Knee arthrosis is so common that it has a separate name - gonarthrosis. Another name for this disease is deforming osteoarthritis.
Arthrosis of the knee joint worries 20% of the population, its ICD-10 code is M17. Half of knee pathologies are due to arthrosis. This is a disease in which the tissue of cartilage and articular surface degenerates - they disintegrate. The joint is poorly supplied with nutrients and oxygen, its function deteriorates, and inflammation occurs. He becomes inactive and hurts, the patient’s quality of life decreases. Complications of arthrosis lead to a wheelchair.
Let's figure out what arthrosis of the knee joint is and how to treat it. How can the disease be prevented and how dangerous it is.
Causes and classification
The causes of arthrosis of the knee joint are different - mechanical damage, hereditary predisposition, metabolic disorders.
The occurrence of the disease is associated with excessive stress on the knees. This is an occupational injury in many sports. People with a high degree of obesity, over 60 years of age, almost always have arthrosis of one degree or another due to constant microtrauma. Arthrosis refers to occupational diseases in areas where a person has to stand or lift heavy objects for a long time. The disease can begin after rheumatoid arthritis.
The most common cause of knee arthrosis is injury. The second most common is dysplasia in childhood. Inflammation due to autoimmune pathologies is the third source of arthrosis. Usually there are several reasons, one complements the other.
Types of arthrosis of the knee joint are divided depending on the causes into primary and secondary. If the etiology is unknown, primary arthrosis is diagnosed; if the cause is determined, secondary arthrosis is diagnosed.
Development mechanism
Cartilage is nourished due to constant changes in osmotic pressure. When the joint is loaded, the viscosity of the intra-articular fluid decreases and its quantity increases. In a calm state, the intraarticular fluid becomes viscous and the amount decreases. Normally, these processes alternate. The cartilage plate, acting as a pump, pushes fluid out of the joint when loaded, and when relaxed, sucks it in. This is how the joint tissues are nourished. The pathological process manifests itself if the joint is subjected to destructive influences:
- If the load is great and the joint does not have time to recover, nutrition is disrupted. The cartilage becomes thin, cracks and ulcers appear on it;
- The structure of collagen fibers is disrupted, they absorb worse. The cartilage and patella soften, become inelastic, and perform their functions worse;
- Bone growths appear in the joint. The membrane of the joint capsule becomes irritated and inflamed;
- Since a person begins to take care of his knee and moves little, less intra-articular fluid is produced. The surface of the cartilage becomes dry and rough;
- The knee receives even less nutrition, atrophies, and its destruction accelerates.
Signs of arthrosis of the knee joint appear: it becomes inactive and pain occurs. The pain is especially severe in the morning and after prolonged immobility.
Stages of arthrosis
There are three degrees of arthrosis:
- Initial stage. The tissues have not yet been destroyed. So far, only the function of the synovial membrane is deteriorating. The composition of the intra-articular fluid has changed. The knee can no longer withstand normal load;
- Articular cartilage and menisci begin to deteriorate. Osteophytes—bone formations—grow into the bones. Inflammation and pain appear;
- Difficult stage. The supporting platform of the knee joint is deformed, the axis of the leg changes. The ligaments shorten, the joint capsule becomes rigid. The joint is pathologically mobile, but it is impossible to completely bend or straighten it. Inflammation and pain are pronounced.
On a note!
At the very beginning of the disease, the muscles are intact. Their function is gradually lost. In the third stage, movement is severely limited. Due to a change in the axis of movement, the muscle attachment sites change. The muscles are deformed - they contract or stretch, they can no longer contract normally. The nutrition of all leg tissues suffers.
Symptoms
Symptoms of arthrosis of the knee joint at the beginning of the disease do not manifest themselves in any way and do not force the patient to see a doctor. The patient notices fatigue and pain, but does not attach serious importance to them.
The classic sign of knee arthrosis is immobility and stiffness in the joint, a pulling sensation in the popliteal region, pain after exercise. It is difficult to move in the morning or after a long period of immobility. Relief comes after the patient stretches his knee, massages it, and walks around.
After some time, the intensity and duration of the pain increases. A crunch appears in the joint, it completely stops bending and unbending. A person begins to limp when walking - most patients come to the doctor with this complaint. Treatment of arthrosis of the knee joint usually begins only at the second stage.
If nothing is done, movement becomes possible only with outside help. When the patient lies down, the knee hurts less, but the pain often bothers you at night.
At the second and third stages, the knee joint is deformed - the contours of the bones are sharply outlined, the lower leg is curved. If you put your hand on your knee, you hear a crunching sound when bending and straightening. When the kneecap moves, it also crunches. Fluid collects in the cavity, the joint is swollen, and the tissues bulge.
