Osteoarthritis of the knee joint

Osteoarthritis of the knee joint is a disease of the musculoskeletal system, which consists of deformation and destruction of the cartilage tissue of the joint, as a result of which the structure and functions of the cartilage are disturbed.The disease has several names - gonarthrosis, deforming osteoarthritis.There is no unambiguous scheme for the treatment of arthrosis of the knee joint or a single drug that can equally help everyone suffering from this problem.Since arthrosis is a progressive disease, it is observed more in women with more weight, venous diseases and the elderly.Treatment is carried out and prescribed for each patient individually.

Osteoarthritis of the knee joint can be unilateral or bilateral (depending on whether the disease develops in one or both legs).Adequate treatment should be sought at the first symptoms, because ignoring this problem can lead to eventual destruction of cartilage and bone exposure, resulting in human 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 cartilage rubs against each other when moving, causing severe discomfort to the patient.The cartilage becomes rough, deformed, dry, and even covered with cracks in the advanced stage of the disease.
2. Due to reduced amortization, bone deformation begins, which leads to the formation of osteophytes (growths on the surface of bones) - this is the second stage of the disease.The new membrane of the joint and capsule is also deformed, the knee joint gradually atrophies due to the stiffness of the movement.Also, there is a change in the density of the joint fluid (it becomes thicker, more viscous), blood circulation deteriorates, and the supply of nutrients to the knee joint deteriorates.Thinning of the lining between cartilaginous joints reduces the distance between the joint bones.
3. The disease progresses rapidly and quite quickly passes to the third stage, the patient is practically unable to move due to constant pain in the knee.Global and irreversible changes occur in cartilage tissue and cause human disability.

Often, arthrosis or gonarthrosis develops after an injury or bruise, a person feels constant severe pain in the knee, which significantly hinders his movements.

Reasons for the development of arthrosis

Arthrosis of the knee joint, which takes a long time to heal, can manifest itself due to the following factors:

1. Genetic predisposition.
2. Injuries: sprains, bruises, fractures.When treating an injured knee, the joint is fixed and the person cannot bend or straighten the leg for a certain period of time.This leads to the deterioration of blood circulation, which most often leads to the development of post-traumatic gonarthrosis.
3. Removal of the meniscus.
4. Excessive physical activity that is inappropriate for a person's age, causing injuries or microtraumas, as well as hypothermia of the joints.For example, it is not recommended for elderly people to run or squat on the asphalt, because during these exercises there is a significant pressure on the knee joint, which wears out with age and cannot withstand such loads.
5. Overweight and obesity.This factor causes damage to the meniscus, its damage leads to the development of knee arthrosis.
6. Loose ligaments or weak ligaments.
7. Arthritis or other acquired joint diseases.The inflammatory process can lead to accumulation of synovial fluid or swelling in the joint cavity.This leads to the destruction of the knee cartilage tissue, 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. Straight legs.Incorrect foot structure changes the center of gravity and the joint load is greater.
10. Stress and nervous tension.

Symptoms of knee arthrosis

The clinical picture of the disease is manifested by the following symptoms:

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

Treatment of arthrosis of the knee joint

Treatment of arthrosis of the knee joint should be comprehensive.To date, there is no medical drug that can cure this disorder.One of the most important conditions for successful treatment is timely diagnosis.The sooner the treatment of knee arthrosis begins, the greater the chance to prolong the remission period and prevent the destruction and deformation of cartilage and bone tissue.

During the treatment, the doctor and the patient face a number of tasks:

1. Eliminate or reduce pain;
2. Establishing the supply of food to the knee joint and thereby increasing its recovery function;
3. Activate blood circulation in the knee joint;
4. strengthen the muscles around the joint;
5. Increase joint mobility;
6. Try to increase the distance between the articular bones.

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

Conservative treatment of arthrosis of the knee joint

Pain relievers, anti-inflammatory drugs

The patient is usually prescribed a course of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve or reduce pain.These can be tablets, ointments and injections.The most common pain relievers include the following.These drugs can be used in two ways - orally or locally.

Typically, patients prefer topical treatment in the form of gels, ointments, and warming patches.The effect of these painkillers occurs not immediately, but after a few days (about 3-4 days).The maximum effect is achieved after a week of regular use of the drug.Such drugs do not cure the disease, but relieve pain, because it is impossible to start treatment for pain.

Pain relievers should be taken strictly as prescribed by the doctor;they should be used only for severe pain, as long and frequent use can cause side effects and even accelerate the destruction of joint cartilage.In addition, long-term use of these drugs increases the risk of adverse reactions, including stomach ulcers, duodenal ulcers, disruption of the normal functioning of the liver, kidneys, and allergic manifestations in the form of dermatitis.

Hormones

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

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

Chondroprotectors

In the initial stages of the disease, a course of glucosamine and chondroitin sulfate, called chondroprotectors, is prescribed to restore and nourish the cartilage tissue.This is the most effective treatment for arthrosis.They have almost no contraindications and side effects are rare.

Vasodilators

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

Therapeutic exercise

A course of exercise therapy can be very useful and can give good results only if it is prescribed by a doctor and carried out under supervision, with the recommendation of a specialist or trainer.Self-medication is dangerous to health.Exercise therapy is used to prevent further cartilage destruction, slow the progression of stiffness, and relieve muscle spasms that cause pain.Exercise therapy is contraindicated during periods of exacerbation.A special course of individual exercises, taking into account not only the stage of the disease and the condition of the cartilage, but also the age of the patient, should be prepared 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.Physiotherapy methods act in several directions - relieve pain, reduce inflammation, normalize metabolism within the joint and restore its normal functions.The method and duration of physiotherapy treatment is determined by the patient's medical history and is prescribed only after a comprehensive diagnosis and study of the condition of the joints.

Pain-relieving physiotherapy includes:

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

Sanitation-spa treatment is not less important.This treatment is prescribed for deforming and dystrophic osteoarthritis.This treatment, like those listed earlier, has contraindications, so the attending physician carefully examines the patient's medical history before recommending the spa method.

Surgical treatment of arthrosis of the knee joint

This is a radical method of treating arthrosis of the knee joint, which partially or completely restores the function of the joint.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 final stages of knee arthrosis.Many consider the long recovery time 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:

Prevention of knee arthritis

To avoid this disease, people in the risk group (athletes, the elderly, overweight people, employees of institutions) should follow certain guidelines:

1. Proper nutrition and fight against 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 help you choose a suitable diet individually.
2. Monitor the load on your joints while playing sports and reduce it if necessary.
3. Monitor your health and treat infectious diseases in time, prevent 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. There is no self-medication!Contact the clinic at the first symptoms of knee arthritis.
7. Avoid stress, sleep well.
8. Systematically increase your immunity (harden yourself or take a course of vitamins at least 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.