Depanten Official site
Share this

Osteoarthritis of the knee joint

Arthrosis of the knee joint on X-ray

Osteoarthritis of the knee joint is a special disease that has a destructive effect on the cartilage of the knee joint.

When such a disease occurs, doctors observe serious disturbances in the blood circulation processes in the bone vessels, as a result, they feel severe pain caused by the deformation and destruction of the cartilage tissue, and observe swelling and changes in the appearance of the knees.

In order to prevent the development of serious consequences of gonarthrosis (extremity and joint immobilization deformation), the disease should be identified and treated immediately, only if the disease requires joint replacement surgery.Moreover, do not be independent with folk methods and advertised remedies, but under the supervision of qualified doctors.

What are the reasons?

In medicine, the mechanisms of arthrosis are generally divided into:

  • Primitive- from the natural aging of body tissues in old age and this disease occurs against the background of obesity (10% of cases), heredity and increased stress of increased stress and some factors that increase increased stress.
  • Medium- It accounts for 30% of all cases of arthrosis of the knee joint;It usually appears after an injury, such as a tibia fracture, torn ligaments, or damage to the meniscus.Moreover, with this type of arthrosis of the knee joint, in most cases, the symptoms of the disease appear after 3-4 years, but after a serious injury, it is possible even after 2-3 months.

In 50-60% of cases, the cause of arthrosis of the knee joint is spasm of the muscles of the front surface of the thigh.

What happens to the knee joint with arthrosis?

Excessive regular load, genetic predisposition, metabolic disorders in the body, prolonged muscle spasms and injuries, knee cartilage loses its smoothness and begins to thin.Soft sliding of the sutured bones is replaced by strong friction, and first-degree gonarthrosis develops, in which the cartilage loses its shock-absorbing properties.

The depradation process continues to progress and poor shock absorption leads to flattening of the bone surfaces with the formation of osteophytes in the form of bone growths.In this case, the disease is already secondary and is accompanied by degeneration of the synovial membrane and joint capsule.Absence of pump and movement atrophies, the structure of the knee joint, the consistency of the knee fluid becomes more viscous, the process of cartilage nutrition is disturbed, which leads to an even greater deterioration of the patient's condition.

Thin cartilage causes a decrease in the distance between the bones, which increases up to 1 80%.When walking, due to the abnormal friction and the lack of a shock-absorbing shock absorber, destructive processes increase rapidly in the joint, which leads to the development of the third degree of arthrosis with pronounced symptoms:

  • Pain when moving, especially when going up or down stairs.
  • Both training and rest, and morning stiffness.
  • The patient begins to crush, trying to play the pain.
  • Severe cases of the disease require the use of a puppy or a cane.

The third degree of arthrosis of the knee joint is characterized by the almost complete absence of cartilage tissue, which leads to a decrease in joint mobility.Therefore, no magic methods, super drugs or ointments can restore the worn cartilage tissue, and taking into account the degree of bone deformation, the normal functioning of the joint is impossible.In this case, only surgery can help.

Destruction of the knee joint due to arthrosis

Stages of arthrosis

As arthrosis progresses, the following stages or degrees are distinguished:

  • The initial stage, or Stage 1, is often called compensation, because there are no clinical signs of the pathology yet.The patient may feel discomfort in the knees after physical activity, which quickly disappears after rest;the joints are still fully functional.
  • With 2 degrees of arthrosis, subcompensated, the symptoms of the disease intensify.A required pain syndrome is formed, however, anesthetic ointments and gels are used.Motor activity is impaired and joint instability appears.In the vast majority of cases, patients turn to doctors at this stage.
  • 3rd degree, split, deformity can also be done.The knee joint is twisted, unstable, immobile and completely non-functioning.Pain syndrome is permanent and requires serious medical intervention.A person needs a cane to loosen their joint and movement.

Symptoms and first signs

Depending on the severity of the symptoms, the development of the disease is divided into 3 stages.Symptoms of early development of gonarthrosis vary greatly and are not specific.

The following symptoms are possible at the first stage of pathology:

  1. knee pain when going up or down stairs;
  2. pain in the middle after prolonged exercise or cooling;
  3. The knee can hurt at the end of the day or in the morning;
  4. Stiffness and pain in the morning go away after daily work.

Later, symptoms characteristic of stages 2 and 3 appear (in ascending order):

  • The pain becomes sharp and prolonged;
  • swelling in the joint area;
  • Fluid may be visible in the middle;
  • Between the sub-articular surfaces, pinching of cartilage particles, meniscus, synovial villi is possible as a result of acute immobility (which can also pass acutely);
  • It is difficult to step on your feet;
  • Joint immobility develops.

