Knee osteoarthritis is so common that it has a separate name: gonarthrosis. Another name for this disease is osteoarthritis deformans.
Osteoarthritis 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 the cartilage tissue and joint surface degenerates - they disintegrate. The joint is poorly supplied with nutrients and oxygen, its function deteriorates and inflammation appears. He becomes inactive and suffers, the patient's quality of life decreases. Complications of osteoarthritis lead to a wheelchair.
Let's find out what osteoarthritis 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 osteoarthritis of the knee joint are different: mechanical damage, hereditary predisposition, metabolic disorders.
The onset of the disease is associated with excessive stress on the knees. This is a workplace accident in many sports. People with a high degree of obesity, aged over 60, almost always suffer from osteoarthritis of one degree or another due to constant microtrauma. Osteoarthritis refers to occupational diseases in areas where a person must 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 dysplasia in children. Inflammation due to autoimmune pathologies is the third source of osteoarthritis. There are usually several reasons, one complementing the other.
Types of osteoarthritis of the knee joint are divided according to the causes into primary and secondary. If the etiology is unknown, primary osteoarthritis is diagnosed; if the cause is determined, secondary osteoarthritis is diagnosed.
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. In a calm state, the intra-articular fluid becomes viscous and its quantity decreases. Normally, these processes alternate. The cartilaginous plate, acting as a pump, pushes fluid out of the joint when loaded and, when released, sucks it in. This is how the joint tissues are nourished. The pathological process manifests itself if the joint is subjected to destructive influences:
- If the load is significant and the joint does not have time to recover, nutrition is disrupted. The cartilage becomes thinner, cracks and ulcers appear on it;
- The structure of collagen fibers is disrupted, they are less well absorbed. The cartilage and patella soften, become inelastic and perform their functions less well;
- Bony growths appear in the joint. The membrane of the joint capsule becomes irritated and inflamed;
- Since a person begins to take care of their 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 osteoarthritis of the knee joint appear: it becomes inactive and pain appears. The pain is particularly intense in the morning and after prolonged immobility.
Osteoarthritis stages
There are three degrees of osteoarthritis:
- Initial stage. The tissues have not yet been destroyed. So far, only the function of the synovial membrane deteriorates. The composition of the intra-articular fluid has changed. The knee can no longer support a normal load;
- Articular cartilage and menisci begin to deteriorate. Osteophytes (bone formations) develop in bones. Inflammation and pain appear;
- Difficult step. 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 mobile, but it is impossible to completely bend or straighten it. Inflammation and pain are pronounced.
On a note!
At the very beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movements are severely limited. Due to a change in the axis of movement, muscle attachment sites change. Muscles are deformed - they contract or stretch, they can no longer contract normally. The nutrition of all leg tissues suffers.
Symptoms
Symptoms of osteoarthritis 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 fatigue and pain, but does not attach serious importance to them.
The classic sign of osteoarthritis of the knee is immobility and stiffness of the joint, a feeling of tightness 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 crunch appears in the joint, it completely stops bending and unfolding. A person begins to limp when walking - most patients consult the doctor with this complaint. Treatment of osteoarthritis of the knee joint usually begins only in the second stage.
If nothing is done, the movement only becomes possible with external help. When the patient lies down, the knee hurts less, but the pain often bothers at night.
In the second and third stages, the knee joint is deformed - the outlines of the bones are sharply defined, the lower leg is curved. If you place your hand on your knee, you will hear a cracking sound as you bend over and stand up. When the kneecap moves, it also cracks. Fluid builds up in the socket, the joint is swollen and the tissues bulge.
As the disease progresses, all symptoms become more pronounced.
Diagnostic
The diagnosis of osteoarthritis 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 bones and flexion angle, and determines the degree of angular mobility of the joints.
Analyzes
The patient is sent for a general blood test, biochemical blood test and general urine analysis.
x-ray
An x-ray of the knee joint is the main source of information for making a diagnosis. Osteoarthritis of the knee joint is visible in the photo: the joint space is narrowed, the cartilage is sclerotic, the bones are damaged; there is deformation of the joints, 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 diagnosis is an informative method. Ultrasound does not replace X-rays and does not give an idea of 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 making a diagnosis at an early stage. The disadvantage of MRI is its high cost.
Treatment
Treatment of the knee joint for osteoarthritis is carried out on an outpatient basis, no hospitalization is required.
Treatment scheme:
- Reduce the load as much as possible;
- Respect the prescribed traffic mode;
- Perform therapeutic exercises.
The goal of treatment is to slow down the process of destruction, prevent contractures (inability to completely bend and straighten the leg), and restore joint function if possible. During the rehabilitation period, stay in sanatoriums and resorts gives good results.
Drugs
Only the doctor decides how to treat osteoarthritis of the knee joint. You cannot select your medications yourself.
Inflammation is relieved by NSAIDs (non-steroidal anti-inflammatory drugs).
Good to know!
Since arthritis causes intense pain, NSAID injections provide a rapid effect and a feeling of relief.
Modern treatment of knee osteoarthritis involves the use of NSAIDs of a different group. Their effect is more pronounced.
In case of inflammation of the joint mucosa, the doctor prescribes corticosteroid hormones for intra-articular administration. Hydrocortisone, Kenalog, Diprospan relieve inflammation and pain, but they 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. It restores the protective and cushioning properties of synovial fluid.
Chondroprotectors are often prescribed, but there is no evidence that they are helpful.
Physiotherapy
The most recent methods of treating osteoarthritis of the knee do not exclude appropriate weight bearing. The goal 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 osteoarthritis of the knee joint - when it is necessary to simultaneously protect the knee and develop it, the result of other methods is 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 to be excellent, especially if they could be started from the first stage.
Other methods
Intraosseous blockages provide a therapeutic effect, breaking the cycle of inflammation. Along with the blockade, multichannel electromyostimulation is used using a special device.
Compresses made from homemade ointments and rubs 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 the unconventional approach claim that it is possible to eliminate symptoms and treat osteoarthritis of the knee only using their methods, without resorting to medications. These are physiotherapy (a special set of exercises), ozone therapy (physiotherapy using ozone injected into the joint), homeopathy, treatment with dietary supplements, manual therapy, massage.
Attention!
When using unconventional methods, you must remember that their effectiveness has not been proven.
There are original treatment methods, but opinions about them vary.
Rehabilitation and prevention
Only therapeutic exercises and measured load on the joint can restore the knee joint suffering from osteoarthritis. If the patient follows all the doctor's recommendations and is ready to fight for his health by any means, in most cases the answer to the question "can osteoarthritis of the knee be cured" is positive.
Prevention consists of timely assistance in case of injury, active movements without overload and maintaining an optimal body mass index.
Patient reviews
Reviews of patients who have undergone traditional treatment are generally positive, but there are also negative ones.
When making a final decision regarding 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 inevitably led to disability in the last century. In case of osteoarthritis of the knee joint, it is important to seek help in time to determine the stage of the disease and the extent of treatment.