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

Osteoarthritis of the knee joint (Gonarthrosis) is a degenerative lesion of the joint, resulting in deformity. Inside, the cartilage begins to collapse. Gradually, the function 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, but can not provide a complete cure for the problem. However, therapy is needed to maintain joint mobility and functionality for as long as possible and to improve the patient's quality of life.

Types of diseases

Gonarthrosis of the knee joint can be classified according to its developmental causes. It is primary and secondary. The first type of disease occurs the most. It also has another name - idiopathic osteoarthritis. It is difficult to determine the exact cause of the development of osteoarthritis of the knee, because there are many factors that affect it.

The secondary pathological type is clearly related to one reason or another. For example, it often occurs after a knee injury due to severe physical strain on the knee joint. Such 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 extremities.

Why pathology develops

The knee joint is one of the most complex joints in the human body. Formed by the femur, tibia and patella. Articulation includes a triangular cartilage with separate curved edges - the meniscus. Well-coordinated work of the knee is provided by the musculoskeletal system. Almost all of the bone surfaces of the joint are covered with cartilage tissue about 0. 5 cm thick, which is fed diffusely (by obtaining nutrients from the synovial fluid) along with the blood vessels.

The cartilage in the knee allows the bony surfaces to slide and flatten. If the nutrition of this tissue is impaired, then dystrophic processes begin, becoming more delicate. If left untreated, the cartilage disappears completely and the knee joint stops moving. The reason for the development of osteoarthritis may be different. For example, the following factors can lead to the appearance of a secondary pathological form:

• Excessive stress on the knee joint. In this case, there may be changes that the person is not even aware of. Therefore, the load should be moderate, especially in old age. The biggest damage is squatting and running on hard surfaces (asphalt).
• Knee injury. This can include damage to the meniscus, dislocation of the joint, or fracture. This reason contributes to the development of the disease in young people. Once the extremity is repaired, the blood circulation inside deteriorates. In 90% of citizens, damage or removal of the meniscus causes osteoarthritis.
• She is overweight. Excess weight can damage the meniscus. Restoration of the knee joint is stretched and difficult. Bilateral knee osteoarthritis is more common in obese people. An additional disadvantage is the presence of varicose veins. In this case, the patient develops the most severe form of knee gonarthrosis.
• Weakness of the garden closing apparatus. For this reason, there is a very high joint mobility. Although a person can sit on the rope without any problems without warming up, he suffers from joint microtrauma. If the knee is damaged enough, osteoarthritis begins to develop.
• Disorders of metabolic processes. In this case, the knee joint does not receive enough nutrients.
• Articular pathologies. The presented pathology may be triggered by arthritis of the knee joint (reactive, rheumatoid). It is characterized by the development of inflammation and excessive fluid accumulation 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 lead to 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. It is an inflammation of the bone marrow where purulent masses form. They have a negative effect on the surrounding tissues. Over time, the purulent masses extend beyond the bone of the knee joint. Lack of treatment threatens the development of sepsis.
• Acromegaly. It is an endocrine disease in which growth hormone levels increase. Often, a benign tumor in the anterior pituitary gland helps to increase the volume. If such a disease develops during adolescence, the child develops a special body structure. Excessive growth of cartilage tissue causes deformation of the knee joint.
• Diabetes.
• Hypothyroidism. This disease is also endocrine. Occurs due to a deficiency of thyroid hormones. A person's weight begins to increase, he moves less, and the cartilage of the knee joint wears out.
• Don't freeze. In this condition, ice crystals form in the soft tissues, killing living cells.
• Synovitis (inflammation localized in the synovial sac of the joint).

All of these causes can trigger Gonarthrosis of the knee, although people do not know when the disease begins to develop.

What are the stages in the development of osteoarthritis?

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

• The first degree of osteoarthritis of the knee. The pain at this stage is not very noticeable. The patient may suffer for years, do not rush to contact specialists or undergo any treatment. A person needs help in case of fire. The onset of acute pain is not typical for knee osteoarthritis.
• Grade 2 osteoarthritis of the knee joint. The intensity of anxiety increases. The pain occurs not only after physical exertion in the knee joint, but also at rest. You need more rest to get rid of unpleasant feelings. Swelling appears in the knee joint, the patient hears a crisis. X-ray shows a narrowing of the joint space, a slight deformation of the knee joint.
• Grade 3 osteoarthritis of the knee joint. In this condition, the mobility of the knee is severely limited and sometimes the foot cannot fully straighten. Joint pain is acute and persistent, occurring in response to changing weather conditions. Anxiety hurts in nature, and it is difficult to get rid of it at rest. Often the patient's sleep is disturbed and he uses NSAIDs to alleviate his condition at least a little. In a person, lameness develops and the deformity of the joint is very noticeable.