The result

If left untreated, the following complications of knee arthrosis may develop:

  • Joint deformation.In fact, joint deformation is more of a complication, but the final stage of the disease.
  • Together.Infection usually occurs due to microtrauma.Small cracks in the cartilage tissue can be considered.Pathogenic microorganisms are introduced to the joint from other areas by blood flow or lymph flow.This often happens after infectious diseases.
  • Dislocations and fractures.These complications are explained by knee joint dysfunction.With arthrosis, there is no uniform distribution of the load on the bones of the lower leg from the femur.The ligaments that usually strengthen the joint also weaken.Therefore, at a certain moment (even during normal walking), the bones of the lower leg can be subjected to excessive stress, which will cause a fracture or dislocation.To prevent this, people with severe structural and functional impairments in the knee joint should move with the help of a crutch or a cane.
  • Ankylosis.Ankylosis is a fusion of two bones that were once joined.This complication is perhaps the most severe, because the joint simply disappears.The tibia and femur gradually protect and the tibia is fixed in one position.Of course, it is impossible to move.

Diagnostics

To diagnose gonarthrosis use:

  • blood tests (general and biochemical);
  • Radiography;
  • arthroscopy;
  • Ultrasound;
  • MRI.

The most important diagnostic method to confirm the diagnosis of gonarthrosis is radiography.If it is not possible to examine the initial stages of the disease and the initial stages of the cartilage tissue on x-rays, however, the bone changes of the 2nd and 3rd stages are clearly visible.This:

  1. narrow joint space;
  2. Marginal spines located along the contour of the bones, edges of the patella - osteophytes;
  3. changes in the periosteum;
  4. Change in height from air conditioners and others.

However, the changes can be examined in more detail using arthroscopy.

Ultrasound and MRI help detect changes in the soft tissues of the knee joint during early arthrosis.These methods provide a good indication of cartilage tissue, synovium and fluid status.

How to treat arthrosis?

Treatment for arthrosis of the knee joint is long and sometimes painful.The duration of the disease is related to the fact that it manifests itself once, it is constantly remembered as long as a person lives.

So, to properly treat gonarthrosis, a fairly strong financial contact and discipline is required.How serious a role the patient's treatment plays, because in order to reduce the frequency of exacerbations of the disease, the patient has to change his daily activities, his favorite occupation, give up smoking and alcohol.

There are three main stages in the treatment of knee joint deformities.

The first stage of treatment includes:

  • referring patients to patients with diseases, risk factors and secondary prevention measures;
  • daily gymnastics with stretching elements;
  • contrast shower;
  • Swimming in the pool 2 - 3 times a week;
  • Weight loss.

The second stage of treatment includes:

  • External fixation of the joint using calipers, bandage, elastic bandage and orthosis;
  • the use of ointments and creams based on non-steroidal anti-inflammatory drugs to relieve inflammation and pain;
  • The use of drugs from the group of chrondroprotectors to reduce the rate of cartilage destruction.

The third stage of treatment includes:

  • using a course of NSAIDS;
  • fine injections with hormonal anti-inflammatory drugs;
  • additional use of drugs with declared analgesic effect;
  • surgical replacement of the diseased joint with an implant.

In addition to drug treatment, modern medicine uses methods such as:

  1. Kinesaperapy.In this case, the treatment of arthrosis of the knee joint is carried out using special exercises.The load is selected according to the degree of development of the disease and the physical fitness of the patient.
  2. Ozone therapy.It affects wound healing using ozone.With this physiotherapeutic treatment, the substance can be administered by injection or external use.
  3. dietary supplement.Biologically active supplements are a worthy alternative to other drugs.
  4. Homeopathy.It involves taking small doses of medicine.The course of treatment lasts only a few weeks, but during this period, the correct selection of drugs, normal nutrition and normal nutrition of blood circulation and cartilage tissue cells were ensured.
  5. ExercisesIt allows to improve the blood circulation in the knee joint, to restore the flexibility of the ligaments, to improve the nutrition of cartilage tissue cells and to promote regeneration.

Drug treatment

All drugs used in the treatment of gonarthrosis can help eliminate the main symptoms of the disease and those that restore the function of the knee joint and prevent the progression of the pathology.The first type of medication includes non-steroidal anti-inflammatory drugs and hormonal drugs.The second group includes chrondroprotectors and hyaluronic acid.

Non-antique anti-inflammatory drugs

Drug treatment of arthrosis begins with pain relief.They are the ones that cause the greatest mental and physical suffering to patients and cause the ability to work.Nonsteroidal anti-inflammatory drugs (NSAIDs) have worked well among pain relievers.

