Osteoarthritis of the knee

The following factors may contribute to the development of osteoarthritis of the knee:

• excessive physical activity that does not meet the age requirements, leading to joint damage;
• sedentary lifestyle;
• suffered injuries in the area of the knee joints - knee dislocations, fractures, ruptures and ruptures of ligaments, damage to the body of the meniscus, severe falls to the knee, bruises;
• increased body mass index, which causes increased load on the joints, rupture of the meniscus;
• heredity;
• arthritis or other joint diseases (inflammation can lead to edema or accumulation of large amounts of synovial fluid in the joints, causing destruction of cartilage tissue);
• metabolic disorders that lead to calcium excretion from the body;
• diabetes mellitus of any kind, hormonal disorders and other pathologies of the endocrine system;
• chronic or past diseases of inflammatory and infectious nature;
• violation of blood flow;
• lupus erythematosus, rheumatoid, gouty and psoriatic pathologies, ankylosing spondylitis;
• flat feet, due to which the center of gravity moves and the load on the joint increases;
• nervous overload and stressful situations.

Why arthrosis of the knee joint occurs

Most often, people themselves become the culprits for the development of such a difficult-to-cure disease. Often, when pain occurs in the knee joint, people ignore the painful sensations, preferring to go to the doctor to use any medications that simply mask the pain.

After a few years, you will still have to consult a specialist, because with such a diagnosis, self-medication will not give results. However, the severity of osteoarthritis will be at least average. Fat, intra-articular application of hyaluronic acid and preventive physical education are no longer enough here, as could be done in the early stages of the disease. It will most likely be necessary to take radical action, including sometimes surgery.

Symptoms and diagnosis of osteoarthritis of the knee

The disease can be distinguished by the following characteristics:

• Pain syndrome. Painful feelings usually occur suddenly, but most often with physical exertion, even mild. Pain can be of different natures. In the beginning, it will be a weak lumbago (unfortunately, few people pay attention to them). Mild pain that occurs only occasionally can last for months or even years, until the disease progresses to a more severe stage.
• Pronounced knee deformity. A similar symptom is typical for later stages. And at the beginning of the development of arthrosis, the knee is slightly swollen and swollen.
• Occurrence of dense formations in the posterior wall of the knee joints. Accumulation of a large amount of joint fluid in the cavity of Baker's cyst or in the joint itself.
• A sharp creaking of the joints, accompanied by pain.
• Reduced joint mobility. This is especially pronounced in the last stages of arthrosis. In this case, flexion and extension of the knee causes severe pain, and in the last stages movement becomes almost impossible.

REFERENCE! In patients with osteoarthritis, gait changes: it is characterized by sagging legs and limping.

Pathogenesis of osteoarthritis of the knee joints

Specialists distinguish between primary and secondary arthrosis.

Primary osteoarthritis of the knee joints

Primary gonarthrosis is characterized by the following processes:

1. The articular cartilage is capable of constantly decaying and at the same time recovering quickly. Under normal circumstances, these two processes should balance each other. Over the years, the destruction of cartilage takes place at the same rate, but its recovery slows down. The mass of the person plays an important role here. Indeed, if the weight of one person is 70 kg, then in 10 steps on one leg will transfer 700 kg, and one who weighs 120 kg will transfer as much as 1200 kg, which will become a significant load on the joints and cartilage, which will therefore be fasterto wear out.
2. It is important to remember: the joint feeds on useful elements only when it moves. A sedentary lifestyle leads to a slowdown in metabolic processes, which is why the necessary nutrients do not reach their destination.
3. The likelihood of developing gonarthrosis increases in people whose parents have suffered from this disease.

Secondary osteoarthritis of the knee joint

It is being developed for the following reasons:

• Multiple injuries. In a person of any age, they will cause excessive stress on the cartilage. When any bone covered with cartilage breaks, irregularities appear, so-called "steps". In this area, now, with every movement, the joint will wear out, which will lead to arthrosis.
• Development of rheumatoid arthritis, Koenig's disease, the appearance of purulent inflammation in the joints.
• Vascular dysfunction.

Classification and stages of development of osteoarthritis of the knee joints

Orthopedists divide gonarthrosis into stages on which further treatment of the disease depends. Of course, the course of treatment will depend on other factors, for example, the reasons for the development, location and nature of osteoarthritis.

BITAN! Qualitative treatment can be prescribed only by a doctor after a complete study of the picture of the disease. Self-applied therapy can only worsen the health situation.

