What is osteoarthritis of the knee joint (knee): causes, symptoms and treatment of the disease

Osteoarthritis of the knee joint (gonarthrosis) is a degenerative injury of the joint, which ultimately leads to its deformation. In it, the cartilage tissue begins to collapse. Gradually, the functionality of the knee is impaired and the patient loses the ability to move normally. This disease is very common.

Treatment of osteoarthritis of the knee is long-term but cannot provide a complete cure for the problem. However, therapy is necessary to preserve the mobility and function of the joint for as long as possible, as well as improve the patient's quality of life.

Types of disease

It is possible to classify gonarthrosis of the knee joint by the reasons for its development. It is primary and secondary. The first type of disease occurs more often. It also has another name: idiopathic osteoarthritis. The exact reason for the development of this form of knee osteoarthritis is difficult to establish, as there are too many influencing factors.

The secondary type of pathology is clearly related to one reason or another. For example, it often occurs after a knee injury due to severe physical exertion of the knee joint. This gonarthrosis is often genetically determined. Some diseases can also cause dystrophic changes in the knee joint: diabetes mellitus, rheumatoid arthritis, congenital deformities of the lower limbs.

Why pathology develops

The knee joint is one of the most complex joints in the human body. It consists of the femur, tibia and patella. The joint also includes triangular cartilage with curved edges - menisci. The well-coordinated work of the knee is ensured by the musculo-ligament apparatus. Almost all the bony surfaces of the joint are covered with cartilage tissue, the thickness of which is about 0. 5 cm, feeds on blood vessels, as well as diffuse (obtaining useful substances from the synovial fluid).

Knee cartilage allows bony surfaces to slide and cushion. If the nutrition of this tissue is disturbed, dystrophic processes begin, it becomes thinner. If left untreated, the cartilage disappears completely and the knee joint stops moving. The reason for the development of arthrosis can be different. For example, the following factors can provoke the appearance of a secondary form of pathology:

• Excessive stress on the knee joint. In this case, changes may occur that the person is not even aware of. Therefore, the load should be moderate, especially in old age. The greatest damage comes from crouching and running on hard surfaces (asphalt).
• Knee injury. This can include damage to the meniscus, joint dislocation, fracture. This reason contributes to the development of the disease in young people. After fixing the limb, the blood circulation in it deteriorates. Damage or removal of the menisci in 90% of cases leads to osteoarthritis.
• Too much body weight. Excessive weight can damage the menisci. Restoring the knee joint is long and difficult. In obese people, bilateral knee osteoarthritis often occurs. Another negative point is the presence of varicose veins. In this case, the patient develops the most severe form of knee osteoarthritis.
• Weakness of the ligament apparatus. Due to this, there is too high joint mobility. Despite the fact that a person can sit on the wire without problems even without heating, at this time the joint receives microtrauma. If the knee is damaged enough, osteoarthritis begins to develop.
• Violation of metabolic processes. In this case, the knee joint is not getting enough nutrients.
• Joint pathologies. The presented pathology can be provoked by arthritis of the knee joint (reactive, rheumatoid). It is characterized by the development of inflammation and the accumulation of too much fluid in the joint cavity. The cartilage tissue in the knee begins to deteriorate.
• Stressful situation. Mood swings, the constant presence of the nervous system in a state of tension can cause osteoarthritis of the knee joint.
• Congenital diseases of muscles, ligaments and dysplasia.
• Chondrocalcinosis (premature deposition of calcium salts in the cartilage of the knee). The pathology is systemic.
• Osteomyelitis. This is an inflammation of the bone marrow, in which purulent masses are formed. They negatively affect the surrounding tissues. Over time, the purulent masses go beyond the bone of the knee joint. Lack of treatment threatens the development of sepsis.
• Acromegaly. This is an endocrine disease in which the level of growth hormone increases - growth hormone. Most often, a benign tumor in the anterior pituitary gland contributes to an increase in its quantity. If such a disease develops in adolescence, the child develops a specific physique. The excessive growth rate of cartilage tissue leads to deformation of the knee joint.
• Diabetes.
• Hypothyroidism. This disease is also endocrine. It occurs due to a lack of thyroid hormones. A person's mass begins to increase, he moves little, and the cartilage of the knee joint wears out.
• Freezing. In this case, ice crystals are formed in the soft tissues, which kill living cells.
• Synovitis (inflammation localized in the synovial sac of the joint).

All these reasons are capable of provoking gonarthrosis of the knee, while the person will not even notice when the disease began to develop.

What stages does osteoarthritis go through in its development?

