Osteoarthritis of the knee

The following factors may contribute to the development of osteoarthritis of the knee:

• excessive physical activity that does not meet the age requirements, leading to joint damage;
• sedentary way of life;
• suffered injuries in the area of the knee joints - sprains of the knee, fractures, ruptures and ruptures of ligaments, damage to the body of the meniscus, severe falls of the knee, bruises;
• increased body mass index, which causes increased tension on the joints, rupture of the meniscus;
• heredity;
• arthritis or other joint diseases (inflammation can lead to swelling or accumulation of large amounts of synovial fluid in the joints, provoking the destruction of cartilage tissue);
• metabolic disorders leading to calcium excretion from the body;
• diabetes mellitus of any kind, hormonal disorders and other pathologies of the endocrine system;
• chronic or past diseases of inflammatory and infectious nature;
• impaired blood flow;
• lupus erythematosus, rheumatoid, gouty and psoriatic pathologies, ankylosing spondylitis;
• flat feet, due to which the center of gravity shifts and the load on the joint increases;
• nervous overload and stressful situations.

Why does osteoarthritis of the knee joint occur?

Most often, people themselves are to blame for the development of such an incurable disease. Often, when there is pain in the knee joint, people ignore the painful sensations, preferring to go to the doctor to use any drugs that simply mask the pain.

After a few years, however, you will need to consult a specialist, because with such a diagnosis, self-medication will not work. However, the severity of osteoarthritis will be at least moderate. Ointments, intra-articular application of hyaluronic acid and preventive physical education are no longer enough here, as could be done in the early stages of the disease. It will probably be necessary to act radically, including sometimes with the help of surgery.

Symptoms and diagnosis of osteoarthritis of the knee

The disease can be distinguished by the following signs:

• Pain syndrome. Painful sensations usually appear suddenly, but most often during exercise, even mildly. The pain can be of different nature. In the beginning, these will be weak lumbagos (unfortunately, few people pay attention to them). Mild pain, which occurs only periodically, can last for months or even years until the disease progresses to a more severe stage.
• Pronounced knee deformity. A similar symptom is characteristic of the later stages. And at the beginning of the development of osteoarthritis, the knee swells and swells a little.
• The appearance of dense formations in the posterior wall of the knee joints. The accumulation of large amounts of joint fluid in the cavity of Baker's cyst or in the joint itself.
• Acute crunch of the joints, which is accompanied by pain.
• Reduced joint mobility. This is especially pronounced in the later stages of osteoarthritis. In this case, bending and unbending the knee causes severe pain, and in the last stages movement becomes almost impossible.

REFERENCE! In a patient with osteoarthritis, the gait changes: it is characterized by sagging legs and lameness.

Pathogenesis of osteoarthritis of the knee joints

Specialists distinguish between primary and secondary osteoarthritis.

Primary osteoarthritis of the knee joints

Primary gonarthrosis is characterized by the following processes:

1. The articular cartilage is able to constantly deteriorate and at the same time quickly renew itself. Under normal conditions, these two processes must balance each other. With age, the destruction of cartilage occurs at the same rate, but its recovery slows down. The mass of a person plays an important role here. In fact, if a person weighs 70 kg, then in 10 steps on one leg he will transfer 700 kg, and one who weighs 120 kg will transfer up to 1200 kg, which will become a significant load on the joints and cartilage, which will wear out faster because of this.
2. It is important to remember: the joint feeds on useful elements only when moving. Sedentary lifestyle leads to a slowdown in metabolic processes, due to which the necessary nutrients do not reach their destination.
3. People whose parents have suffered from this disease are more likely to develop gonarthrosis.

Secondary osteoarthritis of the knee joint

It develops for the following reasons:

• Lots of injuries. In people of any age, they will cause excessive stress on the cartilage. When any bone covered with cartilage is broken, irregularities appear, the so-called "feet". In this area now, with each movement, the joint will wear out, leading to osteoarthritis.
• Development of rheumatoid arthritis, Koenig's disease, the appearance of purulent inflammation in the joints.
• Vascular dysfunction.

Classification and stages of development of osteoarthritis of the knee joints

Orthopedists divide gonarthrosis into stages on which further treatment of the disease depends. Of course, the course of treatment will depend on other factors, such as the causes of the development, location and nature of osteoarthritis.

IMPORTANT! Quality treatment can be prescribed only by a doctor after a thorough examination of the disease. Self-therapy can only worsen health.

