The joints of the human body endure daily stress, due to which they become susceptible to various kinds of destructive factors. Among joint diseases, osteoarthritis is common and affects both large and small joints. Arthrosis of the knee joint is a degenerative-dystrophic damage to the knee joint, in which its motor activity is affected. In the absence of proper treatment, the disease can lead to disability.
Since the disease causes characteristic deformities in the joint, it was named deforming osteoarthritis of the knee joint, which correctly describes the typical feature of the pathology. The disease is chronic and is more often diagnosed in women, moreover, those who suffer from overweight and venous pathologies of the lower extremities, but there may be other reasons. Due to age-related changes, it also occurs in older people.
Osteoarthritis in young people can be triggered by injuries. As a result of degenerative-dystrophic changes, the cartilage softens, exfoliates and is covered with cracks of various depths. Subsequently, it ceases to perform its function.
The reasons
Various causes lead to the appearance of deforming arthrosis of the knee joint. The traumatic factor is a common cause of occurrence. Post-traumatic osteoarthritis can develop as a result of a dislocation or fracture in the specified area, as well as a meniscus injury. Usually gonarthrosis of the knee joint appears in young people who are actively involved in sports, or in those whose work is associated with increased mobility, lifting and carrying heavy loads.
Few people know that such damage can also be the result of treatment, when the injury itself has already healed, but during prolonged immobilization of the limb, circulatory disorders occurred in this area. Because of this, gonarthrosis appeared.
Increased physical activity in the knee is one of the main factors in the onset of the disease. It most often affects athletes who have constant active loads on the knee. At a young age, arthrosis may not manifest itself, usually rapid changes begin after the cessation of physical activity.
There is also a risk of disease in those people who, even in adulthood, do not reduce the load on the joints. In such athletes, the risk of fractures and dislocations increases, microtraumas appear. Therefore, already after forty years, doctors recommend that athletes reduce the load and switch to training. It's best to avoid running and squatting, as these are the activities that put the most pressure on the knee joint. Most often, one limb is affected, and left-sided gonarthrosis or right-sided gonarthrosis occurs.
An essential factor for the development of osteoarthritis of the knee joint is the removal of the menisci. If for some reason the menisci were removed, then in 90 percent of cases this leads to the appearance of arthrosis - the so-called knee loop occurs, during which the articular joints experience more friction than usual.
The problem of excess weight is also relevant for people with osteoarthritis. Excess body weight puts unnecessary pressure on the joints. As a result, not the cartilage itself is damaged, but the meniscus. And with a combination of excess weight and varicose veins of the lower extremities, acute arthrosis threatens to appear.
The weak ligamentous apparatus in some patients is a congenital feature, and sometimes the ligaments are affected due to other diseases. One way or another, weak ligaments cause increased mobility in the joint, due to which the joint surfaces are significantly worn. The consequences of ligamentous weakness may not be felt for a long time until patients experience symptoms of true osteoarthritis.
Joint pathologies also lead to the development of the disease. The most common cause of osteoarthritis is arthritis, the inflammation of the joints. With arthritis, typical signs are observed: deterioration in the composition of synovial fluid, pathological changes in cartilage, swelling, redness of soft tissues. Even after curing arthrosis, chronic processes lead to the appearance of arthrosis.
Violations of metabolic processes often lead to pathologies of the musculoskeletal system. Bones and joints lack the nutrients and minerals that are so necessary for tissue strength. With its lack, the bones and cartilaginous surfaces are subject to destructive processes, therefore, even with a slight load, primary arthrosis appears.
Symptoms
Osteoarthritis of the knee joint is manifested by a set of features that are difficult to ignore. Signs are felt not only at the first degree of development of the pathology, but already at the second and third degree give distinct symptoms of arthrosis of the knee joint:
- pain- one of the key signs that does not appear immediately. An interesting fact is that with the development of arthrosis, pain may not be felt even for several months or years, until the disease worsens. Usually, the first signs of pain are discomfort during physical exertion, walking or running, but it also manifests itself when the meniscus is pinched. With the second degree of arthrosis, pain in the joint is felt more strongly, and with the third degree of development, painful sensations appear even at rest. Attacks are aggravated even after short walks without a strong load on the joint, so patients try to avoid knees;
- deformations- the manifestations become more pronounced at the third stage of the development of arthrosis. The knee will retain its normal shape, but will appear slightly swollen and edematous. When arthritis joins, the knee will become red, hot and painful to the touch;
- crunchwith arthrosis appears in the second and third degree of development of the disease. The crackling sounds are different from the healthy clicks that can sometimes be heard when the knee is extended and flexed. In osteoarthritis, the symptoms are characterized by a dry, harsh sound that comes on suddenly and is accompanied by pain;
- synovitis- accumulation of a certain amount of fluid in the joint cavity. It's there and it's normal. But the accumulation of an excessive amount leads to the development of a cyst, the most notable Baker's cyst, which can be determined in the unbent position of the leg;
- limited mobility in the knee- a typical sign of pathology, since patients first consciously try to protect themselves from pain, and in the late stage of arthrosis they cannot straighten the limb at all. In the third degree of development, osteoarthritis deformans of the knee joint (DOA) leads to complete loss of movement. Patients are adapted to move with their legs bent, while using the means of support.