The main classification divides gonarthrosis into four stages of development:

1. Initial phase. At this stage, the disease is just emerging. External symptoms are weakly noticeable or completely absent, the shape of the joint is in a satisfactory condition. Symptoms include only mild discomfort or heaviness in the knee after long walks, as well as strenuous physical exertion. An X-ray will be of little information: an X-ray can show only a slight narrowing of the joint space. Unfortunately, at this stage the person does not seek medical help due to the insignificance of the symptoms.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. The intensity of pain decreases at rest. Movements in the joints become difficult. Squeaking or creaking knees are heard while walking. The X-ray shows a narrowing of the joint space, as well as osteophytes. The patient begins to limp.
3. When osteoarthritis enters the third phase, the pain syndrome will be felt constantly, even in the absence of movement. The processes of deformation and degeneration pass into an irreversible phase. The distortion of the joint becomes pronounced, the distance between the joint surfaces is significantly reduced, and numerous osteophytes increase in size. Painful feelings now disturb the patient even in a state of complete rest. The person becomes dependent on outside support (walkers, canes) and requires the help of other people. Conservative treatment is less effective at this stage.
4. The fourth phase is characterized by constant debilitating pain. Osteophytic growths increase in number and size, cartilage is completely destroyed, joint space is barely delineated or completely absent, bones are severely deformed. Even weak movements become torture for the patient. At this stage of gonarthrosis, the patient is recognized as disabled. In the absence of surgery, the disease can lead to disability.

Complications of osteoarthritis of the knee joints

Advanced osteoarthritis can lead to dislocation and subluxation of the knee joint. In dislocation, the epiphysis of the femur extends completely outside the joint, which makes movement in the joint impossible, and the axis of the leg moves significantly to the side. Fortunately, such a negative variant of disease development is quite rare.

Subluxations are more common. They are characterized by partial displacement of the joints relative to each other and a slight deviation of the tibial axis. In this case, subluxations are accompanied by severe pain and joint dysfunction.

Neglecting the disease can lead to complete loss of lower extremity functionality.

ATTENTION! The habit of sparing a sore leg sometimes causes deformation of the intervertebral discs and the appearance of a hernia.

Consequences of neglected gonarthrosis

The advanced stage of gonarthrosis is almost always characterized by the following adverse symptoms:

• 24-hour pain, from which no painkiller can save;
• loss of limb support (it is impossible to stand on a sore leg or at least lean on it);
• joint block immobilization;
• pronounced curvature of the bones around the knee;
• strong swelling around the affected area.

Methods of treating osteoarthritis of the knee

Prescribed treatment depends on the degree of disease development. There are several therapeutic options.

Hormones

These drugs are prescribed for severe exacerbations, accompanied by synovitis and severe pain. Hormones are usually given by injection. The following medications are most commonly used:

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The course of hormone treatment is usually short, injections are given only in the period of severe exacerbation. Hormones are given on average once every 10 days.

Chondroprotectors

Chondroprotectors are prescribed in the initial phase of disease development. This therapy is currently considered the most effective and safest: there are practically no contraindications, and side effects occur in the rarest cases.

The drugs are aimed at restoring cartilage, improving metabolic processes, nourishing cartilage tissue and protecting against further destruction. But in the later stages of osteoarthritis, chondroprotectors are also powerless.

This group of drugs is produced in the form of injections, ointments, gels, tablets.

Vasodilator drugs

These remedies are necessary to eliminate spasm of small blood vessels, increase blood circulation and supply nutrients to the affected joint area. Prescribed for taking vasodilators together with chondroprotectors.

If joint fluid does not accumulate during gonarthrosis (no synovitis), the use of warming ointments is recommended.

Hyaluronic acid

Alternatively, this tool is called an intraarticular fluid prosthesis because the acid composition is similar in composition to intraarticular fluid. When acid is injected into the joint, it creates a film that prevents strong cartilage friction during movement, affects the extracellular matrix, improves metabolic processes in the joint, and also starts the production of its own hyaluronic acid in the joint - ie. restores joint function to normal, stopping pathological processes that destroy cartilage. . . .

Acid treatment is prescribed only when exacerbation - synovitis - is eliminated.

Physiotherapy

The course of physiotherapeutic exercises will bring positive results only if it is prescribed by a doctor after a complete study of the anamnesis, and all exercises are performed under the supervision of a specialist.

Self-medication often leads to worsening joint condition. Exercise therapy is prescribed for the following purposes:

• slowing the development of stiffness;
• preventing further destruction of cartilage tissue;
• elimination of muscle spasm, leading to pain.

Physiotherapy

Various procedures can be prescribed as additional therapy: electrophoresis, acupuncture, laser therapy, UHF, as well as diadynamic currents. A local massage will also give a good result.

Physiotherapy is aimed at reducing the intensity of pain, eliminating inflammation, normalizing metabolic processes within the affected joint and restoring its normal function.

BITAN! It is important that the patient follows his diet and avoids strenuous physical exertion.

Forecast. Prophylaxis

With the advanced stage of the disease, the prognosis is disappointing. Therefore, it is recommended that if minor symptoms of osteoarthritis occur, consult a physician for advice.

At-risk people (the elderly, athletes, as well as overweight people) must follow the doctor's recommendations and adhere to the following rules:

1. Eat right and control your weight. If necessary, follow a weight loss diet.
2. Reduce the load on the joints while doing sports, constantly monitor it.
3. Treat infectious diseases in a timely manner, preventing their transition to a chronic phase.
4. Rest adequately, avoid stressful situations if possible.
5. Increase the protective functions of the body (occasionally take vitamins, temperament).
6. Avoid hypothermia of the body, especially the lower extremities.