The inflammatory-degenerative process in the knee joint, or gonarthrosis, occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes leading to disability. How to treat osteoarthritis of the knee joint and prevent complications?
What is osteoarthritis
Approximately 22% of the world's population suffers from knee osteoarthritis, and women are more often affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint may collapse completely. This leads to impaired musculoskeletal function. Movement is possible only with the help of crutches, otherwise the person becomes hostage to a wheelchair.
The knee joint is the second largest, after the hip, and the most complex structure. It allows you to bend and straighten your leg in different directions, promotes correct body position and coordination in space. It is a strong and stable joint capable of supporting the weight of a person. Consists of 3 bones: the femur, tibia and fibula, as well as the patella or patella. Includes osteochondral structures, muscles, ligaments and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of joint tissues. First of all, the cartilage suffers. The quality and quantity of synovial fluid, which is found in the joint capsule and contributes to the proper functioning of the knee, decreases. Friction occurs between the joint parts. Little by little, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain appears and a cracking sound is heard.
Causes of disease
It mainly affects older people, especially overweight women. Due to hormonal changes, the cartilage in the knee wears down significantly. Gonarthrosis, to varying degrees, after the age of 60, occurs in more than 80% of people.
There are other reasons for the appearance of osteoarthritis of the knee:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- arthritis;
- lumbar spine diseases;
- hormonal disorders;
- low metabolism.
The risk of developing the disease increases in people who perform repetitive physical work. This group also includes athletes, people leading a sedentary lifestyle and people living in unfavorable environmental conditions. Patients are often people dependent on toxic substances (drugs, alcohol, tobacco).
The cause of joint deformation may be work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to a lack of minerals and vitamins in the body, diet can be the trigger.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. Depending on the nature of the manifestations, the disease is divided into degrees:
- At this stage, there are no obvious clinical signs. There may be slight discomfort and soreness after prolonged exercise, which disappears after rest. The pain is felt in the morning, when moving, it disappears after a while. First degree osteoarthritis is rarely diagnosed by chance during a routine examination.
- Knee pain and stiffness increase. A person spares his leg and tries to load it less. As a result, the muscles atrophy, the joint becomes deformed, training can be felt, and the leg at the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend and it is difficult for the person to walk. A partial or complete loss of mobility develops. The cartilage is completely destroyed, friction between the bones of the joint increases with the formation of osteophytes.
In addition to the pain at levels 2 and 3, a cracking sound is heard in the knee. Fluid and pieces of cartilage tissue can build up in the joint capsule, leading to swelling. In an advanced stage, the inflammatory process is pronounced and the knee joint is deformed.
Diagnostic
If you experience knee pain, you can contact your local doctor who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To know the causes and treatment of knee osteoarthritis, a complete diagnosis is necessary:
- general and biochemical blood test;
- rheumatic tests;
- x-ray;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An x-ray allows you to see the condition of the cartilage and changes in the bones in stages 2 and 3. This is a narrowing of the joint space, osteophytes along the edges of the patella, changes in the periosteum. Arthroscopy provides more detailed information about the meniscus, synovial membrane and the presence of fluid. This method is also used in the treatment of the knee, to remove pieces of cartilage or meniscus.
Treatment of knee osteoarthritis
Therapy is long and sometimes painful. Having appeared once, the disease recurs for the rest of your life. The main drugs used for treatment are nonsteroidal anti-inflammatory drugs. These are most often drugs based on nonsteroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. The drugs are relatively inexpensive, but lead to the formation of ulcers and erosions of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Treatment measures for stage 1 include preventative measures related to exercise. Daily exercise, use of a contrast shower, swimming pool 2 times a week and combating increased body weight are necessary.
Stage 2 requires fixation of the joint - the use of an elastic bandage, bandage or orthosis. To relieve pain, NSAIDs are used in the form of creams and ointments. To reduce the degree of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid activity and low mineralocorticosteroid activity. Additionally, painkillers are prescribed.
A hyaluronic acid solution is injected into the joint. It replaces intra-articular fluid and nourishes the cartilage. When moving, it acts as a shock absorber for the joint. The manipulation is painful, it is carried out by a doctor once the acute period has passed. If conservative treatment fails, stents are made.
Along with drug therapy, exercises using simulators and special devices (physiotherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered by subcutaneous or intramuscular injections, ozone ointments, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in demand as an alternative to drugs for joint restoration. Exercise therapy and massage are indicated. A set of special exercises improves blood circulation and nutrition of cartilage cells, increases the elasticity of ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. In this situation, only surgery will help. No ointment or medication can restore cartilage. Medications can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, the disease sometimes lasts for years. Without proper treatment, the patient's condition deteriorates rapidly. The knee cannot function, serious complications appear:
- joint deformity;
- cosmetic defect - curvature of a limb;
- infection from blood or lymph flow from another source in the body;
- due to the weakness of the ligaments, dislocations and fractures are observed even during normal walking;
- Bone fusion (ankylosis) occurs at the joint, making movement impossible.
Complications develop if the patient does not seek medical attention in time and the disease is advanced. Regular preventive examinations and timely treatment of general diseases of the body will help prevent worsening of the condition and maintain motor function of the limb.