Degrees of development
Osteoarthritis of the knee joint goes through three stages in its development.
With arthrosis of the first degree, the pain is insignificant and occurs only with active physical exertion on the knee joint. Already in the first degree fluid can accumulate in the cavity, which in the second and third is already a cyst. With progression, pain occurs during movement, but quickly passes. Outwardly, the deformation of the knee joint is invisible, so the diagnosis of arthrosis of the knee joint can be difficult.
With a disease of the second degree, the damage to the cartilage tissue is more significant. If you take an x-ray, then the stage of bone growth is already noticeable on it. With any movement, a sudden sharp pain appears in the knee, but, returning to a comfortable position, the knee no longer hurts. In the second stage of DOA, you can hear a crackling noise typical of osteoarthritis. With progression, knee extension and flexion problems worsen. The deformation becomes externally noticeable.
Osteoarthritis of the knee joint of the third degree is characterized by a significant thinning of cartilage tissue. Gradually, the cartilage wears down so much that the bone is exposed in some areas. An X-ray image shows a significant number of osteophytes - bone growths, salts that have appeared in the joint cavity. Outwardly, the changes are clearly visible, and the patient is worried about constant pain. It is not difficult to make a diagnosis: a visual examination is enough and an X-ray control is carried out.
With the progression of this degree, osteoarthritis can lead to a complete loss of functionality. At any degree of development of the pathology, arthrosis of the knee joint can join.
Treatment
Coping with osteoarthritis of the knee joint is not easy, especially if the disease is advanced or inflammation has joined and arthritis has developed.
conservative
The most active group of drugs against osteoarthritis are non-steroidal anti-inflammatory drugs. These are mainly cyclooxygenase-2 inhibitors, they can perfectly relieve inflammation, swelling and contribute to a speedy recovery.
These medications have significant limitations, so they should not be used without a doctor's recommendation. For example, they can exacerbate stomach ulcers, heart disease, and pathology of the urinary organs. Non-steroidal anti-inflammatory drugs are also prohibited during pregnancy.
The second group of agents are chondroprotectors that improve the characteristics of cartilage tissue. They are used for arthrosis to restore the correct structure of cartilage, because in the process of resolution it loses very important components - chondroitin and glucosamine. Therefore, almost all chondroprotectors contain both substances, but some preparations are single-component.
With the help of these drugs, it is possible to help the patient in the first and second stages of the development of the disease, but not in the third, when irreversible changes have occurred.
During conservative therapy, the doctor will also give recommendations on nutrition. If the patient or patient is overweight, it is essential to follow a diet in order to normalize the weight. How to strengthen a stable weight - the doctor will also tell. It is also not recommended to eat a lot of salt, but it is better to supplement the diet with calcium, vitamins and minerals. Jelly, jelly will come in handy.
Operational
The most common type of surgery for osteoarthritis is arthroscopy, but other interventions are performed. Treatment of arthrosis of the knee joint is usually carried out in the second and third degree, when conservative therapy no longer helps.
If a minimally invasive intervention is necessary, for example, when fluid accumulates in the knee joint, it can be done with a puncture. A puncture is made in the cavity of the knee joint and excess fluid is pumped out. This method can both diagnose a disease and simultaneously apply it for treatment. The liquid is taken at the initial stage in a minimal amount, but this already significantly improves the well-being of patients. Then, after examining the biomaterial, another part is removed, and corticosteroids are injected into the joint cavity.
Arthroscopy is the most common. Through a small incision in the skin, several instruments are introduced that allow the examination of the joint and the necessary manipulations in it. With the help of arthroscopy, it is possible to remove the tissue particles that have been separated from the cartilage, but there is always a risk of secondary gonarthrosis.
With severe damage, there is a need to perform a periarticular osteotomy. This is a larger-scale impact on the joint, as a result of which it is slightly filed and set at the desired angle. After the operation, the rehabilitation is longer, but the effect lasts longer.
Significant destruction of the articular elements leads to complete immobilization of the limb. The joint is out of function, which means it needs to be replaced and an operation is required. Knee joint endoprosthesis is an expensive operation, but by itself it allows the patient to regain movement of the limb. Various knee prostheses are installed: plastic, ceramic or metal. These are durable structures that allow you to forget about the problem for several decades.
Physiotherapy
Physiotherapy methods can only be used when the acute period has passed and the patient is recovering.
Actively used methods include:
- ozone therapy- exposure of the affected joint with ozone, and the substance can be injected or used as an external treatment. This type of patient care is very effective, therefore it is often used in the treatment of various pathologies, including arthrosis. The treatment allows to activate blood circulation in the problem area, to achieve an anti-inflammatory and analgesic effect. At the same time, glucocorticoid treatment is carried out;
- kinesiotherapy- treatment is carried out with the help of a special set of exercises. The load is formed taking into account individual data, and when performing exercises, special simulators are used that strengthen the joints. The difference between kinesiotherapy and physical therapy exercises is the active effect not only on knee arthrosis, but also on the whole body.
Apply not only ozone therapy and kinesiotherapy, but also physiotherapy. The author's methods of exercises to eliminate arthrosis of the knee give good results. During the exercises and after them, you may need to wear a special knee brace - an orthosis - to strengthen the right or left knee joint.