The main classification divides gonarthrosis into four stages of development:

1. Initial phase. At this stage, the disease is still emerging. External symptoms are barely noticeable or completely absent, the shape of the joint is in satisfactory condition. Symptoms include only mild discomfort or heaviness in the knee after long walks, as well as strenuous exercise. The X-ray will have little information: the X-ray may show only a slight narrowing of the joint space. Unfortunately, at this stage one does not seek medical help due to the insignificance of the symptoms.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. The severity of the pain decreases at rest. The movement of the joints becomes difficult. There is a squeak or squeak of the knees when walking. The X-ray shows a narrowing of the joint space, as well as osteophytes. The patient begins to limp.
3. When osteoarthritis progresses to the third stage, the pain syndrome will be felt constantly, even in the absence of movement. The processes of deformation and degeneration pass into an irreversible stage. The curvature of the joint becomes pronounced, the distance between the joint surfaces is noticeably reduced, the numerous osteophytes increase in size. Painful sensations already disturb the patient even in a state of complete rest. One becomes dependent on external support (walkers, canes) and needs help from other people. Conservative treatment at this stage is less effective.
4. The fourth stage is characterized by constant excruciating pain. Osteophytic growths increase in number and size, cartilage is completely destroyed, joint space is barely traced or completely missing, bones are severely deformed. Even weak movements become torture for the patient. At this stage of gonarthrosis, the patient is recognized as disabled. In the absence of surgery, the disease can lead to disability.

Complications of osteoarthritis of the knee joints

Advanced osteoarthritis can lead to sprains and subluxations of the knee joint. In dislocation, the epiphysis of the femur extends completely outside the joint, which makes movement in the joint impossible and the axis of the leg shifts significantly to the side. Fortunately, such a negative variant of the disease is quite rare.

Subluxations are more common. They are characterized by partial displacement of the joints relative to each other and a slight deviation of the tibial axis. In this case, subluxations are accompanied by severe pain and joint dysfunction.

Neglecting the disease can lead to complete loss of lower limb function.

ATTENTION! The habit of sparing a sore leg sometimes causes deformity of the intervertebral discs and the appearance of hernias.

Consequences of neglected gonarthrosis

The advanced stage of gonarthrosis is almost always characterized by the following adverse symptoms:

• round-the-clock pain from which no painkiller can save;
• loss of limb support (impossible to stand on a sick leg or at least lean back);
• immobilization of the joint block;
• pronounced curvature of the bones around the knee;
• severe swelling around the affected area.

Methods of treatment of osteoarthritis of the knee

Prescribed treatment depends on the stage of development of the disease. There are several options for therapy.

Hormones

These drugs are prescribed for severe exacerbations, accompanied by synovitis and severe pain. Hormones are usually given by injection. The following drugs are most commonly used:

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The course of hormone treatment is usually short, injections are made only in a period of severe exacerbation. Hormones are administered at an average frequency once every 10 days.

Chondroprotectors

Chondroprotectors are prescribed in the early stages of the disease. Currently, this therapy is considered the most effective and safe: there are virtually no contraindications, and side effects occur in the rarest cases.

The drugs are aimed at restoring cartilage, improving metabolic processes, nourishing cartilage tissue and protecting it from further destruction. But in the later stages of osteoarthritis, chondroprotectors are also powerless.

This group of drugs is produced in the form of injections, ointments, gels, tablets.

Vasodilator drugs

These funds are needed to eliminate spasm of small vessels, increase blood circulation and supply nutrients to the affected joint. It is prescribed to take vasodilators together with chondroprotectors.

If joint fluid does not accumulate during gonarthrosis (no synovitis), the use of warming ointments is recommended.

Hyaluronic acid

In another way, this tool is called an intra-articular prosthesis, because the composition of the acid is similar to the composition of the intra-articular fluid. When the acid is injected into the joint, it forms a film that prevents strong friction of the cartilage during movement, affects the extracellular matrix, improves metabolic processes in the joint, and also triggers the production of hyaluronic acid in the joint - ie returns to normal. functioning of the joint, stopping the pathological processes that destroy cartilage. . . .

Acid treatment is prescribed only in the elimination of exacerbations - synovitis.

Physiotherapy

The course of physiotherapy exercises will bring positive results only if it is prescribed by a doctor after a complete study of medical history and all exercises are performed under the supervision of a specialist.

Self-medication often leads to deterioration of the joints. Therapeutic therapy is prescribed for the following purposes:

• slowing the development of stiffness;
• prevention of further destruction of cartilage tissue;
• elimination of muscle spasm leading to pain.

Physiotherapy

Various procedures can be prescribed as adjunctive therapy: electrophoresis, acupuncture, laser therapy, UHF, and diadynamic currents. The local massage will also give a good result.

Physiotherapy is aimed at reducing the severity of pain, eliminating inflammation, normalizing metabolic processes inside the affected joint and restoring its normal function.

IMPORTANT! It is important for the patient to follow their diet and avoid strenuous exercise.

Forecast. Prevention

At an advanced stage of the disease, the prognosis is disappointing. Therefore, it is recommended that if you experience even mild symptoms of osteoarthritis, consult a doctor for advice.

People at risk (elderly people, athletes, as well as overweight people) should follow the doctor's recommendations and follow the following rules:

1. Eat right and control your weight. Follow a weight loss diet if necessary.
2. Reduce the load on the joints while exercising, constantly monitor it.
3. Treat infectious diseases in a timely manner, preventing them from becoming chronic.
4. Get enough rest, avoid stressful situations if possible.
5. Increase the protective functions of the body (periodically take vitamins, temperament).
6. Avoid hypothermia of the body, especially of the lower extremities.