The joints of the human body are resistant to everyday stress, therefore they become susceptible to various types of destructive factors. Among joint diseases, osteoarthritis is common and affects both large and small joints. Arthrosis of the knee joint is a degenerative-dystrophic lesion of the knee joint, in which its motor activity is impaired. In the absence of proper treatment, the disease can lead to disability.
Since the disease causes characteristic deformities of 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 more often diagnosed in women, moreover, those with overweight 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. Subsequently, he ceased to exercise his function.
The reasons
Various causes lead to the appearance of deforming arthrosis of the knee joint. The traumatic factor is a frequent cause of occurrence. Post-traumatic arthrosis can develop as a result of a dislocation or fracture in the specified area, as well as injury to the meniscus. Usually, gonarthrosis of the knee joint appears in young people who are actively engaged in sports or in people whose work is associated with increased mobility, lifting and carrying heavy loads.
Few people know that such damage can also be the result of treatment, when the injury itself has already healed, but during prolonged immobilization of the limb, circulatory disorders in this area have occurred. Because of this, gonarthrosis appeared.
Increased physical activity on the knee is one of the main factors in the onset of the disease. It most often affects athletes who have constant active loads on the knee. At a young age, arthrosis may not manifest itself, usually rapid changes begin after stopping physical activity.
There is also a risk of disease in people who, even in adulthood, do not reduce the load on the joints. In such athletes, the risk of fractures and dislocations increases, microtraumas appear. Therefore, already after forty, doctors recommend athletes to reduce the load and switch to coaching. It is best to avoid running and squats, as these are the activities that put the most strain on the knee joint. Most often, one limb is affected and either left-sided gonarthrosis or right-sided gonarthrosis occurs.
An essential factor for the development of arthrosis of the knee joint is the removal of the menisci. If for some reason the menisci were removed, in 90% of cases this leads to the development of arthrosis - the so-called knee loop occurs, during which the articular joints experience morefriction than usual.
The problem of excess weight also concerns people suffering from arthrosis. Excess weight puts unnecessary pressure on the joints. As a result, it is not the cartilage itself that is damaged, but the meniscus. And with a combination of excess weight and varicose veins of the lower extremities, acute arthrosis threatens to appear.
The weakness of the ligament apparatus in some patients is a congenital feature, and sometimes the ligaments are affected due to other diseases. One way or another, weak ligaments cause increased mobility in the joint, due to which the articular surfaces are significantly abraded. The consequences of weak ligaments may not be felt for a long time until patients show symptoms of true osteoarthritis.
Joint pathologies also lead to the development of the disease. The most common cause of osteoarthritis is arthritis - inflammation of the articular joints. With arthritis, typical signs are observed - deterioration in the composition of synovial fluid, pathological changes in cartilage, swelling, redness of soft tissues. Even after cured arthrosis, chronic processes lead to the appearance of arthrosis.
Violations of metabolic processes often lead to pathologies of the musculoskeletal system. Bones and joints lack the nutrients and minerals that are so necessary for strong tissues. With their lack, bones and cartilaginous surfaces are subject to destructive processes, therefore, even with a slight load, primary arthrosis appears.
Symptoms
Osteoarthritis of the knee joint manifests with a set of characteristics that are hard to miss. Signs are felt not only at the first degree of development of pathology, but already the second and third degrees give distinct symptoms of arthrosis of the knee joint:
- pain- one of the key signs that does not appear immediately. An interesting fact is that with the development of arthrosis, pain may not be felt even for several months or years, until the disease worsens. Usually, the first painful signs are discomfort during physical exertion, walking or running, but it also occurs when the meniscus is pinched. In the second degree of arthrosis, pain in the joint is felt more strongly, and in the third degree of development, painful sensations appear even at rest. Attacks are aggravated even after short walks without a strong load on the joint, so patients try to spare their knees;
- deformations- manifestations become more pronounced in the third stage of development of arthrosis. The knee will retain its normal shape, but will appear slightly swollen and oedematous. When arthritis joins, the knee becomes red, hot and painful to the touch;
- bitewith arthrosis appears in the second and third degrees of disease development. The crunch sounds are different from the sound clicks that can sometimes be heard when the knee is extended and flexed. In osteoarthritis, the symptoms are characterized by a dry, rough sound that comes on suddenly and is accompanied by pain;
- synovitis- accumulation of a certain amount of fluid in the joint cavity. It's there and it's normal. But the accumulation of an excessive amount leads to the development of a cyst - the most noticeable Baker's cyst, which can be determined in the unbent position of the leg;
- limited knee mobility- a typical sign of pathology, since patients first try to consciously protect themselves from pain, and in the advanced stage of arthrosis they cannot straighten the limb at all. In the third degree of development, deforming osteoarthritis of the knee joint (DOA) leads to a complete loss of movement. Patients adapt to move on bent legs, while using means of support.
