Arthrosis of the knee joint is a degenerative-dystrophic pathology that leads to deformation and destruction of articular cartilage. Gradually, the limb loses mobility. According to statistics, almost every third inhabitant of the earth suffers from arthrosis, and this figure is not decreasing. Older people are at risk, particularly those who are overweight. After the age of 65, osteoarthritis is diagnosed in 70-85% of cases treated for knee pain.
A rheumatologist will help maintain the quality of life of a patient with joint pathology.
causes of osteoarthritis
- Destruction of the joint through natural wear and tear (body aging).
- Hormonal disorders (menopause, endocrine diseases).
- Congenital defects of the musculoskeletal system.
- Injuries, surgical interventions on the knee joint.
- Professional sports.
- Monotonous physical work with increased load on the knee joints.
- overweight.
- genetic predisposition.
- autoimmune diseases.
symptoms of the disease
Deforming arthrosis of the knee joint (gonarthrosis) develops slowly and has a chronic course. In the early stages, the disease does not cause pain: a person only feels discomfort, stiffness in the lower limb. Motor restrictions gradually increase. Without adequate treatment, the knee is noticeably deformed. The motor functions are so badly disturbed that it is difficult for a person to walk, sit down and stand up. Deforming osteoarthritis progresses to patient disability. To save the joint, it is necessary to consult a doctor when the first symptoms of any pathology appear.
Depending on the degree of severity, there are three degrees of arthrosis of the knee joint:
- 1 degree. Clinical manifestations of the disease are mild. Most patients ignore the symptoms and continue to lead normal lives. With stage 1 osteoarthritis, a person may experience discomfort in the knee after prolonged standing, intense walking, and physical exertion. The X-ray shows a narrowing of the joint space, osteophytes growing into the joint are visible. If arthrosis is accidentally discovered in the first stage, for example during a medical examination, its development can be significantly slowed down and even stopped.
- 2 degrees. Pain in osteoarthritis of the knee becomes intense, it is difficult to ignore. The leg is particularly annoying early in the morning or in the evening. During the day, aching pain persists at rest. Degenerative processes in the joint are reflected in the gait: the person begins to limp. A crunch in the knee is heard during the movement. Stage 2 osteoarthritis can be complicated by "joint mouse" - this is a condition in which a particle of bone or destroyed cartilage enters the synovial cavity. The foreign body causes severe pain that interferes with movement of the limb. On examination, the knee is deformed. Perhaps the accession of inflammation, swelling. X-ray shows a narrowed joint space and osteophytes, thickening of the bone.
- 3 degrees. A severe form of the disease that develops without treatment. Grade 3 osteoarthritis is the cause of permanent disability. The pain in the knee is very strong, mobility is limited, the person cannot walk independently, every step hurts. The leg is deformed and begins to crackle heavily. On the X-ray, the doctor notes the degeneration of cartilage tissue, the destruction of ligaments, menisci, and the growth of connective tissue.
Diagnosis osteoarthritis
To examine the patient, physical, laboratory and instrumental diagnostic methods are used:
- Blood analysis is general, biochemical, immunological.
- Analysis of synovial fluid.
- radiography.
- Ultrasound of the knee.
- CT or MRI if indicated.
The examination plan is always individual and depends on the patient's condition.
Treatment of osteoarthritis of the knee joint
Therapy includes a number of procedures, medications and recommendations for lifestyle changes. It's important that you don't try to treat arthritis yourself. Patients often use anesthetic ointments in the early stages of the disease and go to the doctor when the joint is already destroyed. The earlier treatment is started, the more effective it is.
Medical treatment
The doctor prescribes drugs to relieve inflammation, swelling, pain relief, activation of metabolic processes and tissue regeneration. Drugs are selected individually.
The following funds are available:
- Non-steroidal anti-inflammatory drugs(NSAIDs) in the form of tablets, ointments, injections. Means well relieve pain, swelling, improve the patient's well-being.
- glucocorticosteroidsin the form of injections directly into the knee joint. Injections are indicated in severe cases of the disease when the limb is practically immobilized.
- pain blocks. Help to manage symptoms and alleviate disease progression.
- chondroprotectors. The drugs help restore cartilage tissue and slow down the destruction of the joint.
Conservative treatment
shock wave therapy
The method is non-invasive, helps to remove salt deposits and improves the trophism of connective tissue. Physiotherapy improves blood circulation, has a beneficial effect on the elasticity of ligaments. Shock wave therapy is carried out in courses of 4-10 procedures.
Plasma lifting (PRP therapy)
The patient's own platelet-rich plasma is injected into the joint. The course of plasmolifting accelerates tissue regeneration.
phonophoresis
The method combines the action of ultrasound and therapeutic ointments. Funds for physiotherapy, as a rule, have a complex composition and are made in a pharmacy by prescription. Ultrasound increases the penetrating power of the active substance.
massage
The procedure is contraindicated at the stage of exacerbation of arthrosis. When the inflammation is removed, the pain syndrome is reduced, you can start a massage course. The technique of lymphatic drainage helps prevent accumulation of synovial fluid. Massage also improves blood circulation in the knee, relieves muscle spasms. The procedure is most effective after performing special exercises for osteoarthritis of the knee joint.
Bathe
You can take a course prescribed by a doctor or as part of a home cure. With arthrosis, radon, turpentine and hydrogen sulfide baths are indicated. The interventions not only have a positive effect on the knee, but also on the hip and ankle joints.
hirudotherapy
Medicinal leeches are placed around the deformed joint. The saliva of these creatures contains active ingredients that help restore cartilage. Hirudotherapy is usually prescribed for 1st and 2nd degree osteoarthritis to reduce swelling and reduce pain.
physical therapy
Gymnastics in arthrosis of the knee joint is a mandatory component of complex treatment. Special exercises will help maintain muscle tone in the diseased limb and prevent congestion. Gymnastics starts in the morning without getting up. Then another 3-4 sets of exercises are done for a few minutes during the day. It makes sense to supplement therapeutic exercises for arthrosis of the knee joint with swimming.
surgery
Surgical intervention is indicated for osteoarthritis of the 2nd and 3rd degree:
- puncture. With the help of a syringe, the accumulated fluid is pumped out of the joint cavity. Reduces internal pressure, reduces swelling, inflammation, improves mobility. The procedure is performed on an outpatient basis by appointment of the surgeon.
- arthroscopy. The procedure serves to rehabilitate the knee joint. Arthroscopy is performed through small punctures, so the operation is quite well tolerated, the rehabilitation period is short.
- corrective osteotomy. The classic technique of treating deforming arthrosis, which consists in correcting the deformed anatomical axis of the lower limb, followed by fixing the site of wedge resection of the bone with a titanium plate. After an osteotomy, the patient needs several months of rehabilitation.
- endoprosthetics. The installation of an artificial joint takes place in the case of an extremely deforming arthrosis of the knee joint and allows the knee to return to its previous range of motion without pain. After total arthroplasty, the patient needs a long (about 2-3 months) rehabilitation.
arthroscopy
Minimally invasive treatment method. A video camera and microsurgical instruments are inserted into the joint cavity. The doctor conducts a thorough examination of the joint, extracts osteophyte particles, destroyed cartilage, scar tissue. Arthroscopy helps temporarily relieve pain and restore joint mobility.