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

Symptoms of knee osteoarthritis

The development of osteoarthritis does not happen overnight. With its development, the symptoms become more intense. The following manifestations are characteristic of gonarthrosis:

• A squeaking and clicking sound. The patient may feel this symptom quite late. However, he says that the joint surfaces are damaged, and grooves and bone growths form on them.
• Swelling and enlargement of the knee.
• Painful feelings. In the early stages of the development of osteoarthritis, they are invisible and can be seen only after a severe static load on the knee joint. Dynamic training, in turn, improves joint condition, nutrition, and subsequent prognosis. In osteoarthritis, the nerve endings remain open as the top layer of cartilage is removed. After a while (after rest), the fibers are covered with a small layer of fibrin and become less sensitive - the pain in the knee passes. If the knee joint continues to collapse, the discomfort will not leave the person even at rest. Bursa, edema occurs, which further tightens the nerves. The inflammatory process begins.
• Limited mobility. This symptom allows to distinguish arthrosis from other pathologies of the knee joint. Hardness appears in the morning after sleep and disappears after half an hour. If this condition lasts longer, it indicates the presence of an inflammatory process.
• The range of motion has been reduced. The patient is unable to fully correct the pain. Because the patient is constantly in pain, he tries to reduce the range of motion, and the ligaments adapt. That is, they are shortened and do not allow the knee joint to fully perform its function.
• Joint traffic jam. Occurs as a result of a strong change in joint surfaces.
• Speeches and subluxations. They appear in the final stages of the development of osteoarthritis, when the joint is severely deformed.

Over time, a person experiences muscle atrophy, an increase in osteophytes, and a weakening of the lateral ligaments. The consequences of osteoarthritis are severe because the person becomes disabled.

How to correctly diagnose osteoarthritis?

To begin the proper treatment of osteoarthritis, the patient must undergo a thorough examination. Diagnosis should be differential and include the following studies:

1. Radiography of the knee joint. It is performed in two projections with gonarthrosis. The specialist needs an X-ray of both the injured and healthy knee. Radiography allows to identify the following symptoms of osteoarthritis: narrowing of the joint space, osteophytes, subchondral sclerosis. Also, the presented work of the knee joint reveals subluxation, ossification of cartilage tissue.
2. Arthroscopy. This is a minimally invasive procedure used not only for the diagnosis but also for the treatment of osteoarthritis. Finally, it provides the use of a special LED conductor with a camera. It is inserted through a small hole on the side of the knee. The whole picture of the internal state of the connection is displayed on the monitor. However, the procedure has one drawback: the joint is not pressurized and pathogenic microorganisms can enter it.

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

7. Thermography. The procedure is based on recording heat radiation from the surface of the patient's body. Thus, you can identify tumors, foci of inflammation. A study is scheduled for the purpose of differential diagnosis.
8. General blood test. Helps to determine the severity and nature of inflammation.
9. General urinalysis. Thanks to it, it is possible to determine the systematic nature of the pathology.
10. Blood chemistry.

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

Treatment of knee osteoarthritis

Treatment of osteoarthritis should be comprehensive and long-term. Since it is not possible to completely stop the destruction of the joint, the patient must be continuously treated to improve their quality of life.

Drugs in the treatment of osteoarthritis

The doctor may prescribe the following medications:

• Non-hormonal anti-inflammatory drugs. Used in the form of tablets and ointments. However, in the case of severe pain syndrome, which can not be eliminated by standard methods, an injection is used. Helps to quickly soothe pain, eliminate swelling and reduce the intensity of inflammation. These remedies can only relieve the symptoms, but they cannot cure osteoarthritis. These drugs should be prescribed only by a doctor. The course of treatment does not last more than 14 days, and relief comes in 2-3 days.
• Chondroprotectors for osteoarthritis of the knee joint. Each of these drugs contains beneficial substances that can restore cartilage. However, it will only be effective if its application is started on time. If the cartilage is completely removed, the use of chondroprotectors will be useless. Treatment with such means will be long-term (at least 6 months). Although injections are possible, pills and topical medications are most commonly used.
• Vasodilators. They help relieve spasms and pain syndrome, restore normal blood circulation and improve nutrition of the knee joint.
• Glucocorticosteroids. It is often used in the most difficult cases when other drugs do not have a positive effect. Intra-articular injections inside the knee are used for osteoarthritis. They are allowed to use once a year.
• Enzymes. They restore cartilage structure in the early stages of knee osteoarthritis. Both are prescribed for injection into the joint.
• Hyaluronic acid. Provides smooth movement of the knee joint as it can replace synovial fluid.
• Topical preparations - ointments, creams, gels. And they only eliminate the symptoms.
• Medicinal compresses. In this case, a drug that can penetrate the skin, helps to remove muscle cramps and has a reorbent effect is used. Compresses can be made using medical bile.

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

Features of physiotherapy and sports therapy

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

• Massage. It helps to restore normal blood circulation in the tissues and eliminate muscle spasms.
• Electrophoresis with drugs allows to eliminate inflammation in the joints and has an analgesic effect.
• Magnetic therapy. With the help of special radiation, the tissues surrounding the affected right or left joint are stimulated. Metabolic processes in cells are improved.
• UHF. The waves stimulate the production of synovial fluid that lubricates the knee.
• Phonophoresis with corticosteroids.
• Electrotherapy helps to relieve not only pain but also swelling.

• Mud treatment.
• 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, eliminates swelling and helps to improve the nutrition of cartilage tissue.