The effectiveness of knee treatment depends on the degree of development of osteoarthritis diagnosed in the patient:

• First degree knee osteoarthritis. The pain at this stage does not make itself felt much. The patient can endure discomfort for years, while in no hurry to turn to specialists or carry out any type of treatment. A person needs help during an exacerbation. A sharp onset of pain is not typical of knee osteoarthritis.
• 2nd degree knee joint arthrosis. The intensity of the discomfort increases. Pain occurs not only after physical exertion on the knee joint, but also at rest. To get rid of unpleasant sensations, you need to rest more. In the area of the knee joint, swelling appears, the patient feels a crunch. X-ray shows a narrowing of the joint space, a slight deformation of the knee joint.
• 3rd degree knee joint arthrosis. In this case, the mobility of the knee is severely limited and sometimes the leg cannot fully straighten. Joint pain becomes severe and constant, appears as a response to changing weather conditions. The discomfort is painful in nature and it is difficult to get rid of it even at rest. Often the patient's sleep is disturbed, and to alleviate his condition at least a little, he uses NSAIDs. A person develops lameness, and the deformity of the joint is very noticeable.

Treatment of osteoarthritis should be started as early as possible, before bone destruction becomes critical. In case of irreversible changes, only surgery will help the patient.

Knee Osteoarthritis Symptoms

The development of osteoarthritis does not occur overnight. As it progresses, the symptoms become more intense. For gonarthrosis, the following manifestations are characteristic:

• Crunch and click that is heard with a certain movement. The patient may notice this symptom quite late. However, he says that the joint surfaces are damaged, grooves and bone growths have appeared.
• Swelling and enlargement of the knee.
• Painful sensations. In the first stage of the development of arthrosis, they are invisible and can appear only after severe static load on the knee joint. Dynamic exercise, in turn, improves the condition of the joint, its nutrition and subsequent prognosis. As the top layer of cartilage is obliterated in osteoarthritis, the nerve endings are exposed. After some time (after rest), the fibers are covered with a small layer of fibrin and become less sensitive - the pain in the knee disappears. If the knee joint continues to collapse, the discomfort does not leave the person even at rest. Edema appears in the bursa, which compresses the nerves even more. The inflammatory process begins.
• Limited mobility. This symptom makes it possible to differentiate osteoarthritis from other pathologies of the knee joint. Stiffness appears in the morning after sleep and disappears after half an hour. If this condition lasts longer, this indicates the presence of an inflammatory process.
• Reduced range of motion. The patient is unable to straighten the limb to the end. Since the patient constantly feels pain, he tries to reduce the range of motion and the ligaments adapt to it. That is, they are shortened and do not allow the knee joint to fully perform its function.
• Joint jam. It arises as a result of a strong change in the articular surfaces.
• Dislocations and subluxations. They appear in the last stage of the development of arthrosis, when the joint is severely deformed.

Over time, a person experiences muscle wasting, proliferation of osteophytes, and weakening of the lateral ligaments. The consequences of osteoarthritis are serious, as a person becomes disabled.

How to correctly define osteoarthritis?

To begin the correct treatment of arthrosis, the patient must undergo a thorough examination. Diagnostics should be differential and include the following studies:

1. X-ray of the knee joint. With gonarthrosis, it is performed in two projections. The specialist needs an x-ray of both the damaged and the healthy knee. Radiography allows you to determine the following signs of arthrosis: narrowing of the joint space, osteophytes, subchondral sclerosis. In addition, the presented study of the knee joint reveals subluxation, places of ossification of cartilage tissue.
2. Arthroscopy. This is a minimally invasive procedure that is used not only to diagnose osteoarthritis, but also to treat it. It involves the use of a special LED conductor with a camera at the end. It is inserted through a small opening on the side of the knee. The whole picture of the internal state of the joint is reflected on the monitor. However, the procedure has a drawback: the joint is depressurized and pathogenic microorganisms can enter it.

3. Ultrasound. This diagnostic method is absolutely safe. The procedure helps to examine the soft tissues of the knee, as well as cartilage, synovium, blood vessels.
4. CT. This is an X-ray examination method, however, it allows you to see not only bone structures, but also soft tissues. Thanks to computer equipment, the specialist can build a three-dimensional model of the knee. However, to obtain accurate information, the patient must receive a significant dose of radiation.
5. Scintigraphy. This is a contrast radiographic examination.
6. magnetic resonance. In this case, magnetic rays are used to obtain information. The image shows the soft tissues more clearly.

7. Thermography. The procedure is based on recording the thermal radiation from the patient's body surface. So you can identify tumors, foci of inflammation. One study is assigned for the purpose of differential diagnosis.
8. General blood analysis. Helps determine the severity of inflammation, determine its nature.
9. General urine examination. Thanks to him, it is possible to determine the systemic nature of the pathology.
10. Blood chemistry.

