Osteoarthritis of the knee joint is one of the most common diseases of the musculoskeletal system and, unfortunately, the most common cause of loss of mobility, disability, and sometimes disability.With osteoarthritis, the cartilage that covers the joint surface is irreversibly affected, causing the joint to stop functioning properly and causing pain.
Officially, the disease is called “osteoarthritis deformans”;another name is gonarthrosis (from the ancient Greek "goni" - knee).The knee joints are the largest joints in the human body and the most commonly affected by osteoarthritis.Much less often, the disease affects the hip and ankle joints.
How does gonarthrosis occur?
Normally, healthy cartilage is elastic and smooth, completely covering the moving areas of the bone and allowing them to slide.Cartilage also softens the stress placed on bones when walking or exercising.
When cartilage is destroyed (this is how osteoarthritis manifests itself), the upper layer of this elastic tissue becomes thinner.Sometimes the cartilage delaminates, tears appear;This is how the joint loses its main "shock absorber" and "bearing".The bones begin to rub against each other, the joint swells, gradually loses its normal appearance and pain appears.
Causes of gonarthrosis and risk factors.
Deforming osteoarthritis is more common in older and overweight women, but this does not mean that young and physically active people do not suffer from this pathology.Sometimes the development of the disease is provoked by intense physical work or excessive stress in the gym.
Here is a far from complete list of the causes of osteoarthritis of the knee joint:
- sports injuries: meniscus injuries, fractures and dislocations;
- inflammatory processes in the joints and concomitant diseases;
- metabolic disorders - some diseases lead to the formation of intra-articular deposits;
- excessive stress on the joint, including prolonged standing or physical work associated with lifting heavy objects;
- Uneven load on the joints due to the curvature of the legs - osteoarthritis manifests itself faster in overloaded areas.
Much depends on genes: a person may have a hereditary predisposition to osteoarthritis of the knee joints.In these people, the gene responsible for the development and stability of cartilage tissue is altered.
There are several factors that increase the risk of gonarthrosis:
- increase in body weight.Due to the increasing load on the joint, the cartilage tissue wears out faster;
- age over 40 years.Most people of this age have reduced physical activity.Due to physical inactivity, muscles atrophy, weak muscle tissue does not adequately supply the joints, and the risk of cartilage damage increases.
Osteoarthritis symptoms
Osteoarthritis of the knee joint is not a disease that can appear suddenly.It makes itself known well in advance: it all starts with a slight pain in the knee when walking.The pain may increase if you have to go up or down stairs.As a rule, the knee hurts at the beginning of movement, then the pain disappears and returns with prolonged loading on the joint.
If you ignore these symptoms and do not consult a doctor about them, the disease will begin to progress.Then, the pain will go from temporary to continuous, the knee will begin to hurt more even at rest and will swell.As the cartilage deteriorates, the mobility of the entire joint will be limited.
Some people notice that the knee "reacts" to weather changes.This really happens: the nerve endings in the joint capsule are sensitive to changes in atmospheric pressure.
The following symptoms are characteristic of gonarthrosis:
- knee pain when moving and walking;
- morning stiffness in the knee joint, when the range of motion is minimal;
- knee swelling;
- Dry and harsh crunching sound when moving: This sound is produced due to friction of the joint surfaces.
As the disease progresses, the symptoms will change:
- the pain will bother you even at rest;
- the joint becomes deformed and loses its functions;
- Due to the deformation of the knee, the gait will change.
Degrees of gonarthrosis
There are 3 stages of development of osteoarthritis of the knee joint.
1st gradedisease - almost asymptomatic.It begins with the first manifestations of the disease (almost painless, for example, fatigue in the legs) and lasts until the first bone deformities appear.If the knee has changed shape due to synovitis, that is, due to the accumulation of fluid in the joint, but the intra-articular cartilage is not damaged, the disease is still in stage 1.
2nd gradecharacterized by progressive changes in bone tissue.Externally, the knee may look the same as in stage 1: deformed and enlarged.Pain increases: in addition to the incoming pain that occurs during movement, crepitus (cracking) is added in the affected knee.The joint becomes less mobile, it becomes difficult to squat and walk on uneven surfaces.
3rd gradethe degree of gonarthrosis is the most painful.At this stage, there is almost no cartilage tissue left, and if the disease is severe, the bones may grow together.The joint is then completely immobilized and the person has to move only with the help of a crutch or cane.Usually at this time doctors make a verdict on the endoprosthesis of the damaged joint.
