knee arthrosis

The following factors can contribute to the development of arthrosis of the knee joints:

• excessive physical activity that does not meet age requirements, leading to joint damage;
• sedentary lifestyle;
• suffered injuries in the area of the knee joints - dislocations of the knee, fractures, torn and torn ligaments, damage to the body of the meniscus, severe falls to the knee, bruises;
• increased body mass index, which causes greater stress on joints, meniscus rupture;
• heredity;
• arthritis or other joint diseases (inflammation can lead to edema or accumulation of large amounts of synovial fluid in the joints, causing the destruction of cartilage tissue);
• metabolic disturbances that lead to the excretion of calcium from the body;
• diabetes mellitus of any kind, hormonal disturbances and other pathologies of the endocrine system;
• chronic or past illnesses of an 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 shifts and the load on the joint increases;
• nervous overload and stressful situations.

Why Arthrosis of the Knee Joint Occurs

Most of the time, people themselves become to blame for the development of such an intractable disease. Often, when knee joint pain arises, people ignore the painful sensations, preferring to go to the doctor to use any medication that simply masks the pain.

After a few years, you will still have to see a specialist, as with this diagnosis self-medication will not work. However, the severity of the arthrosis will be at least average. Here, ointments, intra-articular administration of hyaluronic acid and preventive physical education are no longer sufficient, as could be done in the early stages of the disease. It will probably be necessary to act radically, even sometimes with the use of surgical intervention.

Symptoms and Diagnosis of Arthrosis of the Knee Joints

The disease can be distinguished by the following characteristics:

• Pain syndrome. Painful sensations usually occur suddenly, but more often with physical exertion, however slight. The pain can be of a different nature. At first they will be weak lumbago (unfortunately few people pay attention to them). Mild pain that occurs only periodically can last for months, or even years, until the disease progresses to a more severe stage.
• Marked deformity in the knee. A similar symptom is typical of later stages. And early in the development of osteoarthritis, the knee swells and swells up a little.
• The appearance of dense formations on the posterior wall of the knee joints. Accumulation of a large amount of joint fluid in the cavity of the Baker's cyst or in the joint itself.
• Marked stretching of the joints, which is accompanied by pain.
• Decreased joint mobility. This is especially pronounced in the later 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 a patient with arthrosis, gait changes: it is characterized by falling legs and lameness.

Pathogenesis of arthrosis of the knee joints

Experts distinguish primary from secondary arthrosis.

Primary arthrosis of the knee joints

For primary gonarthrosis, the following processes are characteristic:

1. Articular cartilage is capable of constantly deteriorating and at the same time rapidly renewing itself. Under normal conditions, these two processes should balance. Over the years, cartilage destruction occurs at the same rate, but its recovery is slower. A person's mass plays an important role here. In fact, if a person's mass is 70 kg, then in 10 steps on one leg they will transfer 700 kg, and one who weighs 120 kg will transfer up to 1200 kg, which will become a significant load on joints and cartilage. , which wears out faster because of it.
2. It is important to remember: the joint feeds on useful elements only during movement. A sedentary lifestyle leads to a slowdown in metabolic processes, which is why the necessary nutrients do not reach their destination.
3. The probability of developing gonarthrosis is increased in people whose parents suffered from this disease.

Secondary arthrosis of the knee joint

It develops for the following reasons:

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

Classification and stages of development of arthrosis of the knee joints

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

IMPORTANT! Qualitative treatment can only be prescribed by a physician after a thorough study of the disease picture. Self-administered therapy can only aggravate the health situation.

