Osteoarthritis of the knee

The following factors may contribute to the development of osteoarthritis of the knee joints:

• excessive physical activity that does not meet the requirements of age, leading to joint damage;
• sedentary lifestyle;
• has suffered injuries in the area of the knee joints - knee dislocations, fractures, rupture and rupture of ligaments, damage to the meniscus body, severe falls in the knee, bruising;
• increase in body mass index, which causes increased stress in the joints, meniscus rupture;
• inheritance;
• arthritis or other joint diseases (inflammation can lead to the appearance of edema or accumulation of a large amount of synovial fluid in the joints, provoking the destruction of cartilage tissue);
• metabolic disruptions leading to the excretion of calcium from the body;
• diabetes mellitus of any kind, hormonal disruption and other pathologies of the endocrine system;
• chronic or past diseases of an inflammatory and infectious nature;
• violation of blood flow;
• lupus erythematosus, rheumatoid pathology, gout and psoriatic, ankylosing spondylitis;
• flat feet, due to which the center of gravity shifts and the load on the joints increases;
• nervous overload and stressful situations.

Why osteoarthritis of the knee joint occurs

Most often, people themselves become the culprits of developing such a difficult disease. Often, when pain appears in the knee joint, people ignore the painful sensations, preferring to go to the doctor to use any medicine that simply masks the pain.

After a few years, you will need to consult a specialist, as with such a diagnosis, self-medication will not work. However, the severity of osteoarthritis will be at least moderate. Ointments, intra-articular administration of hyaluronic acid and preventive physical education are no longer enough, as could be done in the early stages of the disease. Most likely, it will be necessary to act radically, sometimes including the use of surgical intervention.

Symptoms and diagnosis of osteoarthritis of the knee joints

The disease can be distinguished by the following characteristics:

• Pain syndrome. Painful sensations usually occur suddenly, but more often with physical exertion, even if mild. The pain can be of a different nature. At first, these will be weak lumbago (unfortunately, few people pay attention to them). Mild pain that appears only periodically can last for months, or even years, until the disease develops to a more severe stage.
• Significant knee deformity. A similar symptom is typical of later stages. And at the beginning of the development of osteoarthritis, the knee swells and swells slightly.
• The appearance of dense formations in the posterior wall of the knee joints. Accumulation of a large amount of joint fluid in the Baker cyst cavity or in the joint itself.
• A sharp crackling of the joints, which is accompanied by pain.
• Decreased joint mobility. This is especially pronounced in the later stages of osteoarthritis. In this case, bending and stretching the knee causes severe pain and in the final stages movement becomes almost impossible.

REFERENCE! In a patient with osteoarthritis, gait changes: it is characterized by drooping legs and lameness.

Pathogenesis of osteoarthritis of the knee joints

Specialists distinguish primary and secondary osteoarthritis.

Primary osteoarthritis of the knee joints

For primary gonarthrosis, the following processes are characteristic:

1. The articular cartilage is capable of constantly deteriorating and at the same time rapidly renewing. Under normal conditions, these two processes must balance each other. With age, cartilage destruction occurs at the same rate, but its recovery slows down. The mass of a person plays an important role here. Indeed, if a person's mass is 70 kg, then in 10 steps on one leg he will transfer 700 kg, and he who weighs 120 kg will transfer up to 1200 kg, which will become a considerable loadin joints and cartilage, which will be consumed faster because of this.
2. It is important to remember: the node feeds on useful elements only when it moves. A sedentary lifestyle leads to a slowing down of metabolic processes, therefore the necessary nutrients do not reach their destination.
3. The possibility of developing gonarthrosis increases in people whose parents suffered from this disease.

Secondary osteoarthritis of the knee

It takes place for the following reasons:

• Multiple injuries. In a person of any age, they will cause excessive stress on the cartilage. When any cartilage-covered bone is broken, irregularities appear, the so-called "steps". In this area, now, with every movement, the wrist will be consumed, leading to osteoarthritis.
• Development of rheumatoid arthritis, Koenig's disease, the appearance of purulent inflammation in the joint area.
• Vascular dysfunction.

Classification and developmental stages of osteoarthritis of the knee joints

Orthopedists divide gonarthrosis into stages, on which further treatment of the disease depends. Of course, the course of treatment will also depend on other factors, for example, the reasons for the development, localization and nature of osteoarthritis.

IMPORTANT! Qualitative treatment can be prescribed only by a doctor after a thorough study of the picture of the disease. Self-administered therapy can only worsen the health situation.

