Depanten Official site
Share this

Osteoarthritis of the knee joint

arthrosis of the knee joint on x-ray

Osteoarthritis of the knee joint is a specific disease that has a destructive effect on the cartilage of the knee joint.

When such a disease occurs, doctors observe serious disturbances in the processes of blood circulation in the bone vessels, as a result of which deformation and destruction of cartilaginous tissue occurs, the person feels severe pain that limits any movement of the legs and knees, and observes swelling and changes in the appearance of the knees.

To prevent the development of serious consequences of gonarthrosis (deformation of the limb and ankylosis - immobilization of the joint), when only joint replacement surgery can help the patient, the disease must be timely identified and treated.Moreover, treat not independently with folk methods and advertised remedies, but under the supervision of qualified doctors.

What are the reasons?

The mechanisms of arthrosis in medicine are usually divided into:

  • Primary- which occurs at an advanced age due to the natural aging of body tissues and against the background of some factors that provoke this disease, such as obesity (10% of cases), heredity and increased stress throughout life.
  • Secondary- represents 30% of all cases of arthrosis of the knee joint;it usually occurs after an injury, a fracture of the tibia, torn ligaments or damage to the meniscus.In addition, with such arthrosis of the knee joint, the symptoms of the disease appear in most cases after 3-4 years, but after a serious injury it is possible even after 2-3 months.

In 50-60% of cases, the cause of arthrosis of the knee joint is a spasm of the muscles of the anterior surface of the thigh.

What happens to the knee joint with osteoarthritis?

With excessive regular loads, genetic predisposition, metabolic disorders in the body, prolonged muscle spasms and injuries, the knee cartilage loses its smoothness and begins to thin.The soft sliding of the jointed bones is replaced by strong friction and the first degree of gonarthrosis develops, in which the cartilage loses its shock-absorbing properties.

The degradation process continues to progress and poor shock absorption leads to flattening of bone surfaces with the formation of osteophytes in the form of bone growths.In this case the disease already has a second degree and is accompanied by degeneration of the synovial membrane and joint capsule.The lack of pumping and movement atrophies the structure of the knee joint, the consistency of the knee fluid becomes more viscous, the process of cartilage nutrition is disrupted, which leads to an even greater worsening of the patient's condition.

The thinning of the cartilage leads to a reduction in the distance between the articulating bones by up to 80%.While walking, due to abnormal friction and the absence of shock absorbers, destructive processes in the joint increase rapidly, this quickly leads to the development of the third degree of arthrosis with pronounced symptoms:

  • Pain during movements, especially when going up or down stairs.
  • Pain both during physical activity and at rest, morning stiffness.
  • The patient begins to limp, trying to spare the painful joint.
  • Severe cases of the disease require the use of crutches or a cane.

The third degree of arthrosis of the knee joint is characterized by an almost complete absence of cartilaginous tissue, which leads to a minimal decrease in joint mobility.Therefore, no magical methods, supermedicines or ointments can restore worn cartilage tissue, and given the degree of bone deformation, normal functioning of the joint is impossible.In this case only surgery can help.

destruction of the knee joint due to arthrosis

Stages of osteoarthritis

As arthrosis progresses, the following stages or degrees are distinguished:

  • The initial stage, or stage 1, is often called compensated, since there are no pronounced clinical signs of pathology yet.The patient may experience discomfort in the knees after physical activity, which quickly disappears after rest;the joints are still fully functional.
  • With grade 2, undercompensated arthrosis, the symptoms of the disease intensify.A pronounced painful syndrome is formed, which, however, is relieved by locally used anesthetic ointments and gels.Motor activity is impaired and joint instability appears.In the vast majority of cases, patients turn to doctors at this stage.
  • The 3rd degree, decompensated, can also be called deforming.The knee joint is twisted, unstable, immobile and completely non-functional.The pain syndrome is constant and requires serious medical intervention.To unload the joint and move, a person needs a cane.

Symptoms and first signs

Depending on the severity of the symptoms, the development of the disease is divided into 3 stages.Symptoms of the early development of gonarthrosis vary greatly and are nonspecific.

In the first stage of the pathology, the following signs are possible:

  1. knee pain when squatting or climbing stairs;
  2. joint pain after prolonged exercise or cooling down;
  3. the knee may hurt at the end of the day or in the morning;
  4. stiffness and pain in the morning disappear after daily work.

Subsequently, the characteristic symptoms of stages 2 and 3 appear (in ascending order):

  • the pain becomes acute and prolonged;
  • swelling in the joint area;
  • fluid may appear in the joint;
  • between the articular surfaces, pinching of particles of cartilage, meniscus, synovial villi is possible, as a result of which strong immobility occurs (it can also pass abruptly);
  • it's hard to step on your toe;
  • joint immobility develops.

