The joints of the human body withstand daily stress, so they become susceptible to various types of destructive factors. Osteoarthritis is common among joint diseases, and affects both large and small joints. Osteoarthritis of the knee joint is a degenerative-dystrophic damage to the knee joint, in which its motor activity is impaired. In the absence of appropriate treatment, the disease can lead to disability.
Because the disease causes characteristic deformities in the joint, it is called deforming arthrosis of the knee joint, which rightly describes a typical characteristic of the pathology. The disease is chronic and is more often diagnosed in women, moreover, those with overweight and venous pathologies of the lower extremities, but there may be other reasons. Due to age changes, it also occurs in the elderly.
Osteoarthritis in young people can be caused by injuries. As a result of degenerative-dystrophic changes, the cartilage softens, peels and becomes covered with cracks of different depths. After that, it ceases to perform its function.
Reasons
Various causes lead to the appearance of deforming arthrosis of the knee joint. Traumatic factor is a common cause. Post-traumatic osteoarthritis can develop as a result of dislocation or fracture in the specified area, as well as meniscus injuries. Usually, gonarthrosis of the knee joint occurs in young people who are actively involved in sports or in those people whose work is associated with increased mobility, lifting and carrying heavy loads.
Few people know that such damage can be a consequence of treatment, when the injury itself has already healed, but during prolonged immobilization of the extremities, there was a disturbance of circulation in this area. This caused gonarthrosis.
Increased physical activity in the knee is one of the leading factors in the development of the disease. It most often affects athletes who have constant active loads on the knee. At a young age osteoarthritis can not manifest itself, usually rapid changes begin after cessation of physical activity.
There is also a risk of disease in those people who do not reduce the load on the joints even in adulthood. In such athletes, the risk of fractures and dislocations increases, microtraumas occur. Therefore, after forty years, doctors recommend athletes to reduce the load, switch to training. Running and squats are best avoided, as these are the activities that put the most strain on the knee joint. One limb is most often affected and left gonarthrosis or right gonarthrosis occurs.
An important factor in the development of osteoarthritis of the knee joint is the removal of the meniscus. If the menisci are removed for some reason, then in 90 percent of cases it leads to the appearance of arthrosis - the so-called knee loop occurs in which the ankle joints experience greater friction than usual.
The problem of excess weight is also relevant for people with osteoarthritis. Being overweight puts unnecessary pressure on the joints. As a result, it is not the cartilage itself that is damaged, but the meniscus. And with a combination of overweight and varicose veins of the lower extremities threatens the emergence of acute osteoarthritis.
Weak ligament apparatus in some patients is an innate feature, and sometimes the ligaments are affected due to other diseases. In one way or another, weak ligaments cause increased mobility in the joint, due to which the joint surfaces are significantly abraded. The effects of weak ligaments may not be felt for long until patients experience symptoms of true osteoarthritis.
Joint pathologies also lead to the development of disease. The most common cause of osteoarthritis is arthritis - inflammation of the joints. In arthritis, typical signs are observed - deterioration of the composition of synovial fluid, pathological changes in cartilage, swelling, redness of soft tissues. Even after osteoarthritis is cured, chronic processes lead to arthrosis.
Injuries to metabolic processes often lead to pathologies of the musculoskeletal system. Bones and joints lack the nutrients and minerals that are so essential for tissue strength. With their deficiency, bones and cartilage are susceptible to destructive processes, and even with a small load, primary arthrosis occurs.
Symptoms
Osteoarthritis of the knee joint is manifested by a complex of characteristics that are difficult to miss. Signs are felt not only in the first stage of pathology, but the second and third stages give clear symptoms of osteoarthritis of the knee:
- bol- one of the key characters that does not appear immediately. Interestingly, with the development of osteoarthritis, pain cannot be felt for even months or years, until the disease worsens. Usually, the first signs of pain are discomfort during physical exertion, walking or running, but it also manifests itself when the meniscus is tight. In the second stage of arthrosis, the pain in the joint is felt more strongly, and in the third stage of development, painful sensations appear even at rest. The attacks worsen even after short walks without a heavy load on the joint, so patients try to spare their knees;
- deformations- manifestations become more pronounced in the third phase of arthrosis development. The knee will retain its normal shape, but will look slightly swollen and edematous. When arthritis joins, the knee will become red, hot and painful to the touch;
- crunchingin arthrosis it occurs in the second and third stages of the disease. Crispy sounds are different from the healthy clicks that can sometimes be heard when the knee is stretched and bent. In osteoarthritis, the symptoms are characterized by a dry, rough sound that occurs suddenly and is accompanied by pain;
- synovitis- accumulation of a certain amount of fluid in the joint cavity. It is there and it is normal. But the accumulation of excess leads to the development of cysts - the most noticeable Baker's cyst, which can be determined in the unbended position of the leg;
- limited knee mobility- a typical sign of pathology, since patients first try to consciously protect themselves from pain, and in the late stage of arthrosis they cannot correct the limb at all. In the third stage of development, deforming osteoarthritis of the knee joint (DOA) completely leads to loss of movement. Patients adapt to the movement on bent legs, with the use of support.
