Osteoarthritis of the knee joint

Osteoarthritis of the knee joint is a disease of the musculoskeletal system, which consists in the deformation and destruction of the cartilaginous tissue of the joint, resulting in disruption of the structure and functions of the cartilage.The disease has several names - gonarthrosis, deforming osteoarthritis.The treatment of osteoarthritis of the knee joint does not have an unambiguous scheme or a single medicine that can equally help everyone suffering from this problem.As osteoarthritis is a progressive disease, it is more frequently seen in overweight women, venous diseases and the elderly.Treatment is carried out and prescribed individually for each patient.

Osteoarthritis of the knee joint can be unilateral or bilateral (depending on whether the disease develops in one or both legs).At the first symptoms, it is necessary to resort to appropriate treatment, as ignoring this problem can lead to the final destruction of the cartilage and the exposure of the bone and, consequently, the person's disability.

There are three stages of the disease:

1. The initial stage of knee arthrosis is characterized by the loss of shock-absorbing properties and, as a result, the cartilages rub against each other during movement, causing great discomfort to the patient.The cartilage becomes rough, deformed, dries out and, in the advanced stages of the disease, is even covered in fissures.
2. Due to reduced depreciation, bone deformation begins, which leads to the formation of osteophytes (growths on the surface of the bones) - this is the second stage of the disease.The new joint membrane and capsule are also subject to deformation, the knee joint gradually atrophies due to the stiffness of movement.There is also a change in the density of the joint fluid (it becomes thicker, more viscous), poor circulation and deterioration in the supply of nutrients to the knee joint.Thinning of the lining between cartilaginous joints reduces the distance between the articulating bones.
3. The disease progresses rapidly and quickly passes into the third stage, when the patient is practically unable to move due to constant knee pain.Global and irreversible changes occur in cartilaginous tissue, leading to human disability.

Most often, osteoarthritis or gonarthrosis develops after an injury or bruise, while a person feels severe and constant pain in the knee, which significantly hinders movement.

Reasons for the development of osteoarthritis

Arthrosis of the knee joint, the treatment of which takes quite a long time, can be manifested by the following factors:

1. Genetic predisposition.
2. Injuries: dislocations, bruises, fractures.When treating an injured knee, the joint is fixed and the person cannot bend or straighten the leg for a certain time.This leads to deterioration of blood circulation, which most often provokes the development of post-traumatic gonarthrosis.
3. Removal of the meniscus.
4. Excessive and inappropriate physical activity for the person's age, causing injuries or microtraumas, in addition to hypothermia of the joints.For example, running on the asphalt or squatting is not recommended for elderly people, as during these exercises there is significant pressure on the knee joint, which wears out with age and cannot withstand such loads.
5. Overweight and obesity.This factor leads to injuries to the menisci, which lead to the development of osteoarthritis of the knees.
6. Loose ligaments or weak ligaments.
7. Arthritis or other acquired joint diseases.The inflammatory process can cause accumulation of synovial fluid in the joint cavity or swelling.This provokes the destruction of the cartilaginous tissue of the knee, which leads to arthrosis of the knee joints.
8. Metabolic disorders in the human body.An insufficient amount of calcium significantly worsens the condition of bone and cartilage tissue in the human body.
9. Flat feet.Inadequate foot structure shifts the center of gravity and the load on the joint increases.
10. Stress and nervous tension.

Knee osteoarthritis symptoms

The clinical picture of the disease presents the following symptoms:

1. Painful sensations.The pain occurs suddenly, depending on the physical load on the knee joint.Painful sensations can be of different nature.In the initial stage, it is mild low back pain, which the person usually does not pay much attention to.Periodic mild pain may be observed for months, and sometimes years, until the disease progresses to a more aggressive stage.
2. Visible knee deformity.This symptom appears in the later stages.At first, the knee appears swollen or swollen.
3. Accumulation of joint fluid in the joint cavity or Baker's cyst.This is a dense formation on the back wall of the knee joint.
4. Joint crunching.Sharp crunching sounds, accompanied by pain, are observed in patients in the second and third stages of the disease.
5. Inflammatory reactions in the articular synovium, as a result of which the cartilage swells and increases in volume.
6. Joint mobility decreases.Observed in later stages.Bending the knee becomes almost impossible and is accompanied by severe pain.In the final stage, the knee may be completely immobilized.A person's movement becomes difficult or completely impossible (some patients move with their legs bent).

Treatment of osteoarthritis of the knee joint

Treatment of arthrosis of the knee joint should be comprehensive.To date, there is no medication that alleviates this disorder.One of the most important conditions for successful treatment is timely diagnosis.The sooner treatment for knee osteoarthritis is started, the greater the chances of prolonging the period of remission and preventing the destruction and deformation of cartilage and bone tissue.

During treatment, the doctor and patient face several tasks:

1. Eliminate or reduce pain;
2. Establish the supply of nutrients to the knee joint and thus increase its recovery function;
3. Activate blood circulation in the knee joint;
4. Strengthen the muscles around the joint;
5. Increase joint mobility;
6. Strive to increase the distance between the articulating bones.

Treatment of the disease, depending on the stage of its development, can be conservative or surgical.

Conservative treatment of arthrosis of the knee joint

Analgesics, anti-inflammatories

To alleviate or reduce pain, the patient is usually prescribed a course of nonsteroidal anti-inflammatory drugs (NSAIDs).These can be tablets, ointments and injections.Among the most common painkillers are the following.These medications can be used in two ways – orally or topically.

