The joints of the human body withstand daily stresses, and therefore become vulnerable to various types of destructive factors. Among the diseases of the joints, osteoarthritis is widespread and affects both large and small joints. Arthrosis of the knee joint is a degenerative-dystrophic damage to the knee joint, in which its motor activity is impaired. Without proper treatment, the disease can lead to disability.
Since the disease provokes characteristic deformities in the joint, it was called deforming arthrosis of the knee joint, which rightly describes the typical feature of the pathology. The disease is chronic and is diagnosed more often in women, also in people suffering from obesity and venous pathologies of the lower extremities, but there may be other reasons. Due to age-related changes, it also occurs in older people.
Osteoarthritis in young people can be triggered by injuries. As a result of degenerative-dystrophic changes, the cartilage softens, exfoliates and becomes covered with cracks of different depths. Then it stops fulfilling its function.
The reasons
Various causes lead to the occurrence of deforming arthrosis of the knee joint. Traumatic factor is a common cause of occurrence. Post-traumatic osteoarthritis can occur as a result of a dislocation or fracture in the indicated area, as well as a meniscus injury. Gonarthrosis of the knee joint usually occurs in young people who are actively involved in sports, or in people whose work involves increased mobility, lifting and carrying heavy loads.
Very few people know that such damage can also be the result of treatment if the injury itself has already healed, but circulatory disorders in this area have occurred when the extremity has been immobilized for a long time. Because of this, gonarthrosis appeared.
Increased physical activity on the knee is one of the leading factors in the onset of the disease. Athletes who constantly have active loads on their knees are most often affected. At a young age, arthrosis can not manifest itself, usually rapid changes begin after the cessation of physical activity.
There is also a risk of disease in those people who do not reduce the load on their joints even as adults. In such athletes, the risk of fractures and dislocations increases, microtraumas appear. Therefore, after forty years, doctors recommend reducing the load and switching to coaching. Running and squats are best avoided as these activities put the most strain on the knee joint. One extremity is usually affected, resulting in left-sided gonarthrosis or right-sided gonarthrosis.
A key factor in the development of arthrosis 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 occurrence of arthrosis - the so-called grinding of the knee occurs, in which the articular joints experience more friction than usual.
The problem of excess weight is also relevant for people suffering from osteoarthritis. Excessive body weight puts unnecessary pressure on the joints. This does not damage the cartilage itself, but the meniscus. And with a combination of obesity and varicose veins in the lower extremities, there is a risk of acute arthrosis.
Some patients are born with weak ligaments, and sometimes the ligaments are affected due to other diseases. One way or another, weak ligaments lead to increased mobility of the joint, causing significant wear and tear on the joint surfaces. The consequences of ligament weakness may not be felt for a long time before patients experience symptoms of true osteoarthritis.
Joint pathologies also lead to the development of the disease. The most common cause of osteoarthritis is arthritis – an inflammation of the joints. With arthritis, typical signs are observed - deterioration in the composition of the synovial fluid, pathological changes in the cartilage, swelling, redness of the soft tissues. Even after osteoarthritis has healed, chronic processes lead to the occurrence of osteoarthritis.
Violations of metabolic processes often lead to diseases of the musculoskeletal system. Bones and joints lack the nutrients and minerals so necessary for tissue strength. Due to their lack, bones and cartilage surfaces are exposed to destructive processes, therefore, even with a small load, primary arthrosis occurs.
symptoms
Osteoarthritis of the knee joint manifests itself in a complex of features that are difficult to overlook. Signs are felt not only in the first degree of the development of pathology, but already the second and third degrees give clear symptoms of arthrosis of the knee joint:
- Pains- one of the key characters that does not appear immediately. An interesting fact is that with the development of osteoarthritis, pain may not be felt even for several months or years until the disease worsens. Usually, the first signs of pain are discomfort during physical exertion, walking or running, but they also manifest themselves when the meniscus is pinched. With the second degree of arthrosis, the pain in the joint is felt more intensely, and with the third degree of development, painful sensations appear even at rest. Seizures worsen even after short walks without heavy stress on the joint, so patients try to rest their knees;
- deformations- Manifestations become more pronounced in the third stage of arthrosis development. The knee retains its normal shape but appears slightly swollen and edematous. If arthritis joins, the knee will turn red, become hot, and be painful to the touch;
- crunchwith arthrosis occurs in the second and third degrees of development of the disease. The grinding sounds are distinct from the healthy clicking sounds sometimes heard when the knee is extended and flexed. In osteoarthritis, the symptoms are characterized by a dry, harsh sound that comes on abruptly and is accompanied by pain;
- synovitis- Accumulation of a certain amount of fluid in the joint cavity. It's there and it's normal. However, the accumulation of an excess amount leads to the development of a cyst - the most noticeable Baker's cyst, which can be detected in the unbent position of the leg;
- limited mobility in the knee- a typical sign of the disease, as the patients first try to consciously protect themselves from pain, and in the late stages of arthrosis are no longer able to stretch the limb. In the third degree of development, deforming knee joint osteoarthritis (DOA) leads to a complete loss of movement. Patients become accustomed to moving on bent legs while using the supports.
degrees of development
Osteoarthritis of the knee joint goes through three stages in its development.
