The knee joint 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 due to arthrosis. This is a disease in which the cartilage tissue and the joint surface degenerates - falls apart. 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 arthrosis lead to a wheelchair.
Let's see what arthrosis of the knee joint is and how to treat it. How to prevent the disease 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 use of the knee. This is an occupational injury in many sports. Severely obese people over the age of 60 almost always have some degree of arthrosis due to constant microtrauma. Arthrosis refers to occupational diseases where the person has to stand for a long time or lift heavy objects. The disease can begin after rheumatoid arthritis.
The most common cause of knee arthrosis is injury. The second most common is childhood dysplasia. Inflammation caused by autoimmune pathologies is the third source of arthrosis. There are usually several reasons, one complementing the other.
Types of arthrosis of the knee joint are divided into primary and secondary depending on the causes. If the etiology is unknown, primary arthrosis is diagnosed, if the cause is, secondary arthrosis.
Development mechanism
Cartilage is nourished by 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 intra-articular fluid becomes viscous and its quantity decreases. Usually these processes alternate. The cartilage plate, which acts as a pump, pushes the fluid out of the joint when it is under load, and sucks it in when it is relaxed. This is how joint tissues are nourished. The pathological process manifests itself when the joint is exposed to destructive effects:
- If the load is high and the joint does not have time to recover, nutrition is interrupted. Cartilage thins, cracks and ulcers appear on it;
- The structure of the collagen fibers is disrupted, they are absorbed worse. The cartilage and kneecap soften, become inflexible and perform their function worse;
- Bone growths appear in the joint. The membrane of the joint capsule becomes irritated and inflamed;
- As a person begins to take care of their knees and move less, less intra-articular fluid is produced. The surface of the cartilage becomes dry and rough;
- The knee receives even less nourishment, it atrophies, and its destruction accelerates.
Signs of arthrosis of the knee joint appear: it becomes inactive and pain occurs. The pain is especially strong in the morning and after prolonged immobility.
Stages of arthrosis
There are three stages of arthrosis:
- Initial stage. 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 bear the normal load;
- Articular cartilage and menisci begin to deteriorate. Osteophytes - bone growths - grow into the bones. Inflammation and pain occur;
- It's a difficult stage. The supporting platform of the knee joint is deformed, the axis of the leg changes. The ligaments shorten, the joint capsule becomes stiff. The joint is abnormally mobile, but it is impossible to fully bend or straighten it. Inflammation and pain are pronounced.
In a comment!
At the beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is severely restricted. Due to the change in the movement axis, the muscle attachment sites change. Muscles become deformed - they contract or stretch, they can no longer contract normally. The nutrition of all leg tissues suffers.
Symptoms
The symptoms of arthrosis of the knee joint do not appear in any way at the beginning of the disease and do not force the patient to consult a doctor. The patient notices fatigue and pain, but does not attach any serious importance to them.
The classic sign of knee arthrosis is immobility and stiffness of the joint, pulling sensation in the popliteal region, pain after exercise. It is difficult to move in the morning or after prolonged 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 crunch appears in the joint, it completely stops bending and bending. The person begins to limp while walking - most patients turn to the doctor with this complaint. Treatment of arthrosis of the knee joint usually begins only in the second stage.
If we do nothing, movement becomes possible only with external help. When the patient lies down, the knee hurts less, but the pain often bothers him at night.
In the second and third stages, the knee joint is deformed - the contours of the bones are sharply outlined, the lower leg is curved. If you place your hand on your knee, you will hear a cracking sound as it bends and straightens. When the kneecap moves, it also crunches. Fluid collects in the cavity, the joint swells, and the tissues bulge.
As the disease progresses, all symptoms become more pronounced.
Diagnostics
The diagnosis of arthrosis of the knee joint is carried out comprehensively: anamnesis is collected, laboratory and instrumental methods are prescribed.
Control
The doctor examines the injured joint, measures the bones and the angle of flexion, and determines the degree of angular mobility of the joint.
Analyzes
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. The picture shows arthrosis of the knee joint: the joint space is narrowed, the cartilages are sclerotic, the bones are damaged; joint deformation, salt deposition and dystrophic changes are present. Osteophytes are clearly visible in the image.
Good to know!
In the case of arthrosis of traumatic origin, X-rays are of great diagnostic value and should be performed.
Ultrasound
Ultrasound diagnostics is an informative method. Ultrasound does not replace X-rays and does not give an idea of the nature of the destructive process taking place in the joint.
MRI
Magnetic resonance imaging gives a complete picture of the disease. This is a modern and accurate research method that allows for diagnosis at an early stage. The disadvantage of MRI is the 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;
- Follow the prescribed mode of transport;
- Do therapeutic exercises.
The aim of the treatment is to slow down the destruction process, prevent contractures (inability to fully bend and straighten the leg), and, if possible, restore the function of the joint. During the rehabilitation period, staying in sanatoriums and resorts shows good results.
Drug
Only the doctor decides how to treat arthrosis of the knee joint. You cannot choose medicine.
Inflammation is relieved by NSAIDs (non-steroidal anti-inflammatory drugs).
Good to know!
Because arthritis causes severe pain, NSAID injections provide quick action and relief.
Modern treatment of knee arthrosis involves the use of NSAIDs from another group. Their effect is more pronounced.
If there is inflammation of the joint mucosa, the doctor prescribes corticosteroid hormones for intra-articular administration. Hydrocortisone, Kenalog, Diprospan relieve inflammation and pain, but have many contraindications.
If necessary, anti-enzyme 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. 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 appropriate loading. The goal of physical therapy is to ensure the necessary amount of movement, but not to overload the joint, to maintain 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 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 physiotherapy procedures have proven to be excellent, especially if they can be started in the early stages.
Other methods
Intraosseous blocks provide a therapeutic effect, interrupting the cycle of inflammation. In addition to the blockade, multi-channel electromyostimulation is applied with a special device.
Poultices made from homemade ointments and rubs relieve pain and swelling.
Prosthetics
If necessary, surgery is performed - the patient is fitted with a knee joint endoprosthesis. Modern prosthetic methods allow patients to return to sports.
Alternative and traditional medicine
Supporters of the unconventional approach argue that the elimination of symptoms and the treatment of arthrosis of the knee joint is possible only with their methods - without the use of drugs. This is kinesitherapy (a special set of exercises), ozone therapy (physiotherapy using ozone, which is injected into the joint), homeopathy, treatment with dietary supplements, manual therapy, massage.
Attention!
When using unconventional methods, you should remember that their effectiveness has not been proven.
There are original methods of treatment, but opinions differ.
Rehabilitation and prevention
Only therapeutic exercises and measured loading of the joint can restore the knee joint in 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 "can arthrosis of the knee joint be cured" is positive.
Prevention consists of helping injuries in time, active movement without overloading and maintaining an optimal body mass index.
Patients' opinions
The opinions of patients who have undergone traditional treatment are generally positive, but there are also negative ones.
When making a final decision about treatment, consult your doctor without forming an opinion based on opinions.
Medicine has learned to successfully treat joint diseases, the consequences of which inevitably led to disability in the last century. 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.