Medicines can be used in two ways - topically or orally (in tablets).Topical treatment (preferred) often includes patches, ointments, or gels.Analgesic effect, as a rule, occurs on the 3-4th day and develops to a maximum on the 7-10th day.

The course of treatment with donsteroid drugs should be limited to 10-14 days.NSAIDS have a limited range of use and are used with great caution in the treatment of elderly patients.

Hormonal drugs

In cases where NSAID treatment is insufficient and the disease continues to progress, the doctor may prescribe hormonal injections.They belong to "heavy artillery" and help to quickly relieve pain, reduce inflammation and swelling of surrounding tissues.

Due to the large number of side effects, hormonal drugs are used in short courses, only during the acute period of the disease, the inflammatory fluid accumulates in the joint cavity.The drug is taken into the joint space no more than once every 10 days.

Chondroprotectors

Chondroprotectors are prescribed to prevent further destruction of joint cartilage surfaces.

These medications also help reduce pain and reduce signs of inflammation in the surrounding soft tissue.In addition, chondroprotectors slow down the destruction of articular tissues and stabilize the disease due to shock absorption and lubrication functions.Chondroprotectors improve nutrition of cartilage, normalize the composition and properties of fluid as a whole and protect pain receptors from excessive irritation.

Hyaluronic acid

Hyaluronic acid is called a liquid prosthesis of besar-articular fluid.In its properties, the natural synovial (articular) fluid that nourishes the cartilage tissue is similar to the natural synovial (articular) fluid that surrounds the knee joint during movement.

Hyaluronic acid preparations are injected into the joint, thereby creating a thin protective film that prevents the cartilage surfaces from rubbing against each other.Injections are performed only after the acute stage of the disease.

Therapy and exercises for arthrosis

Physical exercise helps restore and strengthen joint function.These should not be carried out slowly and carefully and should not exceed the permissible load.

The following exercises are considered the most effective:

  1. Slowly raise your straight legs apart while lying on your stomach.This exercise uses the thigh and calf muscles.The load must not be allowed to move to the rear.You should not raise your legs too high.The key is to tense your muscles at the top;
  2. This exercise is similar to the first one, only now you need to raise the leg with the knee bent.At the top, the thigh muscles should become more tense.The exercise should be performed the same number of times on each leg;
  3. Lying on the floor (on your stomach), raise your straight legs up, then spread them apart and bring them together.This exercise requires strong, trained abdominal muscles, so it is not suitable for all patients.In addition, performing it can increase blood pressure.For patients suffering from hypertension or other diseases of the cardiovascular system, it is better to avoid it;
  4. To perform the next exercise, you need to lie on your side, put one leg on the floor at the knee and slowly raise the other and keep it at the top point.It is important that the angle is the same when performing on each leg;
  5. You will need a chair for this exercise.While sitting on it, the legs are straightened one by one, raised and kept in a straightened position for the maximum possible time;
  6. It is useful to rise on your tiptoes while holding the back of a chair or bed.As in other exercises, you need to stretch for a few seconds at the top point and tense your leg muscles;
  7. A smooth movement from the ankle to the heel allows you to activate blood circulation in the lower extremities.Such movements should be performed alternately: one foot on the toe, the other on the heel and vice versa.All movements should be smooth;
  8. Leaning against the back of a chair or bed, stand on your heels for a minute to stretch your toes.If you cannot stand in this position during the indicated period, you should start with a small, gradual increase;
  9. A massage performed in a standing position.Legs should be rubbed with lively movements directed from the knee up.It is necessary to complete the massage by hitting the skin.

The doctor will conduct several sessions in the office and show the patient the basic techniques so that he can self-massage the problematic knee.Competent measures improve the condition of the damaged area.

Massage and self-massage

Massage your palm, palm, fingertips, fingers or fist with yourself.Move gently on the knee, apply strong pressure to the affected area: strong patting, blows, active kneading of the tissues, often worsen the condition.

Main methods:

  • The first stage illuminates counterclockwise, the second stage is circular movements;
  • Press one palm on the bad knee, tap lightly with the fingers of the other;
  • Maintain the original position of our palm, not with your fingers, but on the edge of your palm;
  • Gently stroke the knee in a circle, gradually increasing the pressure (but moderately);
  • During therapy, massage the affected area twice a day for 10-15 minutes.For preventive purposes, it is enough to do a light massage once every 7 days.

Before the procedure, apply ointment or gel with anti-inflammatory effect to the pain.

Physiotherapy treatment

All methods of physiotherapy can be divided into several groups:

  1. Reduce pain;
  2. Reduce inflammation;
  3. Accelerate joint nutrition recovery and recovery of joint function.

The doctor can determine which treatment is necessary based on the patient's current symptoms and also the underlying diseases.