Important: Only a doctor can determine the exact degree of development of the disease.Sometimes, with mild symptoms, the disease severely affects the cartilaginous membrane;Therefore, for an accurate diagnosis, additional studies are usually performed:
- x-ray: to see if the cartilaginous surfaces are deformed and what condition the joint space is in;
- CT or MRI: for more detailed studies.
How is gonarthrosis diagnosed and treated?
The first thing to remember is that timely diagnosis and early treatment will help stop the disease in its tracks.Therefore, the appearance of the first discomfort in the knee joint is a good reason to visit the doctor and undergo an examination.
Doctors make the diagnosis of osteoarthritis based not only on medical history, discomfort, and the current condition of the knee joint.The results of additional studies also play an important role: they are often prescribed to clarify the stage of gonarthrosis and the severity of the disease.
To accurately diagnose osteoarthritis of the knee joint, doctors usually prescribe:
- radiography.If pathological processes have begun in the knee (for example, deposits of calcium crystals or bone tumors have appeared in the joint capsule), these changes will be visible in photographs.Doctors often prescribe X-ray examinations, but without a thorough examination of the knee joint, its mobility and the condition of the muscles supporting it, the picture is incomplete;
- Ultrasound: can be used to evaluate the condition of the soft tissues surrounding and lining the joint.Ultrasound complements the results of the x-ray so that the doctor can see changes not only in the bone structures, but also in the tissues;
- MRI - magnetic resonance imaging.An MRI is prescribed for complaints of knee pain if the doctor suspects damage to the menisci, ligaments or tendons;
- Arthroscopy is an invasive examination in which the joint cavity is examined from the inside using a camera.The cameras are inserted through small incisions in the skin;Through these same incisions, doctors can perform minor manipulations, for example, removing a piece of destroyed cartilage, partially smoothing out irregularities in the cartilage tissue, etc.
The treatment of osteoarthritis is usually carried out with medication, trying first to relieve pain, improve joint mobility and recover the ability to move.Osteoarthritis causes irreversible changes in cartilage tissue;Therefore, it is impossible to speak of a complete cure.But it is possible to stop the progression of the disease and therefore slow down further tissue destruction.
This is what the standard treatment for gonarthrosis looks like:
- local remedies: patches, creams, ointments and gels;
- pain relievers;
- Anti-inflammatory medications, especially non-steroidal ones.Their use is considered the "gold standard" of medicine, but these drugs destroy the gastric mucosa;
- blockades and chondroprotectors - drugs whose effect appears only after prolonged use;
- rarely: physiotherapy and sanatorium treatment.
There are recommendations to use orthopedic knee pads to support the joint and reduce pain.But all the methods listed above are methods of passive influence on the functioning of the joint.
This treatment relieves only some symptoms: it neutralizes pain, inhibits inflammatory processes, etc.The disease itself continues to progress and gradually destroys the joint.In the final stages of osteoarthritis, a person loses not only the ability to work, but also the ability to move.In such cases, it is necessary to prosthetic the joint, that is, insert an artificial structure into the knee.This surgical intervention does not go unnoticed and imposes its own limitations and, therefore, reduces quality of life.
Methods of active influence on the joint have a completely different effect when, using the body's own resources, the tone of the muscles that supply blood and nutrients to the joint is restored.This treatment is most effective if carried out under the supervision of qualified and experienced doctors.
Treatment of gonarthrosis with kinesitherapy.
Kinesitherapy, that is, movement therapy, activates the body's own forces.Correctly selected load allows you to effectively work with the necessary muscles and, by strengthening the muscle corset, improve the condition of joints and cartilage.
Kinesitherapy treatment begins with a thorough examination and, necessarily, myofascial testing.A kinesitherapist examines the condition of a sore knee, analyzes the condition of muscle tissue, tendons and ligaments.Taking into account the data of ultrasound, computed tomography, MRI and radiography, the degree of gonarthrosis is determined and a therapeutic exercise program is drawn up.
Classes are held on a multifunctional simulator - a proprietary simulator with a special design.The exercises are performed in such a way as to avoid excessive stress on the joint and work only on those muscles that need to be strengthened and developed.In the initial stages, patients are prescribed ground joint gymnastics, which consists of exercises on a mat without weights.
The therapeutic effect of kinesitherapy is ensured by the restoration of blood microcirculation and improvement of lymphatic drainage.The cartilage receives more nutrition, the development of osteoarthritis slows down to a complete stop, and the biomechanics of the articular joint is completely restored.
Such a serious disease as osteoarthritis of the knee joints cannot be ignored.The best way to prevent it is to lead a healthy lifestyle: balanced diet, physical activity.But if problems with joints have already begun, you should not wait for serious warning signs to appear;At the first symptoms you should seek help from qualified doctors.