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 exertion 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, the pain occurs during movement, but quickly passes. Externally, the deformity of the knee joint is invisible, so the diagnosis of osteoarthritis of the knee joint can be difficult.
With a disease of the second degree, the damage to the cartilage tissue is greater. If you take an x-ray, the stage of bone growth is already noticeable there. With any movement, a sudden sharp pain appears in the knee, but, returning to a comfortable position, the knee no longer hurts. In the second stage of DOA, you may hear a cracking sound typical of osteoarthritis. With progression, knee extension and flexion problems worsen. The deformation becomes noticeable on the outside.
Arthrosis of the knee joint of the third degree 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 image shows a significant amount of osteophytes - bone growths, salts that have appeared in the joint cavity. Outwardly, the changes are clearly visible, and the patient is worried about constant pain. It is not difficult to make a diagnosis - a visual examination is enough, and an x-ray control is carried out.
With the progression of this degree, osteoarthritis can lead to a complete loss of functionality. At any degree of development of pathology, arthrosis of the knee joint can join.
Treatment
Dealing with osteoarthritis of the knee joint is not easy, especially if the disease is advanced or inflammation has joined and arthritis has developed.
conservative
The most active group of drugs against osteoarthritis are nonsteroidal anti-inflammatory drugs. They are mainly cyclooxygenase-2 inhibitors, they can perfectly relieve inflammation, swelling and contribute to rapid recovery.
These drugs have significant limitations, so they should not be used without a doctor's recommendation. For example, they are able to exacerbate stomach ulcers, heart disease, pathology of the urinary organs. Nonsteroidal anti-inflammatory drugs are also prohibited during pregnancy.
The second group of agents are chondroprotectors that improve the characteristics of cartilage tissue. They are used for arthrosis to restore the correct structure of cartilage, since in the process of resolution it loses very important components - chondroitin and glucosamine. Therefore, almost all chondroprotectors contain these two substances, but some preparations are single-component.
With the help of these drugs, 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 treatment, the doctor will also give recommendations on nutrition. If the patient is overweight, it is imperative to follow a diet in order to normalize the weight. How to strengthen a stable weight - the doctor will also tell you. 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.
Operational
The most common type of surgery for osteoarthritis is arthroscopy, but other procedures are performed. Treatment of arthrosis of the knee joint is usually carried out in the second and third degree, when conservative treatment no longer helps.
If a minimally invasive intervention is necessary, for example when fluid accumulates in the knee joint, it is possible to make a puncture. 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 apply it for treatment. The liquid is taken at the initial stage in a minimum amount, 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. Through a small incision in the skin, several instruments are introduced to allow examination of the joint and necessary manipulations. With the help of arthroscopy, it is possible to remove tissue particles that have separated from the cartilage, but there is always a risk of the appearance of secondary gonarthrosis.
In case of severe lesions, it is necessary to perform a periarticular osteotomy. This is a larger-scale impact on the seam, after which it is lightly filed and set at the desired angle. After the operation, rehabilitation is longer, but the effect lasts longer.
Significant destruction of articular elements leads to complete immobilization of the limb. The seal does not fulfill its function, which means that it must be replaced and an operation must be carried out. The endoprosthesis of the knee joint is an expensive operation, but only it allows to put the patient back in motion in the limb. Various knee prostheses are installed - plastic, ceramic or metal. These are durable structures that allow you to forget about the problem for several decades.
Physiotherapy
Physiotherapy methods can be used only when the acute period has passed and the patient is on the way to recovery.
Actively used methods include:
- ozone therapy- exposure of the affected joint to ozone, and the substance can be injected or used as an external treatment. This type of patient assistance is very effective, so it is often used in the treatment of various pathologies, including arthrosis. The treatment helps to activate blood circulation in the problem area, to achieve an anti-inflammatory and analgesic effect. At the same time, treatment with glucocorticoids is carried out;
- physiotherapy- treatment is carried out using a special set of exercises. The load is formed taking into account individual data, and when performing exercises, special simulators are used to strengthen the joints. The difference between physiotherapy and physiotherapy exercises is the active effect not only on osteoarthritis of the knee, but also on the whole body as a whole.
Apply not only ozone therapy and physiotherapy, but also physiotherapy. Good results are given by the author's methods of exercises to eliminate arthrosis of the knee. During exercises and after them, you may need to wear a special knee brace - a brace, to strengthen the right or left knee joint.