Knee arthrosis is so common that it has a separate name - gonarthrosis. Another name for this disease is deforming osteoarthritis.
Osteoarthritis 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 tissue of cartilage and the joint surface degenerates - they fall 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 find 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 reasons for the occurrence of arthrosis of the knee joint are different - mechanical damage, hereditary predisposition, metabolic disorders.
The occurrence of the disease is associated with excessive load on the knees. It is an occupational injury in many sports. People with a high degree of obesity, over the age of 60, almost always have arthrosis to one degree or another due to constant microtraumas. Arthritis refers to occupational diseases in areas where a person has to stand or lift heavy objects for a long time. The disease can start after rheumatoid arthritis.
The most common cause of knee osteoarthritis is injury. In second place in terms of frequency is dysplasia in childhood. Inflammation due to 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 depending on the causes into primary and secondary. If the etiology is unknown, primary arthrosis is diagnosed, if the cause is established, secondary arthrosis is diagnosed.
Mechanism of development
Cartilage is nourished thanks to 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, acting as a pump, pushes fluid out of the joint when it is loaded and sucks it up when it is relaxed. This is how joint tissues are nourished. The pathological process manifests itself if the joint is subjected to destructive influences:
- If the load is high and the joint does not have time to recover, nutrition is disturbed. The cartilage thins, cracks and ulcers appear on it;
- The structure of collagen fibers is broken, they absorb worse. The cartilage and patella soften, become inelastic and perform their functions worse;
- Bony growths appear in the joint. The membrane of the joint capsule is irritated and inflamed;
- As a person begins to take care of their 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 immobilization.
Stages of arthrosis
There are three degrees of arthrosis:
- Beginning phase. 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 withstand normal load;
- Articular cartilage and menisci begin to deteriorate. Osteophytes - bone formations - grow in the bones. Inflammation and pain appear;
- 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 hard. The joint is pathologically mobile, but it is impossible to fully bend or straighten. Inflammation and pain are pronounced.
For the record!
At the very beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is severely restricted. Due to a change in the axis of movement, the places of attachment 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 legs suffers.
Symptoms
The symptoms of arthrosis of the knee joint at the beginning of the disease do not manifest themselves in any way and do not force the patient to go to the doctor. The patient notices fatigue and pain, but does not attach serious importance to them.
The classic sign of arthrosis of the knee is immobility and stiffness in the joint, a feeling of pulling in the back of the knee, pain after physical exertion. Difficulty moving in the morning or after a long period of immobility. Relief comes after the patient stretches the knee, massages it, and walks.
After some time, the intensity and duration of the pain increases. A crunch appears in the joint, it completely stops bending and extending. 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 at the second stage.
If nothing is done, movement becomes possible only with external assistance. When the patient is lying 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 sharply defined, the lower leg is curved. If you put your hand on your knee, you hear a crunch when you bend and straighten. When the knee cap moves, it also crunches. Fluid collects in the cavity, the joint swells and the tissues swell.
As the disease progresses, all symptoms become more pronounced.
Diagnosis
The 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, measures the bones and the angle of flexion, determines the degree of mobility of the joints at an angle.
Analyzes
The patient is sent for a general blood test, a biochemical blood test and a general urinalysis.
Roentgen
The X-ray of the knee joint is the main source of information for making the diagnosis. Arthrosis of the knee joint can be seen in the photo: the joint gap is narrowed, the cartilage is sclerosed, the bones are damaged; there is joint deformation, salt deposition and dystrophic changes. Osteophytes are clearly visible on the image.
Good to know!
In 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 give a picture of the nature of the destructive process in the joint.
MRI
Nuclear magnetic resonance gives 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
Treatment of the knee joint in case of arthrosis is carried out on an outpatient basis, hospitalization is not required.
Treatment scheme:
- Reduce the load as much as possible;
- Observe the prescribed traffic regime;
- Do therapeutic exercises.
The goal of treatment is to slow down the destruction process, prevent contractures (impossibility 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.
medicines
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 arthrosis of the knee joint 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 have many contraindications.
If necessary, anti-enzyme substances are injected into the joint cavity - Kontrical, Ovamin, 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 shock-absorbing properties of the synovial fluid.
Chondroprotectors are often prescribed, but there is no evidence that they help.
Physiotherapy
The latest methods of treating arthrosis of the knee do not exclude proper loading. The goal of physical therapy is to provide the necessary amount of movement, but not overload the joint, 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 sharply decreases or decreases to zero. It is possible to get rid of the disease if the patient is conscious.
Laser therapy and physiotherapy
Laser treatment and physical therapy treatments have proven to be excellent, especially if they were able to start at the first stage.
Other methods
Intraosseous blockades provide a therapeutic effect, interrupting the cycle of inflammation. Along with the blockade, multichannel electromyostimulation using a special device is used.
Compresses of homemade ointments and rubs can relieve pain and swelling.
Prosthetics
If necessary, an operation is performed - the patient is fitted with a knee joint endoprosthesis. Modern prosthetic methods allow patients to return to sports.
Alternative and traditional medicine
Proponents of the non-traditional approach claim that it is possible to eliminate the symptoms and treat arthrosis of the knee joint only with their methods - without resorting to drugs. This is kinesitherapy (a special set of exercises), ozone therapy (physiotherapy with ozone that is injected into the joint), homeopathy, treatment with nutritional supplements, manual therapy, massage.
attention!
When using non-traditional methods, you should remember that their effectiveness has not been proven.
There are original methods of treatment, but the reviews about them are different.
Rehabilitation and prevention
Only therapeutic exercises and measured loading of 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 any 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 overloading and maintaining an optimal body mass index.
Patient reviews
Reviews of patients who have undergone traditional treatment are usually positive, but there are also negative ones.
When making a final treatment decision, you should consult your doctor without forming an opinion based on examinations.
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 degree of treatment.