As the disease progresses, all symptoms become more pronounced.
Diagnostics
Diagnosis of arthrosis of the knee joint is carried out comprehensively: an anamnesis is collected, laboratory and instrumental methods are prescribed.
Inspection
The doctor examines the damaged joint, takes measurements of the bones and flexion angle, and determines the degree of mobility in the joints at an angle.
Analyzes
The patient is sent for a general blood test, a biochemical blood test, and a general urinalysis.
X-ray
An X-ray of the knee joint is the main source of information for making a diagnosis. Arthrosis of the knee joint is visible in the photo: the joint space is narrowed, the cartilage is sclerotic, the bones are damaged; there is joint deformation, salt deposition and dystrophic changes. Osteophytes are clearly visible in the image.
Good to know!
For arthrosis of traumatic origin, x-rays have great diagnostic value and must be performed.
Ultrasound
Ultrasound diagnostics is an informative method. Ultrasound does not replace x-rays and does not provide a picture of the nature of the destructive process in the joint.
MRI
Magnetic resonance imaging provides a complete picture of the disease. This is a modern and accurate research method that allows you to make a diagnosis at an early stage. The disadvantage of MRI is its high cost.
Treatment
Treatment of the knee joint for arthrosis is carried out on an outpatient basis; hospitalization is not required.
Treatment regimen:
- Reduce the load as much as possible;
- Observe the prescribed traffic mode;
- Perform therapeutic exercises.
The goal of treatment is to slow down the process of destruction, prevent contractures (the inability to fully bend and straighten the leg), and restore the function of the joint if possible. During the rehabilitation period, staying in sanatoriums and resorts shows good results.
Drugs
Only the doctor decides how to treat arthrosis of the knee joint. You cannot select medications on your own.
Inflammation is relieved with NSAIDs (non-steroidal anti-inflammatory drugs).
Good to know!
Since arthritis causes severe pain, NSAID injections provide a quick effect and a feeling of relief.
Modern treatment of knee arthrosis involves the use of NSAIDs from a different group. Their effect is more pronounced.
If there is inflammation of the joint lining, the doctor prescribes corticosteroid hormones for intra-articular administration. Hydrocortisone, Kenalog, Diprospan relieve inflammation and pain, but they have many contraindications.
If necessary, antienzyme substances are injected into the joint cavity - contrical, ovamine, gordox. They can significantly slow down the destructive process.
Intra-articular injections of hyaluronic acid and its preparations are also prescribed. It restores the protective and shock-absorbing properties of synovial fluid.
Chondroprotectors are often prescribed, but there is no evidence that they help.
Physiotherapy
The newest methods of treating knee arthrosis do not exclude proper loading. The goal of physical therapy is to provide the necessary amount of movement, but not to overload the joint, maintaining balance. If the patient does not understand how to treat arthrosis of the knee joint - when it is necessary to simultaneously protect the knee and develop it, the result of other methods is sharply reduced or reduced to zero. It is possible to get rid of the disease if the patient is conscious.
Laser therapy and physiotherapy
Laser treatment and physiotherapeutic procedures have proven themselves to be excellent, especially if they were able to start at the first stage.
Other methods
Intraosseous blockades provide a therapeutic effect, breaking the cycle of inflammation. Along with the blockade, multichannel electromyostimulation is used using a special device.
Compresses made from homemade ointments and rubs can relieve pain and swelling.
Prosthetics
If necessary, an operation is performed - the patient is fitted with a knee joint endoprosthesis. Modern prosthetic methods allow patients to return to sports.
Alternative and traditional medicine
Proponents of the unconventional approach argue that it is possible to eliminate symptoms and treat arthrosis of the knee joint only using their methods - without resorting to drugs. This is kinesitherapy (a special set of exercises), ozone therapy (physiotherapy using ozone, which is injected into the joint), homeopathy, treatment with dietary supplements, manual therapy, massage.
Attention!
When using unconventional methods, you need to remember that their effectiveness has not been proven.
There are original treatment methods, but reviews about them vary.
Rehabilitation and prevention
Only therapeutic exercises and measured load on the joint can restore the knee joint with arthrosis. If the patient follows all the doctor’s recommendations and is ready to fight for his health by all means, in most cases the answer to the question "can arthrosis of the knee joint be cured" is positive.
Prevention consists of timely assistance for injuries, active movement without overload, and maintaining an optimal body mass index.
Patient opinions
Reviews from patients who have undergone traditional treatment are usually positive, but there are also negative ones.
When making a final decision about treatment, you should consult your doctor without forming an opinion based on reviews.
Medicine has learned to successfully treat joint diseases, the consequences of which in the last century inevitably led to disability. With arthrosis of the knee joint, it is important to seek help in time to determine the stage of the disease and the extent of treatment.