Knee osteoarthritis is so common that it has a separate name: gonarthrosis. Another name for this disease is deforming arthrosis.
Osteoarthritis of the knee joint worries 20% of the population, its ICD-10 code is M17. Half of knee pathologies are due to osteoarthritis. This is a disease in which the cartilage tissue and joint surface degenerate - disintegrate. The joint is poorly supplied with nutrients and oxygen, its function deteriorates and inflammation occurs. It becomes inactive and hurts, the patient's quality of life decreases. Complications of osteoarthritis lead to wheelchair use.
Let's find out what osteoarthritis of the knee joint is and how to treat it. How the disease can be prevented and how dangerous it is.
Causes and classification
The causes of arthrosis of the knee joint are different: mechanical damage, hereditary predisposition, metabolic disorders.
The onset of the disease is associated with excessive stress on the knees. This is a workplace injury in many sports. People with a high degree of obesity, over the age of 60, almost always have arthrosis of one degree or another due to constant microtraumas. Osteoarthritis refers to occupational diseases in areas where a person has to stand or lift heavy objects for a long time. The disease can begin after rheumatoid arthritis.
The most common cause of knee osteoarthritis is injury. The second most common is dysplasia in childhood. Inflammation due to autoimmune diseases is the third source of osteoarthritis. There are usually several reasons, one complementary to the other.
The types of arthrosis of the knee joint are divided according to the causes into primary and secondary. If the etiology is unknown, primary osteoarthritis is diagnosed; if the cause is determined, secondary arthrosis is diagnosed.
Development mechanism
Cartilage is nourished thanks to constant changes in osmotic pressure. When the joint is loaded, the viscosity of the intraarticular fluid decreases and its quantity increases. In a calm state, intraarticular fluid becomes viscous and the amount decreases. Normally these processes alternate. The cartilaginous plate, acting like a pump, pushes fluid out of the joint when loaded and sucks it in when relaxed. In this way the joint tissues are nourished. The pathological process manifests itself if the joint is subjected to destructive influences:
- If the load is large and the joint does not have time to recover, nutrition is stopped. The cartilage becomes thin, cracks and ulcers appear on it;
- The structure of collagen fibers is disrupted, they absorb worse. The cartilage and the kneecap soften, become inelastic and perform their functions worse;
- Bony growths appear in the joint. The membrane of the joint capsule becomes irritated and inflamed;
- As a person begins to care for their knee and moves little, less intra-articular fluid is produced. The surface of the cartilage becomes dry and rough;
- The knee receives even less nourishment, atrophies and its destruction accelerates.
Signs of arthrosis of the knee joint appear: it becomes inactive and pain occurs. The pain is particularly intense in the morning and after prolonged immobility.
Stages of osteoarthritis
There are three degrees of osteoarthritis:
- Initial state. The fabrics have not yet been destroyed. So far, only the function of the synovial membrane is deteriorating. The composition of the intraarticular fluid has changed. The knee can no longer support normal load;
- The articular cartilage and menisci begin to deteriorate. Osteophytes (bone formations) grow in bones. Inflammation and pain appear;
- Difficult phase. The bearing platform of the knee joint is deformed, the axis of the leg changes. The ligaments shorten, the joint capsule becomes stiff. The joint is pathologically mobile, but it is impossible to bend or straighten it completely. Inflammation and pain are pronounced.
A note!
At the beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is severely limited. Due to the change in the axis of movement, the muscle insertion sites change. The muscles are deformed: they contract or stretch, they can no longer contract normally. The nutrition of all leg tissues is affected.
Symptoms
Symptoms of arthrosis of the knee joint at the beginning of the disease do not manifest themselves in any way and do not force the patient to consult a doctor. The patient notices tiredness and pain, but does not attach serious importance to them.
The classic sign of knee osteoarthritis is immobility and stiffness of the joint, a pulling sensation in the popliteal region, pain after exercise. It is difficult to move in the morning or after a long period of immobility. Relief comes after the patient stretches the knee, massages it and walks.
After some time, the intensity and duration of the pain increases. A creak appears in the joint, it completely stops bending and bending. A person begins to limp when he walks: most patients come to the doctor with this complaint. Treatment of arthrosis of the knee joint usually begins only in the second stage.
If nothing is done, movement becomes possible only with external help. When the patient lies down, the knee hurts less, but the pain often bothers at night.
In the second and third stages, the knee joint is deformed: the contours of the bones are sharply outlined, the lower part of the leg is curved. If you put your hand on your knee, you hear a crunch when you bend and straighten. When the kneecap moves, it also creaks. Fluid accumulates in the cavity, the joint swells, and the tissues swell.
As the disease progresses, all symptoms become more pronounced.
