Signs, causes, extent and treatment of osteoarthritis of the knee joint
The legs are the part of the musculoskeletal system that is subject to the greatest stress. Every day we walk long distances, climb stairs, shifting the entire weight of our own weight to our feet.
The statistical facts about this disease are sad. According to rough estimates, it affects 20 percent of all humanity. And this figure is growing every year. In addition, there is a certain trend towards greater vulnerability of women than men. Potentially dangerous age occurs after 40 years, and after 60 the likelihood of knee dysfunction increases significantly.
Physiological essence of the disease
Ostearthrosis of the knee joint (in medicine there is also a special term - gonarthrosis) is a common disease that is chronic in nature and has a significant destructive effect on the knee joint and the surrounding bone tissue. The disease is accompanied by degenerative changes in the knee hyaline cartilage, which loses its strength and functionality. This happens because osteoarthritis is accompanied by the cessation of the normal supply of cartilage cells with the necessary amount of substances, which causes its degeneration.
After the cartilage disappears completely (this happens after a prolonged inflammatory process), the knee joint completely loses its mobility. This is because the hyaline layer acts as a shock absorber, softening friction between adjoining bone tissues. In a healthy body, hyaline cartilage is an elastic plastic mass that resembles a gel and consists of cells (chondrocytes) and matrix fluid.
The physiological cause of bone disorders in ostearthrosis is the appearance of specific spines on the surface of the exposed bone and further pathological deformity of the knee.
You can often hear another name for knee ostearthrosis - "salt deposition". But this designation is erroneous, because the exchange of calcium salts does not in any way affect the occurrence of deformations.
Content:
- Signs of osteoarthritis of the knee joint
- The degree of osteoarthritis of the knee joint
- Deforming osteoarthritis of the knee joint
- Treatment of osteoarthritis of the knee
Signs of osteoarthritis of the knee joint
The most obvious symptom of the disease is pain attacks in the knees. It is the occurrence of unusual sensations in this part of the legs that indicates the onset of inflammatory and destructive processes in bone tissue.
At first, osteoarthritis can make itself felt only by insignificant sensations of tightness and inhibition of movements during flexion-extension of the legs. At this stage, it is worth focusing only on whether such symptoms have occurred before. Also, a mild form of osteoarthritis is accompanied by a slight resistance of the joints and difficulty in moving them after being stationary for a long time (especially after waking up in the morning). It is the stiffness in the morning hours, when the joints have not yet warmed up, and the fluid has stagnated in between, serves as the main reference point.
Simultaneously with the difficulty in the movement of the joints, a characteristic crunch and clicks occur in them when trying to stretch the legs. Unpleasant pain sensations appear, aggravated by physical activity and in the evening, when the joints get tired from prolonged activity during the day.
As it progresses, fatigue pains during physical activity intensify. During especially severe attacks, pain does not disappear during rest, causing inconvenience even during sleep. The person acquires the characteristic lameness, trying to reduce the load on the knee.
The degree of osteoarthritis of the knee joint
Since the symptoms of the disease at first are rather weak, and then increase with progressive intensity, there is a conventional designation of the three stages of knee ostearthrosis.
Osteoarthritis of the knee joint 1 degree
Pain sensations are not yet apparent, they are rather insignificant and irregular. That is why many people ignore these subtle alarming signals and do not go to the doctors in time. The initial stage is characterized by a feeling of stiffness on the inside of the knee. Perceptible discomfort occurs after resting or sitting, but after a little warm-up everything goes away. Long standing or walking, sports training also cause inconvenience.
Despite the first changes in the condition of the knees, no significant changes in their structure were observed. The functionality remains generally the same.
Knee osteoarthritis grade 2
At this stage, the patient pays attention to a change in his condition. But, alas, even at the intermediate stage, many do not think about a clinical examination and consultation with a specialist. Taking the necessary measures is limited to relieving symptoms with medication and self-treatment.