Consequences

If left untreated, the following complications of knee osteoarthritis may develop:

  • Joint deformity.As a matter of fact, joint deformation is more likely not a complication, but the last stage of the disease.
  • Infection in a joint.Infection usually occurs due to microtrauma.They can be considered small cracks in the cartilaginous tissue.Pathogenic microorganisms are introduced into the joint through the flow of blood or lymph from other areas.This often occurs after infectious diseases.
  • Dislocations and fractures.These complications are explained by dysfunction of the knee joint.With osteoarthritis there is no uniform distribution of load from the femur to the bones of the lower leg.The ligaments that normally strengthen the joint also weaken.For this reason, at some point (even during normal walking), the bones of the lower leg may be subjected to excessive stress, which will lead to a fracture or dislocation.To avoid this, people with severe structural and functional disabilities of the knee joint should move with the help of a crutch or cane.
  • Ankylosis.Ankylosis is the fusion of two bones where a joint once existed.This complication is perhaps the most serious, as the joint simply disappears.The tibia and femur gradually fuse and the tibia is fixed in one position.Movement, of course, is impossible.

Diagnostics

To diagnose gonarthrosis use:

  • blood tests (general and biochemical);
  • radiography;
  • arthroscopy;
  • Ultrasound;
  • magnetic resonance imaging.

The most important diagnostic method for confirming the diagnosis of gonarthrosis is x-ray.Although it is not possible to examine the initial stages of the disease and the state of cartilage tissue on X-rays, nevertheless, bone changes of stages 2 and 3 are clearly visible.This:

  1. narrow joint space;
  2. marginal spines located along the contour of the bones, edges of the patella - osteophytes;
  3. changes in the periosteum;
  4. change in the height of one of the condyles and others.

However, the changes can be examined in more detail by arthroscopy.

Ultrasound and MRI help detect changes in the soft tissues of the knee joint during early osteoarthritis.These methods also provide a good indication of the condition of the cartilaginous tissue, synovium and fluid.

How to treat osteoarthritis?

Treatment for osteoarthritis of the knee joint is long and sometimes painful.The duration is due to the fact that once the disease has manifested itself, it will be constantly remembered for as long as the person lives.

Therefore, to adequately treat gonarthrosis, you need a fairly solid financial foundation and discipline.An important role is played by the seriousness with which the patient takes treatment, since often, in order to reduce the frequency of exacerbations of the disease, the patient is forced to change his daily activity, favorite profession, engage in joint development, stop smoking and drinking alcoholic beverages.

There are three main stages in the treatment of deforming arthrosis of the knee joint.

The first phase of treatment includes:

  • communicate to patients the essence of their disease, risk factors and secondary prevention measures;
  • daily gymnastics with stretching elements;
  • contrast shower;
  • swimming in the pool 2 – 3 times a week;
  • weight loss.

The second phase of treatment includes:

  • external fixation of the joint using forceps, bandages, elastic bandages and orthoses;
  • the use of ointments and creams based on non-steroidal anti-inflammatory drugs to relieve inflammation and pain;
  • the use of drugs from the group of chondroprotectors to reduce the rate of cartilage destruction.

The third phase of treatment includes:

  • course use of oral NSAIDs;
  • intra-articular injections with hormonal anti-inflammatory drugs;
  • additional use of drugs with a pronounced analgesic effect;
  • surgical replacement of a diseased joint with an implant.

Along with drug treatment, modern medicine uses such methods as:

  1. Kinesitherapy.In this case, treatment of arthrosis of the knee joint is carried out using special exercises.The load is selected based on the degree of development of the disease and the physical fitness of the patient individually.
  2. Ozone therapy.This is an effect on a sore knee joint using ozone.With this method of physiotherapy treatment the substance can be administered by injection or used externally.
  3. food supplement.Biologically active supplements are a valid alternative to other drugs.
  4. Homeopathy.It involves taking drugs in small doses.The course of treatment lasts only a few weeks, but during this period, provided that the drugs are properly selected, blood circulation and normal nutrition of cartilage tissue cells are completely restored.
  5. Exercisesallow you to improve blood circulation in the knee joint, restore the elasticity of the ligaments, improve the nutrition of the cartilaginous tissue cells and promote their restoration.

Pharmacological treatment

All drugs used in the treatment of gonarthrosis can be divided into those that help eliminate the main symptoms of the disease and those that restore the function of the knee joint and prevent the progression of the pathology.The first type of drugs includes non-steroidal anti-inflammatory drugs and hormonal drugs.The second group includes chondroprotectors and hyaluronic acid.

Non-steroidal anti-inflammatory drugs

Drug treatment of arthrosis begins with eliminating pain.It is they who cause patients the greatest moral and physical suffering and lead to the loss of working capacity.Nonsteroidal anti-inflammatory drugs (NSAIDs) have worked well among painkillers.

