The joints of the human body withstand daily stress, so they become susceptible to various kinds of destructive factors. Among diseases of the joints, arthrosis is common, and it affects both large and small joints. Arthrosis of the knee joint is a degenerative-dystrophic damage to 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 provokes characteristic deformities in the joint, it was called deforming arthrosis of the knee joint, which rightly describes the typical characteristic of the pathology. The disease is chronic and more often diagnosed in women, moreover, those suffering from 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.
Arthrosis 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 various depths. Subsequently, it ceases to perform its function.
The reasons
Various causes lead to the appearance of deforming arthrosis of the knee joint. Traumatic factor is a common cause of occurrence. Post-traumatic arthrosis can develop as a result of a dislocation or fracture in the specified area, as well as a meniscus injury. Usually, gonarthrosis of the knee joint appears in young people who are actively involved in sports, or in those 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 been cured, but during prolonged immobilization of the limb, circulatory disorders in this area occurred. Because of this, gonarthrosis appeared.
Increased physical activity on the knee is one of the leading 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 the cessation of physical activity.
There is also a risk of disease in those 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 years, doctors recommend that athletes reduce the load, switch to coaching. Running and squats are best avoided, as these are the activities that put the most strain on the knee joint. Most often, one limb is affected and 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, then in 90 percent of cases this leads to the appearance of arthrosis - the so-called looping of the knee occurs, during which the articular joints experience more friction than usual.
The problem of excess weight is also relevant for people with arthrosis. Excess body weight puts unnecessary pressure on the joints. As a result, not the cartilage itself is damaged, but the meniscus. And with a combination of excess weight and varicose veins of the lower extremities, acute arthrosis threatens to appear.
Weak ligamentous apparatus in some patients is a congenital feature, and sometimes the ligaments are affected due to other diseases. One way or another, weak ligaments provoke 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 experience symptoms of true arthrosis.
Articular 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 the synovial fluid, pathological changes in the cartilage, swelling, redness of the soft tissues. Even after cured osteoarthritis, 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 tissue strength. 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 is manifested by a complex of characteristics that are hard to miss. Signs are not felt only in the first degree of development of the 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 pain signs are discomfort during physical exertion, walking or running, but it also manifests itself when the meniscus is pinched. With the second degree of arthrosis, the pain in the joint is felt more strongly, and with 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 the development of arthrosis. The knee will retain its normal shape, but will appear slightly swollen and edematous. When arthritis joins, the knee will turn red, become hot and painful to the touch;
- crunchwith arthrosis appears in the second and third degree of development of the disease. The crunchy sounds are different from the healthy clicks that can sometimes be heard when the knee is extended and flexed. In arthrosis, the symptoms are characterized by a dry, rough sound that comes on abruptly 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 excess 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 mobility in the knee- a typical sign of pathology, since patients first try to protect themselves from pain consciously, and in the late stage of arthrosis they cannot straighten the limb at all. In the third degree of development, deforming osteoarthritis of the knee joint (DOA) completely leads to loss of movement. Patients adapt to move on bent legs, while using the 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, pain occurs during movement, but quickly passes. Outwardly, the deformation of the knee joint is invisible, so the diagnosis of arthrosis of the knee joint can be difficult.
With a disease of the second degree, damage to the cartilage tissue is more significant. If you take an X-ray, then the stage of bone growth is already noticeable on it. With any movement, a sharp sudden pain appears in the knee, but, returning to a comfortable position, the knee no longer hurts. At the second stage of DOA, you can hear a crunch typical of arthrosis. With progression, problems with extension and flexion of the knee worsen. Deformation becomes noticeable externally.
Osteoarthritis of the knee joint of the third degree is characterized by a significant thinning of the cartilage tissue. Gradually, the cartilage wears out so much that the bone is exposed in some areas. 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 X-ray control is carried out.
With the progression of this degree, arthrosis can lead to a complete loss of functionality. In any degree of development of the pathology, osteoarthritis of the knee joint can join.
Treatment
Coping with arthrosis of the knee joint is not easy, especially if the disease is advanced or inflammation has joined and arthritis has developed.
conservative
The group of the most active drugs against arthrosis is non-steroidal anti-inflammatory drugs. These are primarily cyclooxygenase-2 inhibitors, they can perfectly relieve inflammation, swelling and contribute to the speedy recovery.
These medicines 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. Non-steroidal anti-inflammatory drugs are also prohibited during pregnancy.
The second group of agents is chondroprotectors that improve the characteristics of cartilage tissue. They are used for arthrosis to restore the correct structure of cartilage, because in the process of resolution it loses very important components - chondroitin and glucosamine. Therefore, almost all chondroprotectors contain both of these substances, but some drugs are single-component.
With the help of these medicines it is possible to help the patient in the first and second stages of the development of the disease, but not in the third, when irreversible changes have occurred.
During conservative therapy, the doctor will also give recommendations on nutrition. If the patient or 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. 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 be useful.
Operational
The most common type of surgery for arthrosis is arthroscopy, but other interventions are performed. Treatment of arthrosis of the knee joint is usually carried out at the second and third degrees, when conservative therapy no longer helps.
If a minimally invasive intervention is required, for example, in case of accumulation of fluid in the knee joint, it is possible to get by with 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 minimal 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 inserted that allow for examination of the joint and the necessary manipulations in it. With the help of arthroscopy, it is possible to remove tissue particles that have separated from the cartilage, but there is always a risk that secondary gonarthrosis will appear.
With severe damage, there is a need to perform a periarticular osteotomy. This is a larger-scale impact on the joint, as a result of which it is slightly filed and set at the desired angle. After the operation, rehabilitation is longer, but the effect lasts longer.
Significant destruction of the articular elements leads to complete immobilization of the limb. The joint does not fulfill its function, which means that it needs to be replaced and an operation needs to be done. Endoprosthetics of the knee joint is an expensive operation, but it alone makes it possible for the patient to return movement 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 mend.
Methods actively used include:
- ozone therapy- exposure to the affected joint with ozone, and the substance can be injected or used as an external treatment. This type of assistance to patients is very effective, therefore it is often used in the treatment of various pathologies, including arthrosis. Treatment makes it possible 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;
- kinesiotherapy- treatment is carried out with the help of a special set of exercises. The load is formed taking into account individual data, and when performing exercises, special simulators are used that strengthen the joints. The difference between kinesiotherapy 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 kinesiotherapy, but also physical therapy. Good results are given by the author's methods of exercises to eliminate arthrosis of the knee. During the exercises and after them, you may need to wear a special knee brace - an orthosis, to strengthen the right or left knee joint.