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 arthrosis, the cartilage that lines the articular surface is irreversibly affected, causing the joint to stop working correctly 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 on the human body and are the most commonly affected by osteoarthritis.Much less commonly, the disease affects the hip and ankle joints.
How does gonarthrosis occur?
Normally, healthy cartilage is elastic and smooth, it completely covers the moving areas of the bone and allows them to slide.Cartilage also softens the stress that bones receive when walking or exercising.
When cartilage is destroyed (this is how arthrosis manifests itself), the top 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 losing its normal appearance, and pain appears.
Causes of gonarthrosis and risk factors
Osteoarthritis deformans is more common 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 labor or excessive stress in the gym.
Here is a far from complete list of the causes of arthrosis of the knee joint:
- sports injuries - meniscal 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 heavy lifting;
- uneven load on the joints due to curvature of the legs - arthrosis manifests itself faster in overloaded areas.
Much 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 gonarthrosis:
- increased body weight.Due to the increasing load on the joint, 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 properly supply joints, and the risk of cartilage damage increases.
Symptoms of arthrosis
Osteoarthritis of the knee joint is not a disease that can appear suddenly.It makes itself known strongly 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 the movement, then the pain disappears and returns again with prolonged load 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 change from passing 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 changes in the weather.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;
- swelling of the knee;
- dry and rough crunching sound when moving - this sound occurs due to friction of the articular 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 knee deformation, gait will change.
Degrees of gonarthrosis
There are 3 stages of development of arthrosis of the knee joint.
1st degreedisease - 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 its 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 at stage 1.
2nd degreecharacterized by progressive changes in bone tissue.Externally, the knee may look the same as at stage 1 - deformed and increased in size.The pain increases: in addition to the incoming pain that occurs during movement, crepitus (crunching) in the affected knee is added.The joint becomes less mobile, it becomes 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 tissue left, and if the disease is severe, the bones can grow together.Then the joint becomes completely immobilized, and the person has to move only with the help of a crutch or stick.Usually at this point doctors make a verdict about endoprosthetics of the damaged joint.
Important: only a doctor can determine the exact degree of development of the disease.Sometimes, with mild symptoms, the disease seriously affects the cartilaginous membrane - therefore, for an accurate diagnosis, additional studies are usually carried out:
- radiography - to see if the cartilaginous surfaces are deformed and in what condition the joint space is;
- 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 at the very beginning.Therefore, the appearance of the first discomfort in the knee joint is a good reason to visit a doctor and undergo an examination.
Doctors make a diagnosis of osteoarthritis based not only on medical history, complaints 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 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 have appeared in the joint capsule - these changes will be visible in the photographs.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 that surround and line the joint.Ultrasound complements the results of radiography so that the doctor can see changes not only in bone structures, but also in 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 joint cavity is examined from the inside using a camera.The cameras are inserted through small incisions on the skin; through these same incisions, doctors can perform minor manipulations - for example, remove a piece of destroyed cartilage, partially smooth out unevenness in the cartilage tissue, etc.
Treatment of arthrosis is usually carried out with medication, trying first of all to relieve pain, improve joint mobility and restore the ability to move.Arthrosis causes irreversible changes in cartilage tissue - therefore, it is impossible to talk about a complete cure.But it is possible to stop the progression of the disease - and thus slow down further tissue destruction.
This is what standard treatment for gonarthrosis looks like:
- local remedies - patches, 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 gastric mucosa;
- blockades and chondroprotectors - drugs whose effect appears only after a long course of use;
- rarely - physiotherapy and sanatorium treatment.
There are recommendations to wear orthopedic knee pads to support the joint and reduce pain.But all of the methods listed above are methods of passive influence on the functioning of the joint.
This treatment relieves only some symptoms - neutralizes pain, inhibits inflammatory processes, etc.The disease itself continues to progress, gradually destroying 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, the joint has to be prosthetized - that is, an artificial structure must be inserted into the knee.Such surgical intervention does not pass without leaving a trace and imposes its own limitations - and therefore reduces the 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 the joint with blood and nutrients is restored.Such 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.
Treatment with kinesitherapy 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 from ultrasound, CT, MRI and radiography, the degree of gonarthrosis is determined and a program of therapeutic exercises is drawn up.
Classes are conducted on a multifunctional simulator - a proprietary simulator with a special design.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 - it consists of exercises on a mat without weights.
The therapeutic effect of kinesitherapy is ensured by restoration of blood microcirculation and improved lymphatic drainage.The cartilage receives more nutrition, the development of arthrosis slows down to a complete stop, and the biomechanics of the articular joint is fully restored.
Such a serious disease as arthrosis of the knee joints cannot be ignored.The best way to prevent it is to lead a healthy lifestyle: a balanced diet, physical activity.But if problems with joints have already begun, you should not wait for serious warning signs - at the first symptoms you should seek help from qualified doctors.