Typically, patients prefer local treatment in the form of gels, ointments and warming patches.The effect of these painkillers does not occur immediately, but after a few days (approximately 3-4 days).The maximum effect is achieved after a week of regular use of the medicine.These medicines do not treat the disease as such, they only relieve pain, since it is impossible to start treating the pain.

Painkillers must be taken strictly as prescribed by a doctor;They should only be used for severe pain, as prolonged and frequent use can cause side effects and even accelerate the destruction of articular cartilage.In addition, with prolonged use of these drugs, the risk of adverse reactions increases, including stomach ulcers, duodenal ulcers, disruption of the normal functioning of the liver, kidneys, and allergic manifestations in the form of dermatitis are also possible.

Hormones

Sometimes, in the treatment of arthrosis of the knee joint, a course of hormonal medications is prescribed.They are prescribed if NSAIDs are no longer effective and the disease itself begins to progress.Most often, hormonal drugs for the treatment of this disease are used in the form of injections.

The course of treatment with hormonal drugs is usually short and prescribed during a period of severe exacerbation, when inflammatory fluid accumulates in the joint.The hormone is injected into the joint approximately once every ten days.

Chondroprotectors

To restore and nourish cartilaginous tissue in the initial stages of the disease, a course of glucosamine and chondroitite sulfate, the so-called chondroprotectors, is prescribed.This is by far the most effective treatment for osteoarthritis.They have almost no contraindications and side effects occur in rare cases.

Vasodilators

To relieve spasm of small vessels, improve blood circulation and supply the knee joint with nutrients, as well as eliminate vascular pain, vasodilators are prescribed.They are crushed together with chondroprotectors.If knee osteoarthritis is not accompanied by fluid accumulation, the use of ointments, gels and warming liquids is also recommended.

Therapeutic exercise

A course of exercise therapy can be very useful and bring good results only when prescribed by a doctor and carried out under supervision, on the recommendation of a specialist or trainer.Self-medication is dangerous to your health.Exercise therapy is used to further prevent the destruction of cartilage tissue, slow the development of stiffness, and relax muscle spasms that cause pain.During periods of exacerbation, exercise therapy is contraindicated.A course of special individual exercises, which take into account not only the stage of the disease and the condition of the cartilage, but also the age of the patient, should be developed by a competent specialist in this field.

Physiotherapy

Physiotherapy is used as one of the methods of conservative therapy - electrophoresis, laser therapy, acupuncture, diadynamic currents, UHF.A local massage course also gives positive results.Physiotherapeutic methods work in several directions - they relieve pain, reduce inflammation, normalize metabolism inside the joint and restore its usual functions.The method and duration of physiotherapeutic treatment are determined by the patient's medical history and are prescribed only after a complete diagnosis and study of the condition of the joints.

Physical therapy for pain relief includes:

1. Medium-wave ultraviolet irradiation (SUV irradiation).The contact of ultraviolet light with the skin of the knee continues until slight redness appears.Substances are formed in the tissues that dull the sensitivity of nerve fibers, thus achieving an analgesic effect.The duration of treatment is prescribed by the doctor depending on the symptoms, frequency and severity of the pain.On average, the course of treatment is approximately 7-8 sessions.
2. Local magnetic therapy aiming at the global recovery of the patient's body.This procedure relieves inflammation, eliminates pain and neutralizes muscle spasms.Effectively used for arthrosis of the knee joint in the initial stages.The course of treatment is usually limited to 20-25 procedures, each of which lasts about half an hour.
3. Infrared laser therapy, low-intensity UHF therapy, centimeter therapy (SMV therapy).
4. Ultrasound, darsonvalization, therapeutic baths, interference therapy, which is prescribed to improve blood circulation in the joint.

Sanitary resort treatment is of no small importance.This treatment is prescribed for deforming and dystrophic osteoarthritis.This treatment, like those listed previously, has its contraindications, which is why the attending physician carefully examines the patient's medical history before recommending the health resort method.

Surgical treatment of osteoarthritis of the knee joint

This is a radical method of treating arthrosis of the knee joint, which partially or completely restores the functioning of the joint.The methods and forms of surgical intervention depend on the degree of joint damage, as well as the patient's medical history.

Late arthrosis of the knee joint can only be treated surgically - the knee joint is completely or partially replaced with an endoprosthesis.Surgical treatment allows not only to improve well-being, but also to restore the patient's ability to work in the last stages of knee arthrosis.Many consider the long recovery period with the use of exercise therapy, mechanotherapy and other means to be a significant disadvantage of the operation.

There are several types of surgical intervention for arthrosis of the knee joint:

Knee arthritis prevention

To avoid this disease, people at risk (athletes, elderly people, overweight people, company workers) must follow some instructions:

1. Proper nutrition and combating excess weight.It is necessary to exclude unhealthy foods from your diet - fatty foods, fried foods, alcohol, and it is better to consult a nutritionist who will individually help you choose a suitable diet.
2. When playing sports, monitor the load on the joints and reduce it if necessary.
3. Monitor your health and treat infectious diseases in a timely manner, preventing them from becoming chronic.
4. Timely and adequate treatment of spinal diseases, if any, development of correct posture.
5. Sports activities (cycling, swimming, walking, special gymnastic exercises for joints).
6. No self-medication!At the first symptoms of knee arthritis, go to the clinic.
7. Avoid stress, sleep well.
8. Systematically increase your immunity (harden yourself or at least take a vitamin treatment 2-3 times a year).
9. Avoid hypothermia of the body, especially the lower extremities.

A healthy lifestyle and timely treatment are the best ways to prevent knee arthritis.