The joints of the human body withstand daily stress, so they become susceptible to various types of destructive factors. Among joint diseases, osteoarthritis is common and affects both large and small joints. Osteoarthritis of the knee joint is degenerative-dystrophic damage to the knee joint, in which its motor activity is impaired. In the absence of adequate treatment, the disease can lead to disability.
Since the disease causes characteristic deformities in the joint, it has been called deforming osteoarthritis of the knee joint, which aptly describes the typical feature of the pathology. The disease is chronic and more often diagnosed in women, moreover, in those suffering from overweight and venous pathologies of the lower limbs, but the reasons may be other. Due to age-related changes, it also occurs in older people.
Osteoarthritis in young people can be triggered by injury. Following degenerative-dystrophic changes, the cartilage softens, exfoliates and becomes covered with cracks of varying depth. It subsequently ceases to perform its function.
The reasons
Various causes lead to the appearance of deforming osteoarthritis of the knee joint. The traumatic factor is a common cause of occurrence. Post-traumatic osteoarthritis can develop due to a dislocation or fracture in the specified area, as well as a meniscus tear. Usually, gonarthrosis of the knee joint appears 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 also be the result of treatment, when the injury itself has already been cured, but during prolonged immobilization of the limb, circulatory disorders occurred in this area. For this reason gonarthrosis appeared.
Increased physical activity on the knee is one of the main factors in the onset of the disease. It most often affects athletes who have constant active loads on the knee. At a young age, osteoarthritis may not manifest itself, usually rapid changes begin after the cessation of physical activity.
There is also a risk of disease in those people who, even in adulthood, do not reduce the load on the joints. In such athletes, the risk of fractures and dislocations increases, microtraumas appear. Therefore, already after forty years, doctors recommend athletes to reduce the load, switch to training. It is best to avoid running and squats, as these are the activities that put the most strain on the knee joint. Most often, a limb is affected and left-sided gonarthrosis or right-sided gonarthrosis occurs.
An essential factor in the development of osteoarthritis of the knee joint is the removal of the menisci. If for some reason the menisci were removed, then in 90 percent of cases this leads to the appearance of arthrosis - the so-called knee loop occurs, during which the joint joints experience more friction than usual.
The problem of excess weight is also relevant for people with osteoarthritis. Excess body weight puts unnecessary pressure on the joints. As a result, not the cartilage itself is damaged, but the meniscus. And with a combination of excess weight and varicose veins of the lower extremities, acute osteoarthritis threatens to appear.
Weak ligament apparatus in some patients is a congenital feature and sometimes the ligaments are affected due to other diseases. One way or another, weak ligaments cause increased mobility in the joint, as a result of which the joint surfaces are significantly abraded. The consequences of weak ligaments may not be felt for a long time until patients experience symptoms of true osteoarthritis.
Joint pathologies also lead to the development of the disease. The most common cause of osteoarthritis is arthritis - inflammation of the joint joints. With arthritis, typical signs are observed: deterioration of the composition of the synovial fluid, pathological changes in cartilage, swelling, redness of soft tissues. Even after cured osteoarthritis, chronic processes lead to the appearance of osteoarthritis.
Violations of metabolic processes often lead to pathologies of the musculoskeletal system. Bones and joints lack the nutrients and minerals that are so necessary for tissue strength. With their lack, the bones and cartilage surfaces are subject to destructive processes, therefore, even with a slight load, primary osteoarthritis appears.
Symptoms
Osteoarthritis of the knee joint is manifested by a complex of features that are difficult to miss. The signs are felt not only in the first degree of development of the pathology, but already the second and third degrees give distinct symptoms of osteoarthritis of the knee joint:
- ache- one of the key signs that does not appear immediately. An interesting fact is that with the development of osteoarthritis, the pain may not be felt even for several months or years, until the disease gets worse. Usually the first signs of pain are discomfort during physical exertion, walking or running, but it also occurs when the meniscus is pinched. With the second degree of arthrosis, pain in the joint makes itself felt stronger, and with the third degree of development, painful sensations appear even at rest. Attacks worsen even after short walks without a strong load on the joint, so patients try to spare the knees;
- deformations- manifestations become more pronounced in the third stage of the development of arthrosis. The knee will retain its normal shape but will appear slightly swollen and edematous. When arthritis joins, the knee turns red, becomes hot and painful to the touch;
- crunchwith arthrosis appears in the second and third degree of development of the disease. Crunchy sounds are different from the healthy clicks that can sometimes be heard when the knee is extended and flexed. In osteoarthritis, the symptoms are characterized by a dry, rough sound that occurs abruptly and is accompanied by pain;
- synovitis- accumulation of a certain amount of fluid in the joint cavity. There is and it is normal. But the accumulation of an excess amount leads to the development of a cyst - the most noticeable Baker's cyst, which can be determined in the unbent position of the leg;
- limited knee mobility- a typical sign of pathology, since patients first try to protect themselves from pain consciously, and in the advanced stage of arthrosis they cannot straighten the limb at all. In the third degree of development, deformation of osteoarthritis of the knee joint (DOA) completely leads to loss of movement. Patients adapt to move on bent legs while using the means of support.