It is important to take into account that specialized treatment precisely at this stage of the development of the disease can bring the maximum effect and restore the previous physical capabilities of a person.
For the second degree of ostearthrosis of the knee joint, prolonged pain in the flexion of the joint is characteristic, even convulsions are possible, which intensify in the evening and at night. Violations of the integrity of the joint are gradually gaining momentum, and "bumps" appear. From time to time, the patient feels complete disability of the knee, persistent swelling occurs. Even after warm-up, the characteristic crackling sound in the knee does not disappear.
Knee osteoarthritis grade 3
Most serious degree of the disease. It is in this state that the sick nevertheless decide to consult a doctor. Pain syndrome takes on a regular form, it cannot be removed even with the help of strong medications. The patient is uncomfortable in any position (both horizontal and vertical), he practically does not rest, as his legs hurt even in sleep. There is a so-called meteosensitivity of the knee joints to changes in the weather.
At the last stage of osteoarthritis, a person's gait changes noticeably, he is no longer able to step normally and lean on the sore leg. If both legs are affected by the disease, then the further possibility of movement is in question. As a result, a person suffering from osteoarthritis cannot do without a cane or even crutches.
On the subject: Knee pain
Deforming osteoarthritis of the knee joint
The factors directly causing this widespread disease include both external and internal processes.
The most common causes of knee osteoarthritis are:
- Overweight. Obviously, the more a person weighs, the harder it is for his legs to withstand the daily load on them. If the mass is significantly higher than the norm, then the knee joints are subjected to high round-the-clock pressure, which increases significantly during physical activity. Joint tissues do not have time to recover, the process of their destruction and deformation becomes irreversible.
- Ingestion of harmful substances. Smoking and alcoholism affect all processes in the body, including the condition of the cartilage tissue. These substances literally "kill" the building material of hard tissues - chondrocytes. In addition, the use of potent medications can have negative consequences. That is why any course of treatment must be agreed with the attending physician.
- Leg injuries. Bruises and fractures, even at a young age, are extremely dangerous, since their consequences can manifest themselves in decades. In the case of severe injury to the knee joint, post-traumatic arthrosis may develop.
- Congenital knee abnormalities. In addition to various failures in the physiological development of cartilage and bone tissue, dysplastic knee osteoarthritis develops.
- Disruptions in the endocrine system. In the high-risk zone there are carriers of type 2 diabetes, in which metabolic processes in the vessels of the extremities slow down. As a result, the cartilage tissue becomes thinner and loses its elasticity, and the process of arthrosis starts.
- Disturbances in the exchange of the hormone estrogen. This problem is not widespread among girls and young women, since their body independently regulates all processes. But with the onset of menopause, the female body is unable to maintain a rational metabolism in tissues. Lack of estrogen radically changes the principle of joint functioning, which is the main cause of ostearthrosis.
- Diseases of the vascular system. Varicose veins and hypertension adversely affect the supply of nutrients and oxygen to the joint. Plasma lingers around the joint and prevents tissues from regenerating on their own.
On the subject: Joint diseases: types, symptoms and treatment
Treatment of osteoarthritis of the knee
Targeted treatment of knee ostearthrosis must take place both in a complex and segmented directions. The primary goals of the course of treatment are the elimination of the factors provoking the disease, the elimination of advanced inflammatory processes and the restoration of the functionality of the damaged area of the knee. To facilitate an overview of all possible treatments, they can be grouped into three broad groups: physiological, drug, and surgery. Depending on the degree of the disease and the characteristics of the patient, these methods can be combined. In any case, the treatment is selected exclusively by a qualified doctor.
Physiological treatment
At the initial stages, it is effective to use special physical measures that balance the load on the joint, its capabilities and endurance. These methods include regulating physical activity according to changes in cartilage tissue, losing weight, and applying various procedures. It should be noted that light loads are also the best prevention of knee ostearthrosis.