Thanks to these diagnostic measures, specialists can accurately determine knee osteoarthritis and prescribe a truly effective treatment.

Treatment of osteoarthritis of the knee

Treatment of osteoarthritis must be versatile and long-term. Since it will not be possible to completely stop the destruction of the joint, therapy will have to be carried out constantly in order to improve the patient's quality of life.

Medicines in the treatment of osteoarthritis

The doctor may prescribe the following medications:

• Non-hormonal anti-inflammatory drugs. They are used in the form of tablets and ointments. However, in case of severe pain syndrome, which cannot be eliminated by standard methods, an injection is used. It helps to quickly calm pain, relieve swelling and reduce the intensity of inflammation. These remedies can only eliminate the symptom, but they cannot cure osteoarthritis. Only a doctor should prescribe these funds. The course of treatment lasts no more than 14 days, and relief comes already in 2-3 days.
• Chondroprotector for osteoarthritis of the knee joint. Each of these medicines contains useful substances that can regenerate cartilage. However, it will only be effective if its application is started on time. If the cartilage is completely cleared, the use of chondroprotectors will be useless. Treatment by such means will be long-term (at least 6 months). Topical pills and medications are most commonly used, although injections are possible.
• Vasodilators. They help relieve spasm and pain syndrome, restore normal blood circulation and improve nutrition of the knee joint.
• Glucocorticosteroids. Most often they are used in the most difficult cases, when other drugs do not give a positive effect. Intra-articular injections in the knee are used for osteoarthritis. They can only be used once a year.
• Enzymes. They provide regeneration of the cartilage structure in the early stages of the development of osteoarthritis of the knee. They are also prescribed for injection into the joint.
• Hyaluronic acid. It provides smooth movement of the knee joint, as it is able to replace synovial fluid.
• Local preparations - ointments, creams, gels. They also only relieve the symptoms.
• Medication tablets. In this case, a drug is used that can penetrate the skin, help eliminate muscle clamps and have a resorbing effect. The compress can be made using medical bile.

Drug therapy in the treatment of osteoarthritis is indispensable. However, the drugs should be used strictly in the dosage prescribed by the doctor. It is impossible to independently increase or decrease the rate, change the daily rate without the knowledge of a specialist.

Features of physiotherapy treatment and physical therapy

You can also treat osteoarthritis of the knee joint using physiotherapy procedures:

• Massage. Helps restore normal blood circulation in tissues, eliminate muscle spasm.
• Electrophoresis with drugs allows you to eliminate inflammation in the joint, and also produces an analgesic effect.
• Magnetotherapy. With the help of specific radiation, the tissues surrounding the affected right or left joint are stimulated. The metabolic processes in the cells are improved.
• UHF. The waves promote the production of synovial fluid, which lubricates the knee.
• Phonophoresis with corticosteroids.
• Electrotherapy helps to eliminate not only pain, but also swelling.

• Mud therapy.
• Hirudotherapy.
• Shock wave therapy.
• Heat treatment. This includes paraffin therapy. Thanks to this procedure, local blood circulation is improved.
• SMV therapy. This physiotherapy stimulates blood circulation, relieves swelling and helps improve the nutrition of the cartilage tissue.

Physical therapy is extremely helpful. It is necessary to restore the elasticity of muscle tissue and ligaments, improve the mobility of the knee joint. The following exercises will be useful:

1. Lying on your stomach, you need to raise your legs in turn. In this case, they should not be bent at the knee. The lifting height is approximately 20 cm.
2. Lie on your left side, you need to bend your left leg and lift it 30 degrees. It is necessary to hold the limb in this position for up to 30 seconds. The same exercise should be performed with the right leg.
3. Sitting in a chair, the legs should be straightened and raised in turn as high as possible.

The set of exercises is selected individually by the attending physician. Gymnastics is best done after a small massage with medicated ointments. Physiotherapy is an effective additional method of treating arthrosis, which enhances the effect of drugs.

Is surgery necessary?

