful to relieve pain and prevent inflammation. Drilling into the cartilage surface as part of an arthroscopy (joint endoscopy) can stimulate the production of new cartilage tissue. If the pain cannot be alleviated by any therapeutic measure, the doctor can replace the affected joint with an artificial joint (endoprosthesis). This type of joint replacement is mainly carried out in cases of knee or hip joint arthrosis.
Osteoarthritis is therefore a progressive joint disease that is accompanied by pain during movement or at rest. Conservative or surgical treatment methods can alleviate the symptoms of the disease, but a cure is not possible.