Knee joint

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

• Excessive physical activity that does not meet the requirements of age leads to damaged joints;
• sedentary lifestyle;
• trauma to the knee joint - knee dislocation, fracture, ligament tear and tear, meniscal body damage, severe fall and knee injury, bruising;
• body mass index increases, puts stress on joints, ruptures meniscus;
• heredity;
• arthritis or other joint diseases (inflammation can lead to the appearance of edema or the accumulation of a large amount of synovial fluid in the joints, causing the destruction of cartilage tissue);
• metabolic disorders that lead to the elimination of calcium from the body;
• diabetes of any kind, hormonal disorders and other pathologies of the endocrine system;
• chronic or past diseases of an inflammatory and infectious nature;
• violation of blood flow;
• lupus erythematosus, rheumatic diseases, gout and psoriasis, ankylosing spondylitis;
• the foot is flat, as a result of which the center of gravity shifts and the load on the joint increases;
• nervous overload and stressful situations.

Why does knee osteoarthritis happen?

Often, it is the person who becomes the culprit in the development of such an incurable disease. Usually, when it comes to pain in the knee joint, people ignore the pain, prefer to go to the doctor and use any medicine that simply covers the pain.

After a few years, you will still have to consult a specialist, since with such a diagnosis, self-medication will not bring results. However, the severity of joint disease will be at least moderate. Here, ointments, the use of hyaluronic acid in the joints and preventive physical education are no longer enough, as can be done in the early stages of the disease process. Most likely, radical action is required, including sometimes using surgical intervention.

Symptoms and Diagnosis of Osteoarthritis of the Knee

The disease can be distinguished by the following characteristics:

• Pain syndrome. The pain usually comes on suddenly, but often occurs with exertion, even a little. The pain can be of a different nature. At first, these will be weak low back pain (unfortunately few people notice them). Mild pain is only cyclical and can last for months or even years until the disease progresses to a more severe stage.
• Signs of knee deformity. A similar symptom is typical for the later stages. And when arthritis begins to develop, the knee will swell and swell a little.
• The appearance of dense formations in the posterior wall of the knee joint. The accumulation of large amounts of synovial fluid in the cavity of the Baker's capsule or in the joint itself.
• Cracking sound of joints, accompanied by pain.
• Reduced joint mobility. This is especially evident in the late stages of joint disease. In this case, bending and extending the knee will cause severe pain, by the end of which, movement is almost impossible.

AUTHORITY TO SOLVE! In a patient with osteoarthritis, gait changes: characteristically drooping legs and a limp.

Pathophysiology of dry joint disease of the knee joint

Specialists distinguish primary and secondary arthropathy.

Primary sclerosis of the knee joint

For primary gonarthrosis, the following processes are characteristic:

1. Cartilage has the ability to continuously degrade and renew rapidly. Under normal conditions, these two processes should balance each other. With age, cartilage destruction occurs at a similar rate, but its recovery slows down. A person's mass plays an important role here. Indeed, if a person's mass is 70 kg, then in 10 steps one foot will move 700 kg, and a person weighing 120 kg will move 1200 kg, which will become a significant load for a person. with joints and cartilage, will wear out faster because of this.
2. It's important to remember: joints eat only useful elements when moving. A sedentary lifestyle leads to a slowed down metabolism which is why essential nutrients do not reach their destination.
3. The chance of developing gonarthrosis is increased in people whose parents have the condition.

Secondary osteoarthritis of the knee joint

It develops for the following reasons:

• Multiple trauma. In a person of any age, they place undue stress on the cartilage. When any bone covered with cartilage breaks down, abnormalities, so-called "steps", appear. In this area, now, with any movement, the joint wears down, resulting in joint dryness.
• Development of rheumatoid arthritis, Koenig's disease, the appearance of purulent inflammation in the joint area.
• Vascular dysfunction.

Classification and stages of development of osteoarthritis of the knee

Orthopedists divide gonarthrosis into stages, depending on the further treatment of the disease. Of course, the course of treatment will also depend on other factors, for example, the reason for the development, the site, and the nature of the joint disorder.

IMPORTANT! Qualitative treatment can be prescribed by a doctor only after a complete study of the picture of the disease. Self-treatment can only aggravate the health situation.