Drugs can be used in two ways: topically or orally (in tablets).Local (preferred) treatments often include patches, ointments, or gels.The analgesic effect, as a rule, occurs on days 3-4, and its maximum develops by days 7-10.

The course of treatment with nonsteroidal drugs should be limited to 10-14 days.NSAIDs have a limited field of use and are used with great caution in the treatment of elderly patients.

Hormonal drugs

In cases where treatment with NSAIDs is not sufficient and the disease continues to progress, the doctor may prescribe hormonal injections.They belong to the means of "heavy artillery" and help to quickly eliminate pain, relieve inflammation and swelling of surrounding tissues.

Due to the large number of side effects, hormonal drugs are prescribed in short courses, only during the acute period of the disease, when inflammatory fluid accumulates in the joint cavity.The drug is administered into the joint space no more than once every 10 days.

Chondroprotectors

To prevent further destruction of the cartilaginous surfaces of the joint, chondroprotectors are prescribed.

These medications also help reduce pain and reduce signs of inflammation in the surrounding soft tissues.Furthermore, chondroprotectors slow down the destruction of joint tissues and stabilize the disease thanks to their shock-absorbing and lubricating functions.Chondroprotectors improve cartilage nutrition, normalize the composition and properties of intraarticular fluid, and protect pain receptors from excessive irritation.

Hyaluronic acid

Hyaluronic acid is called intra-articular fluid prosthetic fluid.In its properties it is similar to natural (intra-articular) synovial fluid, which nourishes the cartilaginous tissue and cushions the knee joint during movements.

Hyaluronic acid preparations are injected into the joint, thus creating a thin protective film that prevents the cartilaginous surfaces from rubbing against each other.Injections are given only after the acute phase of the disease has passed.

Physical therapy and exercises for osteoarthritis

Exercise helps restore joint function and strengthen it.They should be done slowly and carefully so as not to cause distortion and not to exceed the allowable load.

The following exercises are considered the most effective:

  1. Slowly lift your straight legs one at a time while lying on your stomach.This exercise uses your thigh and calf muscles.It is not permitted to transfer the load to the rear.You shouldn't raise your legs too much either.The main thing is to tense the muscles at the highest point;
  2. This exercise is similar to the first, only now you should lift your leg with the knee bent.At the highest point the thigh muscles should be further tensed.The exercise must be performed the same number of times on each leg;
  3. Lying on the floor (on your stomach), lift your legs straight, then spread them apart and bring them together.This exercise requires strong and trained abdominal muscles, so it is not suitable for all patients.Additionally, performing it can increase blood pressure.For patients suffering from hypertension or other diseases of the cardiovascular system it is better to avoid it;
  4. To perform the next exercise, you need to lie on your side, bend the leg lying on the floor at the knee, and slowly lift the other and hold it at the highest point.It is important that the angle when running on each leg is the same;
  5. You will need a chair for this exercise.Sitting on it, the legs are straightened one by one, raised and held for the maximum possible time in a straightened position;
  6. It is useful to stand on tiptoe while holding onto the back of a chair or bed.As with other exercises, you need to linger on the highest point for a few seconds and further strain the leg muscles;
  7. The fluid movement from toe to heel activates blood circulation in the lower limbs.Such movements should be performed alternately: while one leg rests on the toe, the other on the heel and vice versa.All movements must be fluid;
  8. Leaning back in a chair or bed, stand on your heels for a minute, lifting your toes.If you cannot hold this position for the specified time, you should start with less, gradually increasing it;
  9. Massage that is performed in a standing position.The legs should be massaged with vigorous movements directed from the knee to the thigh.It is necessary to complete the massage by stroking the skin.

The doctor will conduct several sessions in the office and demonstrate basic techniques so that the patient can massage the problem knee on their own.Competent actions improve the condition of the damaged area.

Massage and self-massage

Perform self-massage with the palm of your hand, the edge of your palm, your fingertips or your fist.Gently act on the painful knee, maintain strong pressure on the affected area: strong pats, blows, active kneading of the tissues often worsen the condition.

Basic techniques:

  • the first phase is a slight clockwise movement, the second phase is a circular counterclockwise movement;
  • Press one palm on the sore knee, tap it lightly with the fingertips of the other hand;
  • maintain the initial position of the palm, touching not with the fingers, but with the edge of the palm;
  • gently stroke the knee in a circle, gradually increase the pressure (but in moderation);
  • During therapy, massage the affected area twice a day for 10-15 minutes.For preventive purposes it is sufficient to perform a light massage once every 7 days.

Before the procedure, apply an ointment or gel with anti-inflammatory effect to the sore knee.

Physiotherapy treatment

All physiotherapy methods can be divided into several groups:

  1. Reduce pain;
  2. Reduce inflammation;
  3. Restore nutrition to the joint and accelerate the restoration of joint function.