Surgery for arthrosis

Surgical treatment refers to radical methods that partially or completely restore the function of the knee joint.Surgical treatment methods differ in the degree of intervention of the affected joint.

  1. Arthroscopyrefers to the most delicate methods of surgical treatment.This technique is less traumatic and can be used as a therapeutic measure in the early stages of arthrosis.Its main purpose is to extend the life of the damaged joint.Arthroscopy is performed using an endoscope - a flexible probe with a camera at the end.Small punctures are made in the joint of the knee joint, which includes an endoscope and auxiliary instruments.During the operation, the tissue areas that cause pain were removed.The operation is most suitable for young people and can be repeated several times if necessary.
  2. Endoprostheticsbelongs to the most radical surgical techniques.In this case, the complete restoration of the joint function occurs by replacing the entire knee joint or part of it with an implant.This method is the best alternative to the previously existing technique - arthrodis (complete immobilization of the damaged joint).Currently, endoprosthesis replacement provides a positive result in 90% and significantly improves the quality of life of patients.
  3. OsteotomyIt is used when additional deformities develop in the joint and significantly affect joint function.Osteotomy involves creating an artificial bone fracture at a pre-planned location.Subsequently, the bone fragments are aligned in the correct, physiological position and allowed to grow together.Sometimes during the operation, artificial fixators of bone fragments can be used, which contributes to a more stable state of the bone.

Folk treatment

Traditional medicine will also help you.The use of various lotions to relieve swelling and pain has long been practiced by many patients.Here are some helpful recipes:

  1. Burdock leaves.Take 5 burdock leaves and place them over boiling water to steam.Lubricate the injured knee with vegetable oil and apply steamed leaves.Wrap your foot in film and a warm scarf.Leave the lotion on for a few hours.
  2. Cabbage leaf lotion.It is made from fresh cabbage leaves soaked in May and applied to the feet.The therapeutic effect is enhanced by insulation made of woolen fabric or plastic film.This product is suitable for all age groups.
  3. Eggshells, kefir.Grind 2 eggshells and mix with 1 spoon of kefir.Apply the mixture to your knee, wrap and tape it with a cloth and sleep under the blanket.Leave it for a few hours and then wash off the composition with water.This treatment can be used daily.
  4. Horseradish compress.According to this folk recipe, it is recommended to first crush and boil horseradish to increase its medicinal properties.Then it should be applied to the affected area.
  5. Turpentine- Excellent warm-up agent for weights.The knee is rubbed before going to bed and before tying it with a woolen scarf.Already after the first procedure, the patient experiences significant relief.The course of treatment is chosen individually for each person.

Diet

A therapeutic diet consists of consuming or minimally consuming canned, smoked and fried foods (to suppress appetite).To restore damaged cartilage, it is necessary to provide the body with complex carbohydrates (carbohydrates, whole foods).Juices (carrots, beets, apples) should be included in the diet.They will remove toxins from the body and reduce the effect of inflammatory processes.

The diet should include fish and aspic, which act as a kind of chondroprotector and help build new cartilage.It is worth remembering that you cannot prescribe a diet for yourself - only a nutritionist (diet specialist) can choose the best option.

Sample menu:

  • Breakfast: Oatmeal with butter or sugar, fruit juice, boiled eggs;
  • Second breakfast: a glass of low-fat natural yogurt;
  • Lunch: steamed meat or fish, cooked vegetables, unsweetened tea;
  • Afternoon snacks: cottage cheese stew with nuts, a glass of fruit juice;
  • Dinner: vegetable salad, apple, unsweetened tea;
  • Second dinner: a glass of low-fat kefir.

Prevention

Prevents joint diseases:

  • dose the load on your legs during active sports;
  • Create a diet that includes foods and meals that contain calcium, magnesium, and gelatin;
  • If the work does not involve lifting or moving heavy objects, complying with safety rules and carrying loads exceeding a certain limit;
  • Massage yourself regularly to prevent arthrosis, especially if you have constant stress on your feet;
  • Eat right, limit "harmful" foods;
  • Body weight control (excess weight means extra stress on the joints);
  • Get regular exams and treat acute and chronic illnesses.

To predict

Arthrosis of the knee joint is diagnosed in the early stages, the cause of the pathological process is eliminated and the necessary treatment is provided, the prognosis is favorable.Therapy given therapy can achieve long-term remission, but treatment is usually lifelong.

If there is no proper treatment, if the patient does not follow the doctor's instructions, arthrosis of the knee joint becomes the cause of disability.