The main classification divides gonarthrosis into four stages of development:

1. Initial phase. At this stage, the disease just appears. External symptoms are hardly noticeable or completely absent, the shape of the wrist is in satisfactory condition. Symptoms include only mild discomfort or heaviness in the knee after long walks, as well as strenuous physical exercise. An x-ray examination will have little information: an x-ray can only show a slight narrowing of the wrist space. Unfortunately, at this stage, a person does not seek medical help due to the insignificance of the symptoms.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. The severity of the pain decreases at rest. Joint movement becomes difficult. A crackling or crackling of the knees is heard while walking. X-rays show narrowing of the joint space as well as osteophytes. The patient begins to limp.
3. When osteoarthritis has progressed to the third stage, the pain syndrome will be felt constantly, even in the absence of movement. The processes of deformation and degeneration pass into an irreversible phase. The distortion of the joint becomes pronounced, the distance between the articular surfaces is significantly reduced, numerous osteophytes increase in size. Painful sensations now disturb the patient even in a state of complete rest. A person becomes dependent on outside support (stroller, cane) and seeks help from other people. Conservative treatment at this stage is less effective.
4. The fourth stage is characterized by persistent debilitating pain. Osteophyte growths increase in number and size, cartilage is completely destroyed, joint space is barely traceable or completely absent, bones are severely deformed. Even weak movements become torture for the patient. At this stage of gonarthrosis, the patient is recognized as incapacitated. In the absence of surgery, the disease can lead to disability.

Complications of osteoarthritis of the knee joints

Advanced arthrosis can lead to dislocations and subluxations of the knee joint. With dislocation, the femoral epiphysis extends completely out of the joint, due to which movement in the joint becomes impossible, and the axis of the foot shifts significantly to the side. Fortunately, such a negative variant of disease development is quite rare.

Subluxations are more common. They are characterized by a partial displacement of the joints relative to each other and a slight deviation of the tibial axis. In this case, subluxations are associated with severe pain and joint dysfunction.

Neglect of the disease can lead to a complete loss of function of the lower limbs.

CAREFUL! The habit of sparing an injured leg sometimes causes deformity of the intervertebral discs and the appearance of hernias.

Consequences of neglected gonarthrosis

The advanced stage of gonarthrosis is almost always characterized by the following adverse symptoms:

• pain all the time, from which no sedative can escape;
• loss of support for a limb (it is impossible to stand on an injured leg or at least lean on it);
• articulation of the articular block;
• pronounced curvature of the bones around the knee;
• severe swelling around the affected area.

Methods for treating osteoarthritis of the knee joint

The treatment prescribed depends on the degree of development of the disease. There are several therapy options.

Hormones

These drugs are prescribed for severe exacerbation, accompanied by synovitis and severe pain. Hormones are usually given by injection. The following drugs are most often used:

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The course of hormone treatment is usually short; injections are performed only during a period of severe deterioration. Hormones are administered at an average frequency of once every 10 days.

Chondroprotectors

Chondroprotectors are prescribed in the initial stage of disease development. This therapy is currently considered the most effective and safest: there are virtually no contraindications, and side effects occur in rarer cases.

The drugs are aimed at restoring cartilage, improving metabolic processes, nourishing cartilage tissue and protecting it from further destruction. But in the later stages of osteoarthritis, chondroprotectors are also powerless.

This group of drugs is produced in the form of injections, ointments, gels, tablets.

Barnat vasodilator

These funds are needed to eliminate small vessel spasm, increase blood circulation, and supply nutrients to the affected joint area. It is prescribed to take vasodilators along with chondroprotectors.

If articular fluid does not accumulate during gonarthrosis (no synovitis), the use of warming ointments is recommended.

Hyaluronic acid

In another way, this tool is called an intra-articular fluid prosthesis, as the acid composition is similar in composition to the intra-articular fluid. When acid is injected into the joints, it forms a film that prevents strong cartilage friction during movement, affects the extracellular matrix, improves metabolic processes in the joints, and also causes the production of its hyaluronic acid in the joints - d. m. th. restores joint function to normal, stopping the pathological processes that destroy the cartilage. . . .

Acid treatment is prescribed only when the worsening - synovitis is eliminated.

Physiotherapy

A course of physiotherapy exercises will bring positive results only if it is prescribed by a doctor after a thorough study of medical history, and all exercises are performed under the supervision of a specialist.

Self-medication often leads to a worsening of the joint situation. Exercise therapy is prescribed for the following purposes:

• slowing down the development of stiffness;
• preventing further destruction of cartilage tissue;
• elimination of muscle spasm, leading to pain.

Physiotherapy

As additional therapy, various procedures can be described: electrophoresis, acupuncture, laser therapy, UHF, as well as diadynamic currents. Local massage will also give a good result.

Physiotherapy aims to reduce the severity of pain, eliminate inflammation, normalize metabolic processes within the affected joint and restore its normal function.

IMPORTANT! It is important for the patient to monitor his diet and avoid strenuous physical exertion.

Forecast. Prophylaxis

With an advanced stage of the disease, the prognosis is disappointing. Therefore, it is recommended that if even minor symptoms of osteoarthritis appear, consult a doctor for advice.

People at risk (seniors, athletes, as well as overweight people) should follow the doctor's recommendations and adhere to the following rules:

1. Eat properly and control your weight. Follow a diet for weight loss as needed.
2. Reduce the load on the joints while playing sports, constantly monitor it.
3. Treat infectious diseases in time, preventing their transition to the chronic stage.
4. Take adequate rest, avoid stressful situations if possible.
5. Increase the body's protective functions (take vitamins, temperament periodically).
6. Avoid hypothermia of the body, especially of the lower extremities.