Knee arthrosis is so common that it has a special name - gonarthrosis. Another name for this disease is deforming osteoarthritis.
Knee arthrosis affects 20% of the population, its ICD-10 code is M17. Half of knee pathologies are due to arthrosis. This is a disease in which cartilage tissue and the articular surface degenerate - they disintegrate. This joint is poorly supplied with nutrients and oxygen, its function deteriorates and inflammation appears. It becomes inactive and painful, the patient's quality of life decreases. Complications of arthrosis lead to a wheelchair.
Let's understand what arthrosis 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 appearance 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 60 years old, almost always have arthrosis of one degree or another due to constant microtraumas. Arthrosis 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 arthrosis is injury. The second most common is childhood dysplasia. Inflammation due to autoimmune pathologies is the third source of arthrosis. There are usually several reasons, one complementing the other.
The types of arthrosis of the knee joint are divided based 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.
Mechanism of development
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 amount increases. At rest, the intra-articular fluid becomes viscous and the amount decreases. Normally, these processes alternate. The cartilage plate, acting as a pump, pushes fluid out of the joint when it is loaded, and when it relaxes, it absorbs it. This is how joint tissues are nourished. The pathological process is manifested if the joint is subjected to destructive influences:
- If the load is large and the joint does not have time to recover, the food spoils. The cartilage becomes thin, cracks and ulcers appear on it;
- The structure of collagen fibers is broken, they are absorbed worse. Cartilage and patella soften, become inelastic and perform their functions worse;
- Bony growths appear in joints. The membrane of the joint capsule becomes irritated and inflamed;
- As a person begins to take care of his knee and move a little, less intra-articular fluid is produced. The surface of the cartilage becomes dry and rough;
- The knee receives even less food, atrophies and its destruction accelerates.
Signs of arthrosis of the knee joint appear: it becomes inactive and pain appears. The pain is especially strong in the morning and after prolonged immobility.
Stages of arthrosis
There are three degrees of arthrosis:
- Initial stage. The tissue has not yet been destroyed. So far, only the function of the synovial membrane has deteriorated. The composition of the intra-articular fluid has changed. The knee can no longer bear the normal load;
- Articular cartilage and menisci begin to deteriorate. Osteophytes - bony formations - grow in the bones. Inflammation and pain appear;
- Difficult phase. The supporting platform of the knee joint is deformed, the axis of the leg changes. The ligaments shorten, the joint capsule becomes rigid. The joint is pathologically movable, but it is impossible to bend or straighten it completely. Inflammation and pain are pronounced.
On a note!
At the beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is very limited. Due to a change in the axis of movement, the attachment sites of the muscles change. Muscles are deformed - they contract or stretch, they can no longer contract normally. The nutrition of all the tissues of the foot suffers.
Symptoms
The symptoms of arthrosis of the knee joint at the beginning of the disease are not manifested in any way and do not force the patient to visit a doctor. The patient notices fatigue and pain, but does not attach serious importance to them.
The classic sign of knee arthrosis is immobility and stiffness in 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 around.
After a while, the intensity and duration of the pain increases. A crack appears at the joint, it completely stops bending and undoing. A person begins to limp when walking - 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 you at night.
In the second and third stages, the knee joint is deformed - the contours of the bones are pronounced, the lower leg is curved. If you put your hand on your knee, you hear a clicking sound when you bend and straighten. When the kneecap moves, it also snaps. Fluid collects in the cavity, the joint is swollen and the tissue swells.
As the disease progresses, all symptoms become more pronounced.
Diagnosing
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, takes measurements of the bones and the angle of flexion, and determines the degree of mobility in the joint at an angle.
analyzes
The patient is sent for a general blood test, a biochemical blood test and a general urine test.
X-Ray
An X-ray of the knee joint is the main source of information to make a 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 arthrosis of traumatic origin, X-rays have great diagnostic value and should be performed.
ULTRASOUND
Ultrasound diagnostics is an informative method. Ultrasound does not replace X-rays and does not give a picture of the nature of the destructive process in the joint.
MRI
Magnetic resonance 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 arthrosis of the knee joint is performed on an outpatient basis; hospitalization is not required.
Treatment regimen:
- Reduce the load as much as possible;
- Observe the designated traffic pattern;
- Perform therapeutic exercises.
The goal of treatment is to slow down 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.
dope
Only the doctor decides how to treat arthrosis of the knee joint. You cannot choose medicines yourself.
Inflammation is relieved with NSAIDs (non-steroidal anti-inflammatory drugs).
Good to know!
Since arthritis causes severe pain, NSAID injections provide a quick effect and a sense of relief.
Modern treatment of knee arthrosis includes the use of NSAIDs from another group. Their 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 they have many contraindications.
If necessary, antienzyme substances are injected into the joint cavity - contrikal, 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 absorbent properties of synovial fluid.
Chondroprotectors are often prescribed, but there is no evidence that they help.
Physiotherapy
Newer methods of treatment of knee arthrosis do not exclude proper 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 simultaneously protect the knee and develop it, the result of other methods is significantly 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 physiotherapy procedures have proven to be excellent, especially if they can be started in the first stage.
Other methods
Intraosseous blockades provide a therapeutic effect, breaking the cycle of inflammation. Along with the blockade, multichannel electromyostimulation is used using a special device.
Compresses made from ointments and rubs made at home can relieve pain and swelling.
prostheses
If necessary, an operation is performed - the patient is provided with an endoprosthesis of the knee joint. Modern prosthetic methods allow patients to return to sports.
Alternative and traditional medicine
Proponents of the unconventional approach argue that it is possible to eliminate symptoms and treat arthrosis of the knee joint only using their methods - without using drugs. This is kinesitherapy (a special set of exercises), ozonotherapy (physiotherapy using ozone, which is injected into the joints), homeopathy, treatment with dietary supplements, manual therapy, massage.
Careful!
When using unconventional methods, you should remember that their effectiveness has not been proven.
There are original methods of treatment, but reviews about them differ.
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 with all means for his health, in most cases the answer to the question "can arthrosis of the knee joint be cured" is positive.
Prevention consists of timely help for injuries, active movement without overloading and maintaining an optimal body mass index.
Patients' opinions
Reviews from patients who have undergone traditional treatment are usually positive, but there are also negative ones.
When making a final decision on 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.