In the most difficult cases, when the joint is severely destroyed by arthrosis, the patient is prescribed an operation. There are several types of intervention:

1. Joint traction. It involves stretching the joint damaged by osteoarthritis in order to increase the gap between the cartilages. This will prevent further tissue destruction and its gradual recovery.
2. Endoprosthesis is a complete replacement of a joint destroyed by arthrosis. It is performed as a last resort. The replacement can be complete or partial. The prosthesis will need to be changed in 10-15 years.
3. Osteotomy. Such treatment for osteoarthritis allows you to mechanically correct deviations of severely deformed bones. In this case, the solid elements break down in a strictly defined place. Subsequently, the bones are correctly positioned and fused.
4. Arthroscopy. With the help of her, the restoration of the surface of the cartilage destroyed by arthrosis is carried out. In addition, foreign bodies and bone fragments can be removed from the joint using an arthroscope. This operation is used for joint hypermobility. Arthroscopy is considered a mildly traumatic procedure, so rehabilitation afterwards doesn't last long.

It is better not to take him to surgery. Treatment should be started in the early stage of the development of osteoarthritis. Orthopedic devices will help to consolidate the result: a cane, an orthosis to reduce the load, knee pads with infrared radiation.

The use of folk remedies

It is impossible to completely cure osteoarthritis, as the degenerative process will gradually progress. However, it is possible to eliminate the symptoms and stop the destruction of the knee joint in osteoarthritis. Folk remedies can be used during an exacerbation, as well as during relative calm. But first you need specialist advice. The following recipes will be useful for osteoarthritis:

1. Chopped horseradish root should be boiled in a small amount of water over low heat. Next, the gruel must be filtered and placed around the knee affected by osteoarthritis. The compress must be fixed with a bandage. You need to carry out the procedure every day for a month. The compress improves blood circulation and tissue repair.
2. Rubbing any vegetable oil in the area of the knee joint for osteoarthritis will help eliminate the pain. However, it needs to be warmed up a bit.
3. The mummy provides a good effect. It is necessary to mix 3-4 g of raw materials with 100 g of honey and mix thoroughly. It is necessary to rub the medicine into the sore spot in the evening, before bedtime. Then, wrap the affected area with a warm scarf. The welcome of the mummy inside is also appreciated. You can use it at 0. 2g per day.
4. Fresh dandelion flowers can be washed thoroughly and eaten 5-6 pieces per day. Also dried raw materials in the amount of 1 tbsp. you should pour a glass of boiling water, insist and drink 1/3 cup three times a day.
5. Rub the aloe leaves. It is necessary to twist 10 sheets of the plant and squeeze through gauze. The juice is mixed with half a glass of honey and 150 ml of red wine. The resulting product is poured into a dark glass container and applied daily for a month.

Cabbage and burdock leaves will help relieve inflammation in osteoarthritis. Folk remedies cannot be considered a panacea, but they increase the effectiveness of other types of therapy.

Nutritional rules for osteoarthritis

The treatment of osteoarthritis does not require a particularly strict diet, but you must still respect some nutritional rules:

• Reduce your salt intake. Its total amount per day should not exceed 2 g. It is better to salt the dish just before use and not during cooking.
• The amount of spices used during the treatment of osteoarthritis should also be reduced. The same goes for fermented foods, pickles. Marinades and canned food are generally excluded from the diet.
• Animal fats are not recommended.
• The menu must not contain sweets, pastries and bread made from wheat flour.

• With osteoarthritis, alcohol and nicotine are strictly prohibited.
• Dishes with gelatin content are useful: jelly, jellied meat, broths from beef bones.
• It is important that osteoarthritis consumes milk proteins (the products must not be fat), fish, seafood.
• The diet should contain vegetable oils, vegetables and fruits, freshly squeezed juices.
• A person should consume a sufficient amount of fluids per day.

The correct diet for osteoarthritis should be developed by a specialist. You cannot go to extremes, even if the patient is overweight. Dramatic and improper weight loss will only aggravate your health. In this case, the treatment will be significantly delayed.

Prevention of arthrosis

To avoid the possibility of developing osteoarthritis, as well as not to lose the ability to walk, you need to follow the following expert advice:

• We must not forget the movement. Better to go to the pool, ride a bike, go hiking in the open air. You can also go to the dances.
• It is advisable to avoid any injuries and hypothermia of the knee joint, as it causes post-traumatic osteoarthritis.
• It is best to use protective knee pads or other orthopedic devices for prolonged exertion.
• Comfortable shoes are recommended.

• It is important to eat right: osteoarthritis will have no chance if all the necessary nutrients are regularly supplied to the joint.
• If you have excess weight, you should get rid of it.
• It is better to avoid stress, organize work correctly and rest the routine.
• It is necessary to strengthen the body's defenses.
• All inflammatory or infectious pathologies that can provoke the development of osteoarthritis should be eliminated over time.

Proper prevention can significantly delay joint destruction, which under normal conditions is a natural aging process of the body.

Osteoarthritis of the knee joint is an incurable disease, but its progression can be slowed and even stopped by improving the quality of life.