osteoarthritis of the knee joint

Osteoarthritis of the knee joint is a disease of the musculoskeletal system, characterized by deformation and destruction of the cartilage tissue of the joint, as a result of which the structure and function of the cartilage is disrupted.This disease has many names - gonarthrosis, deforming osteoarthritis.There is no clear scheme in the treatment of arthrosis of the knee joint or one drug that can equally help all people suffering from this problem.Since arthrosis is a progressive disease, it is more commonly seen in overweight women, venous disease, and the elderly.Treatment is carried out and prescribed individually for each patient.

Osteoarthritis of the knee joint can be unilateral or bilateral (depending on whether the disease develops on one or both legs).At the first symptoms, it is necessary to resort to adequate treatment, since ignoring this problem can lead to the final destruction of cartilage and bone exposure and, as a result, human disability.

There are three stages of the disease:

1. At the initial stage of knee arthrosis there is a loss of shock-absorbing properties and as a result, the cartilage rubs against each other while walking, causing severe discomfort to the patient.The cartilage becomes rough, deformed, dries up and in advanced stages of the disease even becomes covered with cracks.
2. Degradation of bone mass begins to degenerate, leading to the formation of osteophytes (growths on the surface of bones) – this is the second stage of the disease.The new membrane of the joint and capsule is also subject to degeneration, with the knee joint gradually weakening due to the rapidity of motion.There is also a change in the density of the joint fluid (it becomes thicker, more viscous), poor circulation, and a decline in the supply of nutrients to the knee joint.Thinning of the layer between the cartilaginous joints reduces the distance between the articular bones.
3. The disease progresses rapidly and very quickly moves into the third stage, when the patient becomes practically unable to move due to constant pain in the knee.Global and irreversible changes occur in cartilage tissue, leading to human disability.

Often, arthrosis or gonarthrosis develops after an injury or scratch, while a person feels constant severe pain in the knee, which significantly hinders his activities.

Reasons for the development of arthrosis

Arthrosis of the knee joint, the treatment of which takes quite a long time, can appear due to the following factors:

1. genetic predisposition.
2. Injuries: dislocations, bruises, fractures.When treating an injured knee, the joint is fixed and the person cannot bend or straighten the leg for a certain period of time.This leads to a deterioration in blood circulation, which often provokes the development of post-traumatic gonarthrosis.
3. Removal of meniscus.
4. Excessive physical activity that is not appropriate for a person's age can lead to injuries or microtraumas, as well as hypothermia of the joints.For example, running on asphalt or squats is not recommended for older people, since during these exercises there is significant stress on the knee joint, which wears out with age and is not able to withstand such loads.
5. Overweight and obesity.This factor causes damage to the menisci, injuries of which provoke the development of arthrosis of the knees.
6. Loose ligaments or weak ligaments.
7. Arthritis or other acquired joint disease.The inflammatory process can cause accumulation of synovial fluid in the joint cavity or swelling.This provokes the destruction of the cartilage tissue of the knee, leading to arthrosis of the knee joint.
8. Metabolic disorders in the human body.Insufficient amount of calcium significantly worsens the condition of bone and cartilage tissue in the human body.
9. flat feet.Improper structure of the foot changes the center of gravity and increases the load on the joint.
10. Stress and nervous tension.

Symptoms of knee arthrosis

The clinical picture of the disease has the following symptoms:

1. Painful sensations.Pain occurs suddenly depending on the physical load on the knee joint.Painful sensations can be of different nature.In the initial stage, these are weak lumbago, to which the person usually does not pay much attention.Periodic mild pain may be observed for months, and sometimes years, until the disease progresses to a more aggressive stage.
2. Visible deformity of the knee.This symptom appears in the later stages.At first, swelling or inflammation appears in the knee.
3. Accumulation of joint fluid in the joint cavity or Baker's cyst.It is a dense structure on the posterior wall of the knee joint.
4. Shrinkage of joints.In the second and third stages of the disease, loud crunching sounds are seen in patients, which are accompanied by pain.
5. Inflammatory reactions in the articular synovium, resulting in the cartilage swelling and increasing in volume.
6. Mobility of joints decreases.Seen in later stages.Bending the knee becomes almost impossible and is accompanied by severe pain.In the final stage, the knee can be completely immobilized.It becomes difficult or completely impossible for a person to walk (some patients walk on bent legs).

Treatment of arthrosis of the knee joint

Treatment of arthrosis of the knee joint should be comprehensive.To date, there is no therapeutic drug that provides relief from this disorder.One of the most important conditions for successful treatment is timely diagnosis.The earlier the treatment of knee arthrosis is started, the greater the chance of extending the healing period and preventing destruction and deformation of cartilage and bone tissue.

During treatment, the doctor and the patient are faced with a number of tasks:

1. eliminate or reduce pain;
2. Establish a supply of nutrients to the knee joint and thus enhance its recovery function;
3. Activate blood circulation in the knee joint;
4. strengthening the muscles around the joint;
5. Increase joint mobility;
6. Try to increase the distance between the joined bones.

Treatment of the disease, depending on the stage of its development, can be conservative and surgical.

Conservative treatment of arthrosis of the knee joint

Pain relievers, anti-inflammatory drugs

To relieve or reduce pain, the patient is usually prescribed a course of nonsteroidal anti-inflammatory drugs (NSAIDs).These can be tablets, ointments and injections.The most common painkillers are the following.These medications can be used in two ways – orally or topically.