Degrees of development
Osteoarthritis of the knee joint goes through three stages of its development.
With 1st degree osteoarthritis, pain is insignificant and occurs only with active physical exertion on the knee joint. Already in the first degree, liquid can accumulate in the cavity, which in the second and third is already a cyst. With progression, pain occurs during movement, but it passes quickly. Externally, the deformation of the knee joint is invisible, so the diagnosis of osteoarthritis of the knee joint can be difficult.
With second-degree disease, the damage to cartilage tissue is more significant. If an x-ray is taken, the stage of bone growth is already evident on it. With any movement, sudden severe pain appears in the knee, but, returning to a comfortable position, the knee no longer hurts. In the second stage of DOA, you can hear a crunch typical of osteoarthritis. With progression, knee extension and flexion problems worsen. The deformation becomes evident externally.
Third degree knee joint osteoarthritis is characterized by significant thinning of the cartilage tissue. Gradually, the cartilage wears out so much that the bone is exposed in some areas. An X-ray image shows a significant amount of osteophytes - bone growths, salts that have appeared in the joint cavity. Outwardly, the changes are clearly visible, and the patient is worried about constant pain. It is not difficult to make a diagnosis - a visual examination is enough and X-ray control is performed.
As this degree progresses, osteoarthritis can lead to a complete loss of function. At any degree of development of the pathology, osteoarthritis of the knee joint can join.
Treatment
Coping with osteoarthritis of the knee joint is not easy, especially if the disease is advanced or inflammation has joined and arthritis has developed.
conservative
The group of the most active drugs against osteoarthritis are non-steroidal anti-inflammatory drugs. These are mainly cyclooxygenase-2 inhibitors, they can perfectly relieve inflammation, swelling and contribute to a speedy recovery.
These drugs have significant limitations, so they should not be used without a doctor's recommendation. For example, they are able to exacerbate stomach ulcers, heart disease, pathologies of the urinary organs. Non-steroidal anti-inflammatory drugs are also prohibited during pregnancy.
The second group of agents are chondroprotectors that improve the characteristics of cartilage tissue. They are used for osteoarthritis to restore the correct structure of cartilage, because in the process of resolution 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 medicines it is possible to help the patient in the first and second stages 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 nutrition. If the patient or patient is overweight, it is imperative to follow a diet to normalize the weight. How to strengthen a stable weight - the doctor will also tell. It is also not recommended to eat a lot of salt, but it is better to replenish the diet with calcium, vitamins and minerals. Jelly, jelly will be useful.
Operating
The most common type of osteoarthritis surgery is arthroscopy, but other surgeries are performed. Treatment of osteoarthritis of the knee joint is usually carried out in the second and third degree, when conservative therapy no longer helps.
If minimally invasive surgery is needed, for example, when fluid builds up in the knee joint, a puncture can be done. A puncture is made in the cavity of the knee joint and excess fluid is pumped out. This method can both diagnose a disease and simultaneously apply it for treatment. Liquid is taken at the initial stage in a minimal amount, but this already significantly improves the well-being of patients. Then, after examining the biomaterial, another part is removed and corticosteroids are injected into the joint cavity.
Arthroscopy is the most common. Through a small incision in the skin, several tools are introduced that allow for the examination of the joint and the necessary manipulations in it. With the help of arthroscopy, it is possible to remove the tissue particles that have separated from the cartilage, but there is always a risk that secondary gonarthrosis will appear.
With severe damage, it is necessary to perform a periarticular osteotomy. This is a large-scale impact on the joint, as a result of which it is slightly filed and set 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 limb. The joint does not perform its function, which means that it must be replaced and an operation must be performed. Knee joint endoprosthesis is an expensive operation, but by itself it allows you to bring the patient back to movement of the limb. Various knee prostheses are installed: plastic, ceramic or metal. These are durable structures that allow you to forget about the problem for several decades.
Physiotherapy
Physiotherapy methods can be used only when the acute period has passed and the patient is on the mend.
Methods actively used include:
- ozone therapy- exposure to the affected joint with ozone and the substance can be injected or used as an external treatment. This type of patient care is very effective, so it is often used in the treatment of various pathologies, including osteoarthritis. The treatment allows you to activate blood circulation in the problem area, to achieve an anti-inflammatory and analgesic effect. At the same time, glucocorticoid treatment is carried out;
- kinesitherapy- the treatment is carried out with the help of a special set of exercises. The load is formed taking into account individual data, and when performing exercises special simulators are used that strengthen the joints. The difference between kinesitherapy exercises and physiotherapy exercises is the active effect not only on knee osteoarthritis, but also on the whole body as a whole.
Apply not only ozone therapy and kinesitherapy, but also physical therapy. Good results are given by the author's methods of exercises to eliminate osteoarthritis of the knee. During the exercises and after them, it may be necessary to wear a special knee brace - an orthosis, to strengthen the right or left knee joint.