Knee arthrosis is so common that it has a separate name - gonarthrosis. Another name for this disease is deforming osteoarthritis.
Arthrosis 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 cartilage tissue and the articular surface degenerate - they 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 from 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 occurrence of the disease is associated with excessive stress on the knees. This is an occupational injury in many sports. People with a high degree of obesity, over the age of 60, almost always have osteoarthritis 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 childhood dysplasia. Inflammation due to autoimmune pathologies is the third source of osteoarthritis. There are usually several reasons, one complements the other.
The types of arthrosis of the knee joint are divided depending on the causes into primary and secondary. If the etiology is unknown, primary arthrosis is diagnosed; if the cause is determined, secondary arthrosis is diagnosed.
Development mechanism
Cartilage is nourished due to constant changes in osmotic pressure. When the joint is loaded, the viscosity of the intra-articular fluid decreases and its quantity increases. In a calm state, the intra-articular fluid becomes viscous and the amount decreases. Typically, these processes alternate. The cartilaginous plate, acting like a pump, pushes fluid out of the joint when loaded, and when relaxed, sucks it out. This is how joint tissues are nourished. The pathological process manifests itself if the joint is subjected to destructive influences:
- If the load is heavy and the joint does not have time to recover, nutrition is impaired. The cartilage becomes thin, cracks and ulcers appear;
- The structure of collagen fibers is disturbed, they absorb worse. The cartilage and patella soften, become inelastic and perform their functions worse;
- Bone growths appear in the joint. The joint capsule membrane becomes irritated and inflamed;
- As the person begins to take care of the knee and moves little, less intra-articular fluid is produced. The surface of the cartilage becomes dry and rough;
- The knee receives even less nutrition, atrophies and its destruction accelerates.
Signs of arthrosis of the knee joint appear: it becomes inactive and pain occurs. The pain is especially intense in the morning and after prolonged immobility.
Stages of osteoarthritis
There are three degrees of osteoarthritis:
- Initial state. The tissues have not yet been destroyed. So far, only the function of the synovial membrane is deteriorating. The composition of the intra-articular 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 stage. The knee joint support platform is deformed, the axis of the leg changes. The ligaments shorten, the joint capsule becomes rigid. The joint is pathologically mobile, but it is impossible to completely bend or straighten it. Inflammation and pain are pronounced.
On a note!
At the beginning of the disease, the muscles are intact. Its function is gradually lost. In the third phase, movement is severely limited. Due to a change in the axis of movement, the places of muscle attachment change. The muscles are deformed - they contract or stretch, they can no longer contract normally. The nutrition of all leg tissues is impaired.
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 much importance to them.
The classic sign of knee osteoarthritis is immobility and stiffness of the joint, a pulling sensation in the popliteal region, and 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 crisis appears in the joint, it completely stops bending and straightening. A person begins to limp when walking - most patients go to the doctor with this complaint. Treatment of arthrosis of the knee joint usually begins only in the second stage.
If nothing is done, the movement will only be possible with external help. When the patient is lying down, the knee hurts less, but the pain is usually bothersome 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 place your hand on your knee, you will hear a squeaky sound as it bends and straightens. When the kneecap moves, it also grinds. Fluid accumulates in the cavity, the joint becomes swollen and the tissues bulge.
As the disease progresses, all symptoms become more pronounced.
Diagnosis
The diagnosis of arthrosis of the knee joint is carried out comprehensively: an anamnesis is taken, 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.
Analytics
The patient is sent for a general blood test, a biochemical blood test and a general urine test.
X-ray
X-ray of the knee joint is the main source of information for diagnosis. Arthrosis of the knee joint is visible in the photo: 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 osteoarthritis of traumatic origin, x-rays 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.
MRI
MRI gives a complete picture of the disease. This is a modern and accurate research method that allows you to make an early diagnosis. The disadvantage of MRI is its high cost.
Treatment
Treatment of the knee joint for osteoarthritis is carried out on an outpatient basis, with no need for hospitalization.
Treatment regimen:
- Reduce the load as much as possible;
- Observe the prescribed traffic mode;
- Perform therapeutic exercises.
The goal of treatment is to slow the destruction process, prevent contractures (inability to fully bend and straighten the leg), and restore joint function if possible. During the rehabilitation period, staying in sanatoriums and resorts shows good results.
Drugs
Only the doctor decides how to treat osteoarthritis of the knee joint. You cannot select medicines on your own.
Inflammation is relieved with NSAIDs (nonsteroidal anti-inflammatory drugs).
Good to know!
Because 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 from a different group. Its effect is more pronounced.
If there is inflammation of the joint lining, the doctor prescribes corticosteroid hormones for intra-articular administration. Hydrocortisone, Kenalog, Diprospan relieve inflammation and pain, but have many contraindications.
If necessary, antienzymatic substances are injected into the joint cavity - contrical, 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 help.
Physiotherapy
The latest methods of treating knee arthrosis do not exclude adequate weight bearing. The objective of physiotherapy is to provide the necessary amount of movement, but not overload the joint, maintaining balance. If the patient does not understand how to treat arthrosis of the knee joint - when it is necessary to simultaneously protect the knee and develop it, the result of other methods is drastically 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 have proven to be excellent, especially if they can start in the first phase.
Other methods
Intraosseous blocks provide a therapeutic effect, breaking the cycle of inflammation. Along with the blockade, multichannel electromyostimulation using a special device is used.
Compresses made with homemade ointments and rubs can relieve pain and swelling.
Prosthetics
If necessary, an operation is performed - the patient receives 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 it is possible to eliminate symptoms and treat arthrosis of the knee joint only with their methods - without resorting to medications. These are: kinesiotherapy (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, you need to remember that their effectiveness has not been proven.
There are original treatment methods, but reviews about them vary.
Rehabilitation and prevention
Only therapeutic exercises and 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 for his health by all means, 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 assistance, active movement without overload and maintaining an ideal body mass index.
Patients' opinions
Reviews of patients undergoing traditional treatment are usually 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 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.