Physiotherapy procedures are carried out exclusively within the walls of specialized medical institutions. The regularity of treatment ensures that blood flow is accelerated in problem areas of the knee, inflammation is reduced and muscle spasms are relieved. Treatment in sanitary conditions includes taking special baths, body wraps and the use of mud compresses. In addition, the patient rests mentally, spending more time in the fresh air and reducing the level of stress shocks.
Correct foot massage can improve the general condition of the patient after a few sessions, relieve pain syndrome, and accelerate the transitivity of nerve signals in the cells of the joint. It is important that the masseur maintains a measured pace when working with the kneecap, subjecting it to minimal force.
Physical therapy strengthens the muscles and maintains the vital functions of the knee joints. Muscle atrophy carries a potential danger for a person suffering from osteoarthritis. Physical exercises for osteoarthritis are rather short and not intense, but they need to be performed quite often - at least twice a day. After charging, you need to rest in a supine position for about 40 minutes. The patient is advised to purchase a subscription to the pool, since swimming is the most effective and painless of all types of exercise therapy for this disease.
Orthopedic correction is used to relieve unnecessary stress on the knees. The most popular orthopedic aids:
- Shoes - in case of limb contraction.
- Knee pads - stabilization of the position of the affected joint, fixation of the cup in a painless state.
- Instep supports - the principle of action is similar or identical to the models applicable for flat feet.
- Orthoses - depending on the type of construction and its rigidity, the device stops further destruction of bone and cartilage tissue. Also, side braces provide the patient with maximum freedom of movement and are prescribed for mandatory use in the postoperative period.
Drug treatment
Non-steroidal medications for inflammation can reduce joint dysfunction. These drugs do not cure the disease, they only relieve symptoms and make life easier for the patient. It is allowed to take non-steroid drugs for no more than two weeks and only after the main meals. There are various dosage forms of this category of medicines: ointments, suppositories, solutions and tablets. They have a number of side effects and a tendency to addiction.
The action of chondroprotectors is aimed at the renewal of cartilaginous layers. The most commonly prescribed complex intake of chondroitin sulfate and glucosamine. Their action is aimed at the regeneration of cartilage, stabilization of the formation of interchondral fluid, preservation of its properties.
If injections for intra-articular administration are prescribed, this means that the patient needs to relieve pain as soon as possible and stop the inflammatory process. The principle of injection is to block excess fluid. But these injections are not allowed to be used more than once every two weeks. Intra-articular medications are not prescribed for patients with the highest degrees of joint and bone deformation, pain attacks due to irreversible pathological disorders and carriers of serious chronic diseases (hypertension, diabetes).
Medicines based on hyaluronic acid. The active substances of this substance are responsible for the endurance of the cartilage, its resistance to mechanical damage. It is possible to normalize the level of hyaluron by injecting chondroprotectors. The acid replenished in this way absorbs the mechanical interaction of the surfaces of the joints, protecting them from wear and tear. The usual course of treatment consists of 4-5 injections, with an interval of one week, it can be repeated no more than three times a year.
On the subject: List of modern drugs and drugs for joints
Operation
Serious medical intervention is necessary with the highest degree of joint damage and ineffectiveness of drug treatment. For mild stages of ostearthrosis, arthroscopy is applicable. This mini surgery is done through a couple of small punctures. An endoscope is inserted into the joint, which transmits a video image of the condition of the cartilage tissue. The functions of arthroscopy include: diagnostics of the degree of dysfunction, concentration of inflammation, as well as dissection of the external destroyed tissues of the joint using small blades, which are subsequently dissolved by laser intervention.
Internal knee prostheses are used in the last stages of ostearthrosis. As a result of a simple operation, the unusable knee joint is replaced with an artificial titanium one. After rehabilitation, the operated patient is able to move around normally and return to the former rhythm of life.
On the subject: Effective Home Remedies
In conclusion, it is worth saying that you need to be careful about the health of your legs. Knee joints are the most vulnerable part of them and unauthorized treatment can have the most unintended consequences.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