Physical therapy is extremely beneficial. 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. You should lie on your stomach and lift your legs in turn. In this case, they should not bend at the knees. Lifting height is about 20 cm.
2. You should lie on your left side, bend your left leg and raise it 30 degrees. In this case, the call should be held for up to 30 seconds. The same exercise should be done with the right foot.
3. Sitting in a chair, the legs should be alternated and raised as high as possible.

The set of exercises is selected individually by the attending physician. Gymnastics is performed after a small massage with the best medicinal ointments. Physiotherapy is an effective additional method in the treatment of osteoarthritis, which increases the effectiveness of drugs.

Do you need surgery?

In the most severe cases, when the joint is severely destroyed by osteoarthritis, the patient is prescribed surgery. There are several types of interventions:

1. Joint traction. Covers the elongation of the joint damaged by osteoarthritis to increase the space between the cartilage. This will prevent further tissue destruction and gradual recovery.
2. Endoprosthesis is the complete replacement of a joint destroyed by osteoarthritis. Implemented as a last resort. The change may be complete or partial. The prosthesis should be replaced after 10-15 years.
3. Osteotomy. For osteoarthritis, such treatment allows mechanical correction of severely deformed bone deviations. In this case, the solid elements are broken in a strictly defined place. Then the bones are properly placed and joined.
4. Arthroscopy. With its help, the cartilage surface destroyed by osteoarthritis is restored. In addition, foreign bodies and bone fragments can be removed from the joint using an arthroscope. Such an operation is used for hypermobility of the joint. Arthroscopy is a low-traumatic procedure, so rehabilitation does not take long.

It is better not to bring in surgery. Treatment should be started in the early stages of osteoarthritis. Orthopedic devices will help to combine the result: a cane, an orthosis to reduce the load, knee wires with infrared radiation.

Use of folk remedies

It is not possible to completely cure osteoarthritis, as the degenerative process will progress gradually. However, you can eliminate the symptoms and stop the destruction of the knee joint in osteoarthritis. Folk remedies can also be used during inflammation and during relative calm. But first you need to consult a specialist. The following recipes will be useful for osteoarthritis:

1. Chopped horseradish root should be boiled in a small amount of water on low heat. After that, the corn should be filtered and placed around the knee affected by osteoarthritis. Density should be corrected with a bandage. You should do the procedure every day for a month. The compress improves blood circulation and tissue repair.
2. Rubbing any vegetable oil around the knee joint for osteoarthritis will help relieve the pain. However, you need to warm up a bit.
3. Mummy has a good effect. Mix 3-4 g of raw material with 100 g of honey and mix everything thoroughly. You should apply the medicine to the wound before going to bed at night. Then, wrap the affected area with a warm scarf. The reception of the mummy inside is also welcomed. You can use at 0. 2 g per day.
4. Fresh dandelion flowers can be thoroughly washed and consumed 5-6 times a day. Also dry the raw material 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 wrap 10 layers of the plant and squeeze the 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 jar and applied every day for a month.

Cabbage and burdock leaves will help eliminate inflammation in osteoarthritis. Folk remedies can not be considered a drug, but increase the effectiveness of other types of therapy.

Nutrition rules for osteoarthritis

Treatment of osteoarthritis does not require a particularly strict diet, but you still need to follow some nutritional rules:

• Reduce salt intake. The total daily amount should not exceed 2 grams. It is better to salt the food before use, not during cooking.
• The amount of spices used in the treatment of osteoarthritis should also be reduced. The same applies to fermented foods, pickles. Marinades and canned foods are generally better to eliminate from the diet.
• Animal fats are not recommended.
• The menu should not contain sweets, pastries and bread made from wheat flour.

• Alcohol and nicotine are strictly prohibited in osteoarthritis.
• Gelatin-containing foods are useful: aspic, mixed meat, beef broth.
• It is important for osteoarthritis to consume milk protein (products should not be fat), fish, seafood.
• The diet should include vegetable oil, vegetables and fruits, freshly squeezed juices.
• One person should drink enough fluids a day.

Proper diet for osteoarthritis should be prepared by a specialist. Even if the patient is overweight, you can not overdo it. Dramatic and improper weight loss will only aggravate your health. In this case, treatment will be significantly delayed.

Prevention of osteoarthritis

To prevent the possibility of developing osteoarthritis and loss of ability to walk, you should follow the following expert recommendations:

• We must not forget the action. It is better to go to the pool, ride a bike, go for a walk in the fresh air. You can also go to dances.
• It is advisable to avoid any damage and hypothermia of the knee joint, as it provokes post-traumatic arthrosis.
• It is better to use protective knee pads or other orthopedic devices for long-term tension.
• It is recommended to wear comfortable shoes.

• It is important to eat properly - if the joint is regularly supplied with all the necessary nutrients, there will be no chance of osteoarthritis.
• If you are overweight, you need to get rid of it.
• It is better to avoid stress, as well as to properly organize the rules of work and rest.
• It is necessary to strengthen the body's defenses.
• All inflammatory or infectious pathologies that can lead to the development of osteoarthritis should be eliminated in a timely manner.

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

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