Diagnostics
The diagnosis of arthrosis of the knee joint is carried out comprehensively: an anamnesis is collected, laboratory and instrumental methods are prescribed.
Inspection
The doctor examines the damaged joint, measures the bones and the angle of flexion, and determines the degree of mobility of the joints at an angle.
Analyses
The patient is sent for a general blood test, a biochemical blood test and a general urinalysis.
X-ray
An x-ray of the knee joint is the main source of information for making a diagnosis. In the photo, arthrosis of the knee joint is visible: the joint space is narrowed, the cartilage is sclerotic, the bones are damaged; there is joint deformation, salt deposition and dystrophic changes. Osteophytes are clearly visible in the image.
Good to know!
For arthrosis of traumatic origin, radiographs have great diagnostic value and must be performed.
Ultrasound
Ultrasound diagnostics is an informative method. Ultrasound does not replace X-rays and does not provide a picture of the nature of the destructive process in the joint.
magnetic resonance imaging
MRI provides a complete picture of the disease. This is a modern and accurate research method that allows you to make a diagnosis at an early stage. The disadvantage of MRI is its high cost.
Treatment
Treatment of the knee joint for arthrosis is carried out on an outpatient basis, hospitalization is not required.
Treatment regimen:
- Reduce the load as much as possible;
- Respect the prescribed traffic mode;
- Perform therapeutic exercises.
The goal of treatment is to slow the destruction process, prevent contractures (the inability to fully bend and straighten the leg), and restore the function of the joint, if possible. During the rehabilitation period, staying in sanatoriums and resorts shows good results.
Drugs
Only the doctor decides how to treat arthrosis of the knee joint. You cannot select medications yourself.
Inflammation is relieved with NSAIDs (nonsteroidal anti-inflammatory drugs).
Good to know!
Since arthritis causes severe pain, NSAID injections provide a quick effect and a feeling of relief.
Modern treatment of knee arthrosis involves the use of NSAIDs of a different group. Their effect is more pronounced.
If there is inflammation of the joint lining, the doctor prescribes corticosteroid hormones for intraarticular administration. Hydrocortisone, Kenalog, Diprospan relieve inflammation and pain, but have many contraindications.
If necessary, antienzyme substances are injected into the joint cavity: contrica, ovamine, gordox. They can significantly slow down the destructive process.
Intra-articular injections of hyaluronic acid and its preparations are also prescribed. Restores the protective and shock-absorbing properties of synovial fluid.
Chondroprotectors are often prescribed, but there is no evidence that they can help.
Physiotherapy
The latest methods of treating knee arthrosis do not exclude adequate loading. The goal of physical therapy is to provide the necessary amount of movement, but not overload the joint, while maintaining balance. If the patient does not understand how to treat arthrosis of the knee joint - when it is necessary to protect the knee and develop it at the same time, the result of other methods is sharply reduced or reduced to zero. It is possible to get rid of the disease if the patient is conscious.
Laser therapy and physiotherapy
Laser treatment and physiotherapeutic procedures turned out to be excellent, especially if they were able to start at the first stage.
Other methods
Intraosseous blocks provide a therapeutic effect, interrupting the cycle of inflammation. Along with the blockade, multichannel electromyostimulation is used using a special device.
Homemade compresses and ointments can relieve pain and swelling.
Prosthetics
If necessary, an operation is performed: the patient is given an endoprosthesis of the knee joint. Modern prosthetic methods allow patients to return to sports.
Alternative and traditional medicine
Supporters of the unconventional approach argue that eliminating symptoms and treating arthrosis of the knee joint is possible only using their methods, without resorting to drugs. These are kinesitherapy (a special set of exercises), ozone therapy (physiotherapy with ozone, which is injected into the joint), homeopathy, treatment with dietary supplements, manual therapy, massage.
Attention!
When using unconventional methods, it must be remembered that their effectiveness has not been proven.
There are original treatment methods, but reviews about them vary.
Rehabilitation and prevention
Only therapeutic exercises and the measured load on the joint can restore the knee joint with arthrosis. If the patient follows all the doctor's recommendations and is ready to fight by all means for her health, in most cases the answer to the question "is it possible to cure arthrosis of the knee joint" is positive.
Prevention consists of timely injury care, active movement without overload, and maintaining an optimal body mass index.
Patient opinions
Reviews of patients undergoing traditional treatment are generally positive, but there are also negative ones.
When making a final decision about treatment, you should consult your doctor without forming an opinion based on reviews.
Medicine has learned to successfully treat joint diseases, the consequences of which in the last century have inevitably led to disability. With arthrosis of the knee joint, it is important to seek help in time to determine the stage of the disease and the extent of treatment.