With arthrosis of the 1st degree, the pain is insignificant and occurs only with active physical stress on the knee joint. Already in the first degree, fluid can accumulate in the cavity, which in the second and third is already a cyst. With progression, pain appears during movement, but quickly passes. Externally, the deformation of the knee joint is not visible, so diagnosing osteoarthritis of the knee joint can be difficult.
In second-degree disease, the damage to the cartilage tissue is more significant. If you take an x-ray, the stage of bone growth can already be seen on it. With any movement, a sharp pain in the knee suddenly appears, but when returning to a comfortable position, the knee no longer hurts. In the second stage of DOA, a crunching sound typical of arthrosis can be heard. As it progresses, problems with knee extension and flexion become worse. The deformation is noticeable externally.
Third degree arthrosis of the knee joint is characterized by a significant thinning of the cartilage tissue. Gradually, the cartilage wears down so much that the bone is exposed in some places. An X-ray reveals a significant amount of osteophytes - bone growths, salts that have appeared in the joint cavity. Externally, the changes are clearly visible, and the patient worries about constant pain. It is not difficult to make a diagnosis - a visual examination is enough, and an 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, arthrosis of the knee joint can join.
treatment
Coping with osteoarthritis of the knee joint is not easy, especially when the disease has progressed or inflammation has joined and osteoarthritis has developed.
conservative
The group of the most effective drugs for osteoarthritis are nonsteroidal anti-inflammatory drugs. These are primarily cyclooxygenase-2 inhibitors, they can perfectly relieve inflammation, swelling and contribute to speedy recovery.
These drugs have significant limitations, so they should not be used without a doctor's recommendation. For example, they can aggravate gastric ulcers, heart diseases and pathologies of the urinary organs. Nonsteroidal anti-inflammatory drugs are also prohibited during pregnancy.
The second group of active substances are chondroprotectors that improve the properties of cartilage tissue. They are used in arthrosis to restore the proper structure of cartilage, since when it dissolves, very important components are lost - chondroitin and glucosamine. Therefore, almost all chondroprotectors contain both substances, but some preparations are one-component.
With the help of these medicines, it is possible to help the patient at the first and second stages of the development of the disease, but not at the third, when irreversible changes have occurred.
During conservative therapy, the doctor also gives 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 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. Jelly, jelly will come in handy.
Ready to use
The most common type of surgery for osteoarthritis is arthroscopy, but other procedures are also performed. Osteoarthritis of the knee joint is usually treated in the second and third degree, when conservative therapy no longer helps.
If a minimally invasive procedure is necessary, for example if there is a build-up of fluid in the knee joint, a puncture is possible. 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 use it for treatment. The liquid is taken in a minimal amount at the initial stage, 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. Several instruments are inserted through a small incision in the skin, allowing the joint to be examined and manipulated as necessary. Although it is possible to remove tissue particles that have become detached from the cartilage with the aid of arthroscopy, there is always a risk of secondary gonarthrosis occurring.
If the damage is severe, a periarticular osteotomy must be performed. This is a major intervention in the joint, which requires it to be filed a bit and adjusted to the desired angle. After the operation, rehabilitation takes longer, but the effect lasts longer.
Significant destruction of the articular elements leads to complete immobilization of the limb. The joint is not performing its function, which means it needs to be replaced and operated on. Knee arthroplasty is an expensive operation, but it alone makes it possible to get the patient moving again in the extremity. Various knee prostheses are used – made of plastic, ceramic or metal. These are permanent structures that allow you to forget about the problem for several decades.
physical therapy
Physiotherapeutic methods can be used only when the acute phase is over and the patient is on the mend.
Methods actively used include:
- ozone therapy- Exposure of the affected joint to ozone, and the substance can be injected or used as a topical treatment. This type of support for patients is very effective, so it is widely used in the treatment of various pathologies, including arthrosis. The treatment makes it possible to activate blood circulation in the problem area for anti-inflammatory and analgesic effects. At the same time, treatment with glucocorticoids 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 special simulators that strengthen the joints are used during exercises. The difference between kinesiotherapeutic and physiotherapeutic exercises is the active effect not only on arthrosis of the knee, but on the whole body.
Apply not only ozone therapy and exercise therapy, but also physical therapy. The author's exercise methods for eliminating arthrosis of the knee give good results. During and after the exercises, you may need to wear a special knee brace - an orthosis to strengthen the right or left knee joint.