Incongruence osteoarthritis
| Classification according to ICD-10 | |
|---|---|
| M15-19 | Osteoarthritis (further coding depending on the affected joint) |
| ICD-10 online (WHO version 2019) | |
Incongruence osteoarthritis is a type of osteoarthritis that typically occurs after an accident . Structural changes to the bones involved in the respective joint or changes in the soft tissue situation (e.g. muscles) reduce the stress zone of the joint to such an extent that the pressures occurring under physiological conditions are sufficient to permanently damage the articular cartilage , resulting in osteoarthritis arises (overload damage). In principle, other causes such as osteochondrosis dissecans are also possible.
Arthrosis due to instability of a joint (for example after ligament injury) are not referred to as incongruence arthrosis.
causes
Bony injury
The classic cause of incongruence osteoarthritis of the upper ankle is an even slightly displaced outer ankle fracture (displacements of 1-2 mm are sufficient to reduce the functional joint surface by up to 60%).
Muscle tear
After a rotator cuff rupture (reduced thickness of the muscle cuff ) , the humerus head is higher on the shoulder than before the injury. Depending on the source, one speaks of a humerus high or acromion low. As a result of this change, the position of the actual shoulder joint (glenohumeral joint) also changes, the humerus head slides slightly headward out of its socket . In this case too, there is overload damage to the cartilage and thus osteoarthritis.
Others
The Spondylarthrosis deformans is the cause of a Inkongruenzarthrose the small vertebral joints returned.
In osteochondrosis dissecans , defects can also exist in the stress zones of the articular cartilage, which on the one hand reduces the area of healthy cartilage that is present and on the other hand increases abrasion (punctual pressure but also shear forces), especially in its edge areas.
therapy
The therapy depends on the causes. At best, for example, after a bone fracture, an ideal reconstruction of the bone structure can prevent the occurrence of incongruence osteoarthritis or at least delay it for a long time ( prevention ).
(For treatment of existing incongruence osteoarthritis, see main article osteoarthritis .)
Individual evidence
- ↑ HG Nobody: Internship at the Dog Clinic , Georg Thieme Verlag, 2006, ISBN 3-8304-4141-X , p. 960, (online)
- ↑ a b C.-J. Wirth: Orthopedics and orthopedic surgery. Foot. (= Orthopedics and Orthopedic Surgery. Volume 2). Georg Thieme Verlag, 2002, ISBN 3-13-126241-9 , p. 612, (online)
- ↑ C. Hauser-Bischof: Shoulder rehabilitation in orthopedics and traumatology. Georg Thieme Verlag, 2003, ISBN 3-13-128761-6 , p. 182, (online)
- ↑ M. Buchta: The hammer exam with student consultant access: revision course for the 2nd section of the medical examination. Urban & Fischer-Verlag, 2008, ISBN 978-3-437-43801-1 , p. 788, (online)