Osteoarthritis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease that is accompanied by progressive destruction of cartilage with the gradual involvement of periarticular structures in this process.Lack of timely treatment leads to limited mobility and even disability of the patient.
Description of the disease
Gonarthrosis is diagnosed in 70 to 85% of patients over 65 who consult a doctor for knee pain.Older people are at risk because with age, the articular cartilage becomes thinner, microcracks appear in it and it gradually collapses.New pathological changes appear:
- the composition of the synovial fluid changes, it decreases, which is why the surfaces of the bones begin to touch each other and collapse;
- bony growths (osteophytes) appear;
- the joint capsule becomes denser, which causes joint stiffness;
- A spasm of the muscles surrounding the joint occurs.
Without treatment, the knee becomes deformed and movement is considerably limited.May affect one or both joints
According to statistics, one in five people in the world suffers from knee osteoarthritis.The disease is mainly diagnosed in people over 40 years old, but the age factor is not the only reason for the development of pathology.
Why does knee osteoarthritis appear?
In elderly patients, osteoarthritis of the knee joint occurs due to natural wear and tear of the cartilage tissue.Other causes of the disease:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtrauma;
- previous surgical procedures;
- autoimmune diseases;
- chronic joint diseases;
- regular increased loads on the knee joint, for example, running or jumping, constant standing or kneeling;
- genetic predisposition.
Women over 40, athletes, overweight patients and people working in construction are at risk.
How to recognize osteoarthritis of the knee joint?
The disease develops slowly, over several years, and has a chronic course.Its changes are irreversible, so it is important to start treatment as soon as possible when symptoms appear.
The first signs of knee osteoarthritis:
- knee stiffness;
- discomfort when straightening or bending the knee joint, going up or down stairs;
- cracking or clicking noises when moving;
- slight knee pain, which occurs only after prolonged standing and disappears with rest.
Over time, the discomfort intensifies.Severe stiffness, motor disturbances and severe pain appear, which do not leave the patient even at rest.It is difficult for a person to walk, sit or stand up.Without treatment, the knee joint becomes deformed, causing disability.
The severity of changes, as well as the likelihood of recovery, depends on the stage of the disease.
Degrees of knee osteoarthritis
There are 4 degrees of severity of the disease:
- I graduated.At the beginning of the disease, there are practically no symptoms.There is slight discomfort in the knee after exercise, which does not interfere with a normal lifestyle.Pathological changes can only be detected using X-rays.
- IInd degree.Periodic crunching and pain appear during physical activity, walking, climbing stairs, squatting, or standing for a long time.X-ray images may reveal narrowing of the joint space and early signs of osteophyte formation.
- IIIrd degree.The pain syndrome becomes permanent and does not even let the person rest.The knee hurts particularly in the morning and evening;during the day the pain is painful and tolerable.Since degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a crunch is heard when moving.There is a "joint mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity, causing severe pain.The knee becomes deformed and may become inflamed and swollen.X-rays show signs of joint deformity, osteophytes, significant narrowing of the joint space, and meniscus damage.
- IVth degree.Without treatment, the disease becomes extremely serious.Cartilage, ligaments and menisci are completely destroyed, making it impossible to move the joint, the joint surfaces are deformed and a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnosis
Diagnosis of osteoarthritis of the knee joint is not difficult.An orthopedist-traumatologist carries out the examination and treatment.He examines the patient's knee, assesses motor activity, studies clinical manifestations and palpates to identify areas of swelling and the presence of effusion.
To confirm the preliminary conclusion, he prescribes an instrumental examination:
- X-ray examination - allows you to identify narrowing of the joint space, the presence of osteophytes;
- Computed tomography of the joint is a more informative diagnostic method than X-ray;it shows the condition of the joint cavity;
- Ultrasound of the joint - allows you to determine the volume of fluid in the joint cavity, the presence of osteophytes, assess the condition of the surrounding soft tissues, the thickness of hyaluronic cartilage;
- MRI - suitable for studying not only bone and cartilage tissues, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method;during the procedure, the synovial fluid may be punctured.
Additionally, a clinical and biochemical blood test, an immunological study and a rheumatoid factor test may be required.
Treatment of osteoarthritis
An orthopedist must treat knee osteoarthritis taking into account the clinical picture and the degree of damage to the joint.You cannot heal yourself.
The doctor can prescribe drugs from the following groups:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, which restore cartilage and prevent its further destruction;
- analgesic blockages that effectively eliminate pain;
- glucocorticosteroids, which are indicated in cases of serious illness;
- antispasmodics to eliminate muscle spasms.
Drug therapy is supplemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetotherapy, electrophoresis and phonophoresis.Additionally, physical therapy and massage are prescribed.
You definitely need to control your weight and try to get rid of extra pounds, which cause additional stress on the knee joints.It is important to follow a diet;the diet should contain foods that nourish cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is necessary.This may involve an arthroscopy, an osteotomy or an endoprosthesis.
The most favorable prognosis is that if osteoarthritis is detected at stage 1, then the changes can be slowed down and even stopped.Knee stiffness or pain is not normal;it is worth getting examined to understand the cause of the discomfort.