The main classification divides gonarthrosis into four stages of development:

1. Initial state. At this stage, the disease is just emerging. External symptoms are barely noticeable or completely absent, joint shape is in satisfactory condition. Symptoms include only mild discomfort or heaviness in the knee after long walks, as well as strenuous physical exertion. An X-ray exam will be of little information: an X-ray may 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 symptoms.
2. The second stage is characterized by a noticeable pain syndrome, particularly when walking and climbing stairs, as well as at night. Pain intensity decreases at rest. Joint movement becomes difficult. When walking, you hear a snapping or popping on your knees. On radiography, the narrowing of the joint space becomes noticeable, as well as osteophytes. The patient starts to limp.
3. When the arthrosis progresses to the third stage, the pain syndrome is felt constantly, even in the absence of movement. The deformation and degeneration processes pass to an irreversible stage. Joint distortion becomes pronounced, the distance between the joint surfaces is visibly reduced, numerous osteophytes increase in size. Painful sensations now trouble the patient, even in a state of complete rest. A person becomes dependent on external support (walkers, canes) and requires help from other people. Conservative treatment at this stage is less effective.
4. The fourth stage is characterized by constant debilitating pain. Osteophytic growths increase in number and size, cartilage is completely destroyed, joint space is poorly traced 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 deficient. In the absence of surgery, the disease can lead to disability.

Complications of arthrosis of the knee joints

Advanced arthrosis can cause dislocations and subluxations of the knee joint. With dislocation, the femoral epiphysis extends completely outside the joint, as a result of which movement in the joint becomes impossible, and the leg axis is substantially shifted to the side. Fortunately, this negative variant of disease development is quite rare.

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

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

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

Consequences of neglected gonarthrosis

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

• uninterrupted pain, from which no painkiller can save;
• loss of support for a limb (it is impossible to stand on a painful leg or at least support yourself);
• joint block immobilization;
• pronounced curvature of the bones around the knee;
• severe swelling around the affected area.

Methods for the treatment of arthrosis of the knee joint

The treatment prescribed depends on the degree of development of the disease. There are several therapy options.

hormones

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

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The course of hormone treatment is usually short; injections are given only during a period of severe exacerbation. Hormones are administered with an average frequency of once every 10 days.

Chondroprotectors

Chondroprotective drugs are prescribed early in the development of the disease. This therapy is currently considered the most effective and safe: there are practically no contraindications and side effects appear in the rarest cases.

The drugs aim to restore cartilage, improve metabolic processes, nourish cartilage tissue and protect it from further destruction. But in the later stages of arthrosis, chondroprotectors are also impotent.

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

Vasodilator drugs

These features are needed to eliminate small vessel spasm, increase blood circulation and supply nutrients to the affected joint area. Prescribed for taking vasodilators along with chondroprotectives.

If joint fluid does not accumulate during gonarthrosis (there is no synovitis), warming ointments are recommended.

Hyaluronic acid

On the other hand, this tool is called an intra-articular fluid prosthesis, since the composition of the acid is similar to that of the intra-articular fluid. When the acid is injected into the joint, it forms a film that prevents strong cartilage friction during movement, affects the extracellular matrix, improving metabolic processes in the joint, and also triggers the production of its own hyaluronic acid in the joint - that is, it returns joint function to normal, interrupting the pathological processes that destroy cartilage. . . .

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

Physiotherapy

A course of physical therapy exercises will only yield positive results if prescribed by a physician after a thorough study of the medical history, and all exercises are performed under the supervision of a specialist.

Self-medication usually leads to a worsening of the joint situation. Exercise therapy is indicated for the following purposes:

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

Physiotherapy

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

Physical therapy aims to reduce pain intensity, eliminate inflammation, normalize metabolic processes within the affected joint, and restore normal function.

IMPORTANT! It is important for the patient to monitor their diet and avoid strenuous physical exertion.

Forecast. Prophylaxis

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

People at risk (elderly people, athletes, as well as overweight people) must follow the doctor's recommendations and comply with the following rules:

1. Eat well and control your weight. Follow a weight loss diet as needed.
2. Reduce the load on your joints during sports and monitor it constantly.
3. Treat infectious diseases in a timely manner, preventing their transition to the chronic stage.
4. Get enough rest, avoid stressful situations if possible.
5. Increase the body's protective functions (take vitamins periodically, temperament).
6. Avoid hypothermia of the body, especially of the lower extremities.