Degrees of development
Osteoarthritis of the knee joint goes through three stages in its development.
In arthrosis of the 1st degree, the pain is insignificant and occurs only during active physical exertion on the knee joint. Already in the first degree, fluid can accumulate in the cavity, which is already a cyst in the second and third. With progression, the pain occurs during movement, but passes quickly. Externally, the deformity of the knee joint is invisible, so the diagnosis of osteoarthritis of the knee joint can be difficult.
In second degree disease, cartilage damage is more significant. If you do an X-ray, then the phase of bone growth is already visible on it. With each movement, a sharp sudden pain appears in the knee, but, returning to a comfortable position, the knee no longer hurts. In the second stage of DOA, you may hear a squeak typical of osteoarthritis. Progression worsens problems with knee extension and flexion. The deformation becomes visible from the outside.
Third-degree osteoarthritis of the knee joint is characterized by significant thinning of cartilage tissue. Gradually, the cartilage wears out so much that the bone is exposed in some areas. The X-ray image shows a significant amount of osteophytes - bone growths, salts that have appeared in the joint cavity. From the outside, the changes are clearly visible and the patient is worried about the constant pain. It is not difficult to make a diagnosis - a visual examination and X-ray control are enough.
As this stage progresses, osteoarthritis can lead to complete loss of functionality. Osteoarthritis of the knee joint may be associated with any stage of pathology development.
Treatment
Overcoming knee arthrosis is not easy, especially if the disease has progressed or inflammation has joined and arthritis has developed.
conservative
The group of the most active drugs against osteoarthritis are nonsteroidal anti-inflammatory drugs. These are primarily cyclooxygenase-2 inhibitors, they can perfectly alleviate inflammation, swelling and contribute to faster recovery.
These drugs have significant limitations, so they should not be used without a doctor's recommendation. For example, they are able to worsen stomach ulcers, heart disease, urinary tract pathology. Non-steroidal anti-inflammatory drugs are also prohibited during pregnancy.
Another group of agents are chondroprotectors, which improve the characteristics of cartilage tissue. They are used in arthrosis to restore the proper structure of cartilage, because in the process of resolving it it loses very important components - chondroitin and glucosamine. Therefore, almost all chondroprotectors contain both of these substances, but some preparations are one-component.
With the help of these drugs, it is possible to help the patient in the first and second phase of the development of the disease, but not in the third, when irreversible changes have occurred.
During conservative therapy, the doctor will also give recommendations on diet. If the patient or patient is overweight, it is necessary to adhere to the diet in order to normalize the weight. How to strengthen a stable weight - the doctor will say. It is also not recommended to eat a lot of salt, but it is better to fill the diet with calcium, vitamins and minerals. They want, they want to be useful.
Operational
The most common type of arthrosis surgery is arthroscopy, but other interventions are also performed. Treatment of osteoarthritis of the knee is usually carried out in the second and third degree, when conservative therapy no longer helps.
If minimally invasive intervention is required, for example, when fluid accumulates in the knee joint, a puncture can be performed. A puncture is made in the cavity of the knee joint and the excess fluid is pumped out. This method can also diagnose the disease and at the same time apply it in treatment. In the initial phase, the fluid is taken in a minimal amount, but that already significantly improves the well-being of the patient. Then, after examining the biomaterial, the other part is removed, and corticosteroids are injected into the joint cavity.
Arthroscopy is the most common. Through a small incision in the skin, several instruments are introduced that enable the examination of the joint and the necessary manipulations in it. With the help of arthroscopy, it is possible to remove tissue particles that have separated from the cartilage, but there is always a risk of secondary gonarthrosis.
In severe cases, periarticular osteotomy should be reported. It is a large-scale impact on the wrist, as a result of which a small file is placed at the desired angle. After the operation, the rehabilitation is longer, but the effect lasts longer.
Significant destruction of the joint elements leads to complete immobilization of the extremities. The joint does not perform its function, which means that it needs to be replaced and surgery performed. Knee endoprosthesis is an expensive operation, but in itself allows the patient to return to movement in the limb. Various knee prostheses are installed - plastic, ceramic or metal. These are durable structures that allow you to forget about the problem for decades.
Physiotherapy
Physiotherapy methods can be used only when the acute period has passed and the patient is recovering.
Methods that are actively used include:
- ozone therapy- exposure of the affected joint to ozone, and the substance can be injected or used as an external treatment. This type of help to patients is very effective, so it is often used in the treatment of various pathologies, including arthrosis. The treatment enables the activation of blood circulation in the problem area, achieving anti-inflammatory and analgesic effect. Glucocorticoid therapy is given at the same time;
- kinesiotherapy- treatment is carried out with the help of a special set of exercises. The load is formed taking into account individual data, and special simulators that strengthen the joints are used when performing exercises. The difference between kinesiotherapy and physiotherapy exercises is the active action not only on osteoarthritis of the knee, but also on the whole body as a whole.
Apply not only ozone therapy and kinesiotherapy, but also physical therapy. Good results are given by the author's methods of exercises for removing knee arthrosis. During and after the exercises, you may need to wear a special knee orthosis - an orthosis to strengthen the right or left knee joint.