The main classification divides gonarthrosis into four stages of development:

1. Initial stage. At this stage, new diseases appear. External symptoms are barely noticeable or completely absent, the shape of the joint is in satisfactory condition. Symptoms include only mild or severe discomfort in the knee after prolonged walking, as well as vigorous exertion. X-ray examination will be less informative: X-rays may show only mildly narrowed joint space. Unfortunately, at this stage, a person does not seek medical help due to insignificant symptoms.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. Pain severity decreases with rest. Joint movement becomes difficult. You may hear a crunch or crack in your knees when you walk. On the X-ray, the narrowing of the joint space becomes noticeable, as does the osteoblasts. The patient begins to limp.
3. Once the joint disease has progressed to the third stage, the pain syndrome will be felt continuously, even without movement. The processes of deformation and degeneration move to an irreversible stage. The deformity of the joint becomes pronounced, the distance between the joint surfaces is significantly reduced, many bone-forming substances increase in size. Pain now bothers the patient even at rest. A person becomes dependent on outside support (walker, cane) and needs help from others. Careful treatment at this stage is less effective.
4. The fourth stage is characterized by constant debilitating pain. The bone organizations increase in number and size, the cartilage is completely destroyed, there is no joint space left or completely absent, the bone is severely deformed. Even weak movements become torture for the patient. At this stage of gonarthrosis, the patient is recognized as disabled. In the absence of surgery, the disease can lead to disability.

Complications of knee osteoarthritis

Advanced osteoarthritis can lead to dislocation and degeneration of the knee joint. When dislocated, the femoral protrusion extends completely outside the joint, so movement within the joint becomes impossible and the axis of the leg is essentially displaced to one side. Fortunately, a negative variant of the development of the disease is quite rare.

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

Ignoring the disease can lead to a complete loss of lower extremity function.

ATTENTION! The habit of holding back foot pain sometimes causes disc deformation and the appearance of herniated masses.

Consequences of neglected gonarthrosis

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

• pain around the clock, which no painkiller can save;
• loss of support for a limb (inability to stand on a painful leg or at least to lean on);
• immobility of the joint block;
• pronounced curvature of the bones around the knee;
• Severe swelling around the affected area.

Osteoarthritis of the knee treatment

The method of treatment is indicated depending on the degree of development of the disease. There are several therapy options.

Hormonal

These drugs are prescribed for severe exacerbations, accompanied by bursitis and severe pain. Usually the hormone is given by injection. The following drugs are most commonly used:

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The course of hormone treatment is usually short; Injections are only given during severe exacerbations. Hormones are used with an average frequency of once every 10 days.

Chondroprotectors

Chondroprotectors are prescribed at an early stage of the development of the disease. This therapy is currently considered the most effective and safest: there are practically no contraindications, and side effects appear in the rarest of cases.

The drug is aimed at restoring cartilage, improving metabolism, nourishing cartilage tissue and protecting it from further destruction. But in the final stages of osteoarthritis, chondroprotectors are also helpless.

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

Vasodilators

These funds are needed to eliminate spasm of small vessels, increase blood circulation and deliver nutrients to the affected joint area. Prescribed for oral administration of vasodilators together with phytoprotective chondroprotectors.

If synovial fluid does not accumulate during osteoarthritis (without bursitis), you should use warming ointments.

hyaluronic acid

In another way, the device is called an intra-articular fluid prosthesis, because the composition of the acid is similar to that of the intra-articular fluid. When acid is injected into the joint, it forms a film that prevents strong friction of cartilage during movement, affects the extracellular matrix, improves metabolism in the joint and also activates acid production. hyaluronic acid in the joints - ie bring back the normal functioning of the joints, stop the pathological processes that destroy cartilage. . . .

Acid therapy is prescribed only when exacerbations - synovitis are excluded.

Physical therapy

Physical therapy exercises bring positive results only if prescribed by a doctor after a complete medical history is studied and all exercises are performed under the supervision of a specialist.

Self-medication often leads to worsening of the joint condition. Exercise therapy is indicated for the following purposes:

• slows down the development of stiffness;
• prevent further destruction of cartilage tissue;
• Eliminate muscle spasms, which lead to pain.

Physical therapy

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

Physiotherapy is aimed at reducing the severity of pain, eliminating inflammation, normalizing metabolism inside the affected joint, and restoring normal function of the joint.

IMPORTANT! It is important for patients to monitor their diet and avoid exertion.

Forecast. Preventive

Given the advanced stage of the disease, the forecasts are disappointing. Therefore, it is recommended that even if minor symptoms of joint disease occur, consult a doctor for advice.

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

1. Eat right and control your weight. Follow the weight loss diet as needed.
2. Reduce the load on joints when playing sports, continuous monitoring.
3. Timely treatment of infectious diseases, preventing them from turning into a chronic stage.
4. Get enough rest and avoid stressful situations if possible.
5. Increase the body's protective functions (periodically taking vitamins, oxygen).
6. Avoid hypothermia, especially the lower extremities.