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 concerns 20% of the population, its ICD-10 code is M17. Half of knee pathologies are caused by arthrosis. This is a disease in which the cartilage tissue and articular surfaces deteriorate - they are destroyed. The joints are less supplied with nutrients and oxygen, their function deteriorates, and inflammation occurs. He becomes inactive and sick, the patient's quality of life decreases. Complications of arthrosis lead to a wheelchair.
Let's figure out 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 occurrence of this disease is associated with excessive pressure on the knee. 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 microtrauma. Arthrosis refers to an occupational disease in areas where a person has to stand or lift heavy objects for a long time. This disease can start after rheumatoid arthritis.
The most common cause of knee arthrosis is injury. The second most common is dysplasia in childhood. Inflammation due to autoimmune pathology is the third source of arthrosis. There are usually several reasons, one complementing the other.
Types of arthrosis of the knee joint are divided depending on the cause 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 preserved because of constant changes in osmotic pressure. When the joint is loaded, the viscosity of the intra-articular fluid decreases and its quantity increases. At rest, the intraarticular fluid becomes viscous and its volume decreases. Usually, this process alternates. The cartilage plate, acting as a pump, pushes fluid out of the joint when loaded, and when loosened, sucks it up. This is how joint tissue is preserved. The pathological process manifests itself if the joint suffers from a destructive influence:
- If the load is large and the joints do not have time to recover, nutrition is interrupted. Cartilage becomes thin, cracks and ulcers appear on it;
- The structure of collagen fibers is disrupted, they absorb worse. Cartilage and patella become soft, become inelastic, and perform their functions worse;
- Bony growths appear in the joints. The membrane of the joint capsule becomes irritated and inflamed;
- As a person begins to take care of his knees and move a little, less intra-articular fluid is produced. The cartilage surface becomes dry and rough;
- The knee receives less nutrition, atrophies, and its destruction accelerates.
Signs of arthrosis of the knee joint appear: it becomes inactive and pain occurs. The pain is worse in the morning and after prolonged immobility.
Stage of arthrosis
There are three stages of arthrosis:
- Early stage. The tissue is still not destroyed. So far, only the function of the synovial membrane is deteriorating. The composition of the intra-articular fluid has changed. Knees can no longer withstand normal loads;
- Articular cartilage and meniscus begin to deteriorate. Osteophytes-bone formations-grow into the bone. Inflammation and pain appear;
- Difficult level. The support platform of the knee joint is deformed, the axis of the leg changes. Ligaments shorten, the joint capsule becomes rigid. The joint is pathologically mobile, but it is impossible to fully bend or straighten it. Inflammation and pain are pronounced.
On the note!
At the beginning of the disease, the muscles are still intact. Their function is gradually lost. In the third stage, movement is very limited. Due to changes in the axis of movement, the site of muscle attachment changes. Muscles are deformed - they contract or stretch, they can no longer contract normally. Nutrition of all foot tissues suffers.
symptoms
Symptoms of arthrosis of the knee joint at the beginning of the disease do not show themselves in any way and do not force the patient to see a doctor. The patient is aware of fatigue and pain, but does not attach importance to them.
Classic signs of knee arthrosis are immobility and stiffness in the joint, a pulling sensation in the popliteal area, pain after exercise. It is difficult to move in the morning or after a long period of immobility. Relief comes after the patient stretches his knee, massages it, and walks around.
After some time, the intensity and duration of the pain increases. Irritation appears in the joint, it stops completely bending and does not bend. A person begins to faint 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 outside 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 bone contour is sharply outlined, the lower leg is curved. If you put your hands on your knees, you will hear a pulsing sound when bending and straightening. When the kneecap moves, it also pulsates. Fluid accumulates in the cavity, the joint swells, and the tissue bulges.
As the disease progresses, all symptoms become more pronounced.
Diagnostics
Diagnosis of arthrosis of the knee joint is carried out comprehensively: anamnesis is collected, laboratory and instrumental methods are prescribed.
Inspection
The doctor examines the damaged joint, takes measurements of the bone and flexion angle, and determines the degree of mobility in the joint at the angle.
Analyze
Patients are sent for general blood tests, biochemical blood tests, and general urinalysis.
X-ray
X-rays of the knee joint are the main source of information for making a diagnosis. Arthrosis of the knee joint is visible in the photo: the joint space narrows, sclerotic cartilage, damaged bones; 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 a great diagnostic value and must be performed.
Ultrasound
Ultrasound diagnostics is an informative method. Ultrasound does not replace x-rays and does not provide insight into the nature of the destructive process in the joint.
MRI
Magnetic resonance imaging 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 the high cost.
Treatment
Knee joint treatment for arthrosis is carried out on an outpatient basis; hospitalization is not required.
Treatment regimen:
- Lighten the load as much as possible;
- Obey the designated traffic mode;
- Do therapeutic exercise.
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 recovery period, staying in sanatoriums and resorts shows good results.
Drugs
Only a doctor decides how to treat arthrosis of the knee joint. You cannot choose your own medicine.
Inflammation is relieved with NSAIDs (non-steroidal anti-inflammatory drugs).
Good to know!
Because arthritis causes severe pain, NSAID injections provide quick relief.
Modern treatment of knee arthrosis involves the use of NSAIDs from different groups. Their impact is more significant.
If there is inflammation in the lining of the joint, the doctor prescribes corticosteroid hormones for intra-articular administration. Hydrocortisone, Kenalog, Diprospan relieve inflammation and pain, but they have many contraindications.
If necessary, antienzymes are injected into the joint cavity - contrical, ovamine, gordox. They can significantly slow down the destruction process.
Intra-articular injections of hyaluronic acid and its preparations are also prescribed. It 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 proper loading. The goal of physical therapy is to provide the necessary amount of movement, but not burden the joints, 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 simultaneously, the results of other methods are 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 have proven themselves to be very good, especially if they can start at the first stage.
Another method
Intraosseous blockade provides a therapeutic effect, breaking the cycle of inflammation. Along with the blockade, multi-channel electromyostimulation is used using a special device.
Compresses made from homemade ointments and poultices can relieve pain and swelling.
Prosthetics
If necessary, an operation is performed - the patient is fitted with an endoprosthesis of the knee joint. Modern prosthetic methods allow patients to return to sports.
Alternative and traditional medicine
Supporters of unconventional approaches argue that it is possible to eliminate the symptoms and treat arthrosis of the knee joint using only their methods - without the use of drugs. These are kinesitherapy (special exercise set), ozone therapy (physiotherapy using ozone, which is injected into the joints), homeopathy, treatment with food supplements, manual therapy, massage.
Attention!
When using unconventional methods, you need to remember that their effectiveness has not been proven.
There is an original method of treatment, but reviews about it vary.
Recovery and prevention
Only therapeutic exercises and measured loads 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 in every way, in most cases the answer to the question "can arthrosis of the knee joint be cured" is positive.
Prevention consists of timely assistance for injuries, active movement without excessive load, and maintaining an optimal body mass index.
Patient opinion
Reviews from patients who have undergone traditional treatment are usually positive, but there are also negative ones.
When making a final decision about treatment, you should consult with your doctor without making an opinion based on reviews.
Medicine has learned to successfully treat joint diseases, the consequences of which in the last century inevitably lead to disability. With arthrosis of the knee joint, it is important to get help in time to determine the extent of the disease and the level of treatment.