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.When osteoarthritis occurs, the cartilage that lines the surface of the joint becomes irreversibly damaged, causing the joint to stop functioning properly and causing pain.
Officially, the disease is called “deforming osteoarthritis”;Another name is gonarthrosis (from the ancient Greek “goni” – knee).The knee joints are the largest joints in the human body and are most commonly affected by osteoarthritis.The disease affects the hip and ankle joints much less frequently.
How does gonarthrosis develop?
Normally, healthy cartilage is elastic and smooth, it completely covers the movable areas of the bone and allows them to slide.Cartilage also alleviates the stress that bones experience when walking or exercising.
When the cartilage is destroyed (this is how osteoarthritis manifests itself), the top layer of this elastic tissue becomes thinner.Sometimes the cartilage dissolves and cracks occur - so the joint loses its most important “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
Osteoarthritis deformans occurs more often in older, 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 heavy physical work or excessive stress in the gym.
Here is a far from complete list of the causes of arthrosis 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 involving heavy lifting;
- Uneven stress on the joints due to curvature of the legs - osteoarthritis becomes more noticeable in overloaded areas.
A lot depends on genes - a person may have a hereditary predisposition to arthrosis of the knee joints.In such people, the gene responsible for the development and stability of cartilage tissue is disrupted.
There are several factors that increase the risk of knee osteoarthritis:
- increased body weight.Due to the increasing load on the joint, the cartilage tissue wears out more quickly;
- Age over 40 years.Most people at this age have reduced physical activity.Physical inactivity causes muscles to atrophy, weak muscle tissue does not adequately supply the joints and the risk of cartilage damage increases.
Symptoms of osteoarthritis
Osteoarthritis of the knee joint is not a disease that can occur suddenly.It is clearly noticeable in advance: it all starts with slight pain in the knee when walking.The pain may increase when you have to climb or descend stairs.As a rule, the knee hurts at the beginning of the movement, then the pain disappears and reappears with prolonged stress on the joint.
If you ignore these symptoms and do not consult a doctor, the disease will begin to progress.Then the pain goes from temporary to permanent, the knee begins to hurt more and swell even when at rest.The breakdown of the cartilage limits the mobility of the entire joint.
Some people notice that the knee “reacts” to changes in the weather.This is really what happens - the nerve endings in the joint capsule are sensitive to changes in air 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;
- swelling of the knee;
- dry and rough crunching noise when moving - this noise is caused by friction between the joint surfaces.
As the disease progresses, the symptoms change:
- the pain will bother you even at rest;
- the joint deforms and loses its functions;
- Due to the knee deformity, the gait changes.
Degrees of gonarthrosis
There are 3 stages of development of osteoarthritis of the knee joint.
1st degreeDisease - almost asymptomatic.It begins with the first manifestations of the disease - almost painless, for example tiredness in the legs - and lasts until the first bone deformations appear.If the knee has changed shape due to synovitis - i.e. due to fluid accumulation in the joint - but the intra-articular cartilage is not damaged, the disease is still in stage 1.
2nd degreecharacterized by progressive changes in bone tissue.Externally, the knee may look the same as in stage 1 - deformed and enlarged.The pain increases: In addition to the pain that occurs during movement, there is also crepitation (crunching) in the affected knee.The joint becomes less mobile and it becomes more difficult to squat and walk on uneven surfaces.
3rd degreeThe degree of gonarthrosis is the most painful.At this stage there is almost no cartilage left and in severe cases the bones can grow together.Then the joint becomes completely immobile and the person only has to move with the help of a crutch or cane.Usually, doctors make a judgment about arthroplasty of the damaged joint at this time.
Important: Only a doctor can determine the exact degree of development of the disease.Sometimes, with mild symptoms, the disease seriously affects the cartilage membrane - therefore, for an accurate diagnosis, additional studies are usually carried out:
- X-ray – to determine whether the cartilage surfaces are deformed and what condition the joint space is in;
- CT or MRI – for more detailed examinations.
How is gonarthrosis diagnosed and treated?
The first thing to remember is that timely diagnosis and early treatment can help stop the disease in its tracks.Therefore, the appearance of the first symptoms in the knee joint is a good reason to see a doctor and have yourself examined.
Doctors do not only diagnose osteoarthritis based on the medical history, the symptoms and the current condition of the knee joint.The results of other 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 arthrosis 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 in the joint capsule - these changes are visible in the photos.Doctors most 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 – it can be used to assess the condition of the soft tissues surrounding and lining the joint.Ultrasound complements the results of radiography, allowing the doctor to detect 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 meniscus, ligaments or tendons;
- Arthroscopy is an invasive examination in which the inside of the joint cavity is examined with a camera.The cameras are inserted through small incisions in the skin;Through the same incisions, doctors can perform minor manipulations - for example, remove a piece of destroyed cartilage, partially smooth out unevenness in the cartilage tissue, etc.
Osteoarthritis is usually treated with medication, initially attempting to relieve pain, improve joint mobility and restore mobility.Osteoarthritis leads to irreversible changes in the cartilage tissue - it cannot therefore be said that it is completely cured.But it is possible to stop the progression of the disease - and thus slow down further tissue destruction.
This is what the standard treatment for gonarthrosis looks like:
- local remedies – plasters, creams, ointments and gels;
- painkillers;
- anti-inflammatory drugs, especially non-steroidal ones.Their use is considered the “gold standard” of medicine, but such drugs destroy the stomach lining;
- Blockades and chondroprotectors – drugs whose effect occurs only after long-term use;
- rarely - physiotherapy and sanatorium treatment.
There are recommendations to wear orthopedic knee pads to support the joint and relieve pain.However, all of the methods listed above are methods of passively influencing the function of the joint.
This treatment only relieves some symptoms - neutralizes pain, inhibits inflammatory processes, etc. The disease itself continues to progress and gradually destroys the joint.In the final stage of osteoarthritis, people not only lose the ability to work, but also the ability to move.In such cases, the joint must be treated prosthetically, which means an artificial structure must be inserted into the knee.Such a surgical procedure does not leave its mark, brings with it its own limitations - and thus reduces the quality of life.
Methods of actively influencing the joint have a completely different effect when the body's own resources are used to restore the tone of the muscles that supply the joint with blood and nutrients.Such treatment is most effective when carried out under the supervision of qualified and experienced doctors.
Treatment of gonarthrosis with exercise therapy
Kinesitherapy, i.e. movement therapy, activates the body's own forces.With the correctly selected load, you can effectively work with the necessary muscles and improve the condition of joints and cartilage by strengthening the muscle corset.
Treatment with exercise therapy begins with a thorough examination and necessarily a myofascial examination.A kinesitherapist examines the condition of a sore knee and analyzes the condition of muscle tissue, tendons and ligaments.Taking into account the data from ultrasound, CT, MRI and X-rays, the degree of gonarthrosis is determined and a therapy program is created.
Classes are conducted 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 only use the muscles that need to be strengthened and developed.In the initial stages, patients are prescribed floor exercises - these are exercises on a mat without weights.
The therapeutic effect of exercise therapy is ensured by restoring blood microcirculation and improving lymphatic drainage.The cartilage receives more nutrients, the development of osteoarthritis slows down to a complete standstill, and the biomechanics of the articular joint are completely restored.
Such a serious disease as arthrosis of the knee joints cannot be ignored.The best way to prevent this is to lead a healthy lifestyle: balanced diet, physical activity.However, if problems with the joints are already occurring, you should not wait for serious warning signs, but seek the help of a qualified doctor at the first symptoms.