Knee arthrosis is so common that it has a special name - gonarthrosis. Another name for this disease is deforming osteoarthritis.
Arthrosis of the knee joint worries 20% of the population, its ICD-10 code is M17. Half of knee pathologies are the result of arthrosis. This is a disease in which cartilage tissue and joint surfaces degenerate - they fall apart. The joint is poorly supplied with nutrients and oxygen, its function deteriorates and inflammation occurs. It becomes inactive and painful, the patient's quality of life decreases. Complications of arthrosis lead to wheelchairs.
Let's understand 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 appearance of the disease is associated with excessive loading of the knee. This is an occupational injury in many sports. People with a high degree of obesity, older than 60 years, almost always have arthrosis of one degree or another due to constant microtrauma. Arthrosis refers to occupational diseases in areas where a person has to stand for a long time or lift heavy objects. The disease can start after rheumatoid arthritis.
The most common cause of knee arthrosis is an injury. The second most common is dysplasia in childhood. Inflammation caused by autoimmune pathologies is the third source of arthrosis. There are usually multiple 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, and if the cause is determined, secondary arthrosis is diagnosed.
Development mechanism
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 volume increases. At rest, the intra-articular fluid becomes viscous and the amount decreases. Usually these processes alternate. The cartilage plate, which acts as a pump, squeezes fluid out of the joint when it is loaded, and when it is relaxed, it sucks it up. In this way, 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 becomes thin, cracks and ulcers appear on it;
- The structure of collagen fibers is disturbed, they absorb worse. 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;
- As a person begins to take care of their knee and move around less, 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 occurs. The pain is especially strong in the morning and after prolonged immobility.
Stages of arthrosis
There are three degrees of arthrosis:
- Initial 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 the normal load;
- Articular cartilage and menisci begin to deteriorate. Osteophytes - bone formations - grow in the bone. Inflammation and pain appear;
- Difficult phase. 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 fully bend or straighten it. Inflammation and pain are pronounced.
Note!
At the very beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is very limited. Due to the change in the axis of movement, the attachment points of the muscles change. The muscles are deformed - they contract or stretch, they can no longer contract normally. The nutrition of all the tissues of the legs suffers.
Symptoms
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 visit a doctor. The patient notices fatigue and pain, but does not attach 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 a long period of immobility. Relief comes after the patient stretches the knee, massages it and walks around.
After some time, the intensity and duration of the pain increases. A creaking occurs in the joint, it completely stops bending and bending. 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 in the second stage.
If nothing is done, movement becomes possible only with help from the outside. 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 delineated, the lower leg is curved. If you put your hand on your knee, you hear a creaking sound when bending and straightening. When the kneecap moves, it also squeaks. Fluid collects in the cavity, the joint is swollen, 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.
Inspection
The doctor examines the damaged joint, measures the bones and the angle of flexion and determines the degree of mobility of the joints at an angle.
Analysis
The patient is sent for general blood analysis, biochemical blood analysis and general urinalysis.
x-ray
X-ray of the knee joint is the main source of information for making a diagnosis. The photograph shows arthrosis of the knee joint: the joint space is narrowed, the cartilage is sclerotic, the bones are damaged; joint deformation, salt deposition and dystrophic changes occur. Osteophytes are clearly visible in the picture.
Good to know!
For arthrosis of traumatic origin, X-rays have a great diagnostic value and must be done.
Ultrasound
Ultrasound diagnostics is an informative method. Ultrasound does not replace X-rays and does not give an image of the nature of the destructive process in the joint.
MRI
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 its high cost.
Treatment
Treatment of the knee joint for arthrosis is carried out on an outpatient basis, hospitalization is not required.
Treatment regimen:
- Reduce the load as much as possible;
- Adhere to the prescribed mode of traffic;
- Perform therapeutic exercises.
The goal of treatment is to slow down the process of destruction, prevent contractures (impossibility of fully bending and straightening the leg), and, if possible, restore joint function. During the rehabilitation 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 alleviated by NSAIDs (non-steroidal anti-inflammatory drugs).
Good to know!
Because arthritis causes severe pain, NSAID injections provide a quick effect and a sense of relief.
Modern treatment of knee arthrosis includes the use of non-steroidal anti-inflammatory drugs from another group. Their effect is more pronounced.
If inflammation of the joint mucosa occurs, 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, ovamin, 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 properties of the synovial fluid that cushions the impact.
Chondroprotectors are often prescribed, but there is no evidence that they help.
Physiotherapy
The latest methods of treatment of knee arthrosis do not exclude proper loading. The goal of physical therapy is to ensure the necessary amount of movement, but not to 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 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 physical therapy procedures have proven to be excellent, especially if they can be started in the first stage.
Other methods
Intraosseous blocks provide a therapeutic effect, interrupting the cycle of inflammation. Along with the blockade, multi-channel electromyostimulation using a special device is used.
Poultices made from 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 an unconventional approach claim that it is possible to remove symptoms and treat arthrosis of the knee joint only with their methods - without resorting to drugs. These are kinesitherapy (a special set of exercises), ozonotherapy (physiotherapy with the help of 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 methods of treatment, but reviews about them differ.
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 by all means, in most cases the answer to the question "can arthrosis of the knee joint be cured" is positive.
Prevention consists of timely help for injuries, active movement without overloading and maintaining an optimal body mass index.
Patient opinions
Reviews of patients who underwent traditional treatment are usually positive, but there are also negative ones.
When making a final decision about 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 in the last century inevitably led to disability. With arthrosis of the knee joint, it is important to seek help in time in order to determine the stage of the disease and the scope of treatment.