Typically, patients prefer local treatments in the form of gels, ointments, and warming patches.The effect of these painkillers does not occur immediately, but after a few days (about 3-4 days).The maximum effect is achieved after a week of regular use of the drug.Such drugs do not cure the disease, but only relieve pain, because it is impossible to start treating pain.

Painkillers should be taken strictly as prescribed by the doctor;These should be used only for severe pain, as prolonged and repeated use can cause side effects and even accelerate the destruction of joint cartilage.In addition, long-term use of these drugs increases the risk of adverse reactions, among which stomach ulcers, duodenal ulcers, disruption of the normal functioning of the liver, kidneys, and allergic manifestations in the form of dermatitis are also possible.

hormones

Sometimes, in the treatment of arthrosis of the knee joint, a course of hormonal drugs is prescribed.They are prescribed if NSAIDs are no longer effective and the disease begins to progress on its own.Hormonal drugs are often used in the form of injections to treat this disease.

The course of treatment with hormonal drugs is usually short and is prescribed during periods of severe exacerbation, when inflammatory fluid accumulates in the joint.The hormone is injected into the joint approximately once every ten days.

Chondroprotectors

To restore and nourish cartilage tissue at the initial stage of the disease, a course of glucosamine and chondroitin sulfate, the so-called chondroprotectors, is prescribed.It is the most effective treatment for arthrosis so far.They have almost no contraindications, and side effects occur in rare cases.

vasodilators

To relieve spasm of small vessels, improve blood circulation and delivery of nutrients to the knee joint, as well as eliminate vascular pain, vasodilators are prescribed.They are crushed together with chondroprotectors.If fluid accumulation does not occur with knee arthrosis, it is also recommended to use warming ointments, gels and fluids.

therapeutic exercise

A course of exercise therapy can be very useful and bring good results only if prescribed by a doctor and carried out under supervision on the recommendations of a specialist or instructor.Self-medication is dangerous to health.Exercise therapy is used to prevent the destruction of cartilage tissue, slow the development of stiffness, and relax muscle spasms that cause pain.During periods of exacerbation, exercise therapy is contraindicated.A course of special individual exercises, which takes into account not only the stage of the disease and the condition in which the cartilage is located, but also the patient's age, should be developed by a competent specialist in this field.

physiotherapy

Physiotherapy is used as one of the methods of conservative therapy - electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF.A course of local massage also gives positive results.Physiotherapeutic methods act in several directions - relieve pain, reduce inflammation, normalize metabolism inside the joint and restore its normal functions.The method and duration of physiotherapy treatment is determined by the patient's medical history and only after a thorough diagnosis and study of the condition of the joints.

Pain relieving physiotherapy includes:

1. Medium wave ultraviolet radiation (SUV radiation).Contact of ultraviolet light with the skin of the knee continues until slight redness appears.Substances are formed in the tissues that reduce the sensitivity of nerve fibers, thereby achieving an analgesic effect.The duration of the course of treatment is determined by the doctor depending on the symptoms, frequency and severity of pain.On average, the course of treatment is about 7-8 sessions.
2. Local magnetic therapy aims to heal the patient's body as a whole.This procedure relieves inflammation, eliminates pain and neutralizes muscle spasms.Effectively used for arthrosis of the knee joint in the initial stage.The course of treatment is usually limited to 20-25 procedures, each of which lasts about half an hour.
3. Infrared laser therapy, low intensity UHF therapy, centimeter therapy (SMV therapy).
4. Ultrasound, darsonvalization, therapeutic baths, interventional therapy, which are prescribed to improve blood circulation in the joint.

Of no small importance is sanitary resort treatment.This treatment is prescribed for deforming and dystrophic osteoarthritis.Like the previously listed treatments, this treatment also has its own contraindications, so the attending physician carefully examines the patient's medical history before recommending the sanitary-resort method.

Surgical treatment of arthrosis of the knee joint

This is a revolutionary method of treating arthrosis of the knee joint, partially or completely restoring the functioning of the joint.The methods and forms of surgical intervention depend on the degree of joint damage as well as the patient's medical history.

Late arthrosis of the knee joint can be treated only surgically - the knee joint is completely or partially replaced with an endoprosthesis.Surgical treatment allows not only to improve well-being, but also to restore the patient's working ability at the last stage of knee arthrosis.Many consider the long recovery period from the use of exercise therapy, mechanotherapy and other means to be a significant disadvantage of the operation.

There are several types of surgical interventions for arthrosis of the knee joint:

Knee arthritis prevention

To avoid this disease, people at risk (athletes, elderly people, overweight people, enterprise workers) should follow some instructions:

1. Proper nutrition and fight against excess weight.It is necessary to exclude unhealthy foods from your diet – fatty foods, fried foods, alcohol, and it is better to consult a nutritionist who will personally help you choose a suitable diet.
2. While playing sports, monitor the load on your joints and reduce it if necessary.
3. Monitor your health and treat infectious diseases in a timely manner, preventing them from becoming chronic.
4. Timely and adequate treatment of spinal diseases, if any, development of correct posture.
5. Sports activities (cycling, swimming, walking, special gymnastic exercises for joints).
6. No self-medication!Visit the clinic at the first symptoms of knee arthritis.
7. Avoid stress, get good sleep.
8. Systematically increase your immunity (strengthen yourself or take a course of vitamins at least 2-3 times a year).
9. Protect the body from hypothermia, especially the lower limbs.

A healthy lifestyle and timely treatment is the best way to prevent knee arthritis.