The doctor can determine what type of treatment the patient needs based on existing symptoms and concomitant diseases.

Surgery for osteoarthritis

Surgical treatment refers to radical methods that partially or completely restore the functioning of the knee joint.Surgical treatment methods differ from each other in the degree of intervention in the affected joint.

  1. Arthroscopyrefers to the most gentle methods of surgical treatment.This technique is less traumatic and can be used as a therapeutic measure even in the early stages of arthrosis.Its main goal is to prolong the life of the damaged joint.Arthroscopy is performed using an endoscope, a flexible probe with a camera at the end.Small punctures are made in the knee joint, through which an endoscope and auxiliary instruments are inserted.During the operation, damaged areas of tissue that cause pain are removed.The operation is more suitable for young people and, if necessary, can be repeated several times.
  2. Endoprosthesisrefers to the most radical surgical techniques.In this case, complete restoration of joint function occurs by replacing the entire knee joint or part of it with an implant.This method is the best alternative to the previously existing technique - arthrodesis (complete immobilization of the damaged joint).Currently, endoprosthesis replacement provides up to 90% positive results and significantly improves the quality of life of patients.
  3. OsteotomyIt is used when significant deformations have developed in the joint and the function of the joint is significantly impaired.An osteotomy involves the creation of an artificial bone fracture in a predetermined position.Subsequently the parts of the bone are aligned in the correct and physiological position and left to grow together.Sometimes artificial fixators of bone fragments can be used during the operation, which contribute to a more stable position of the bone.

Folk remedies

Traditional medicine will also help you.The use of various lotions to relieve swelling and pain has long been practiced by many patients.Here are some useful recipes:

  1. Burdock leaves.Take 5 burdock leaves and place them over boiling water to steam them.Lubricate the sore knee with vegetable oil and apply steamed leaves.Wrap your leg with cling film and a warm scarf.Leave the lotion on for a couple of hours.
  2. Cabbage leaf lotion.It is made with fresh cabbage leaves soaked in May honey and applied to the thigh.The therapeutic effect is strengthened by insulation in woolen fabric or plastic film.This product is suitable for people of all ages.
  3. Egg shells, kefir.Grind the shells of 2 eggs and mix with 1 tablespoon of kefir.Apply the mixture to your knee, wrap it with a cloth and cling film and lie down under a blanket.Leave it like this for a couple of hours, then rinse the composition with water.This treatment can be used daily.
  4. Horseradish compress.According to this popular recipe, to enhance the medicinal properties of horseradish, it is recommended to crush and boil it first.Then it must be applied to the affected area.
  5. Turpentine– an excellent warming agent for aching joints.The knee is rubbed with turpentine before going to bed and tied with a woolen scarf.Already after the first procedure the patient experiences significant relief.The course of treatment is selected individually for each person.

Diet

The therapeutic diet involves the avoidance or minimal consumption of canned, smoked and fried foods (to suppress appetite).To restore damaged cartilage, it is necessary to provide the body with complex carbohydrates (baby food, whole grain products).Juices (carrot, beetroot, apple) should also be included in the diet.They will remove toxins from the body and reduce the impact of inflammatory processes.

The diet should include fish and gelatin, which act as a kind of chondroprotector and help create new cartilage.It is worth remembering that you cannot prescribe a diet for yourself - only a nutritionist (dietary specialist) can choose the best option.

Example menu:

  • Breakfast: oat flakes with water without butter or sugar, fruit juice, boiled egg;
  • Second breakfast: a glass of low-fat natural yogurt;
  • Lunch: steamed meat or fish, stewed vegetables, tea without sugar;
  • Afternoon snack: cottage cheese casserole with nuts, a glass of fruit juice;
  • Dinner: vegetable salad, apple, tea without sugar;
  • Second dinner: a glass of low-fat kefir.

Prevention

Prevent joint diseases:

  • measure the load on the legs during active sports;
  • create a diet that includes foods and dishes containing calcium, magnesium, gelatin;
  • if the work involves lifting or moving heavy objects, follow the safety regulations and do not carry loads exceeding a certain limit;
  • Perform self-massage regularly to prevent arthrosis, especially in case of constant stress on the legs;
  • eat well, limit “harmful” foods;
  • body weight control (excess weight means additional stress on the joints);
  • Undergo regular exams and treat acute and chronic diseases.

Forecast

Provided that arthrosis of the knee joint is diagnosed in the early stages, the cause of the pathological process is eliminated and adequate treatment is provided, the prognosis is favorable.The therapy provided allows you to achieve long-term remission, but the treatment is usually lifelong.

In the absence of the necessary treatment, as well as if the patient does not comply with the doctor's prescriptions, arthrosis of the knee joint becomes a cause of disability.