Osteoarthritis of the knee joint, also called gonarthrosis, can significantly impair a person's quality of life. As the disease progresses, there is a gradual loss of hyaline cartilage in the joint. Gradually the cartilage loses its density and height. Razvlecheniya and thinning are noted and disappear completely over time. Therefore, the bone does not have a soft protective cushion, which causes an increased load on the last plate of the innervated joint surface of the bone. As a result of this load, painful feelings develop. According to ICD-10, the code for osteoarthritis of the knee joint is M17.
The knee joint is often affected because it is the knee that has a significant load during walking, physical exertion and running. In this situation, awkward movements can damage the soft tissues of the knee and lead to osteoarthritis. For this reason, gonarthrosis is one of the main causes of disability. According to statistics, this disease affects about 20% of the people on the planet to varying degrees.
This article will discuss why osteoarthritis develops, how to prevent the development of this disease, which doctor treats osteoarthritis of the knee joint, and what treatment methods a doctor can recommend after diagnosis.
Pathogenesis
The disease develops against the background of a mismatch between the load on the joint and the ability to resist it. In this case, cartilage characteristics can be genetically determined or altered as a result of both exogenous and endogenous acquired factors. The development and progression of gonarthrosis can occur with age, against the background of obesity, dysplasia of the femoral-patellar joint or changes in the axis of the lower extremity, violation of the biomechanics of the joint, meniscus and ligament damage.
The pathogenesis is based on the predominance of catabolic substances in cartilage and subchondral bones, meniscus and synovium over anabolic processes. As a result, structural changes occur and the biological properties of cartilage are lost. In addition, the pathological process spreads to the muscles and ligaments.
Joint cartilage is composed of connective tissue matrix and chondrocytes. The connective tissue matrix contains type II collagen and aggregate molecules. The cushioning properties of cartilage are provided by a precise connective tissue matrix.
The inflammatory process in osteoarthritis is not as intense as in arthritis. However, there are also anti-inflammatory mediators in osteoarthritis.
Classification
According to the origin of gonarthrosis, the following types are distinguished:
- Primary (idiopathic)- develops without the influence of external causes.
- Secondary- certain factors contribute to the development of the disease. They are often associated with injuries, fractures, joint surgery, as well as inflammatory factors - acute and chronic arthritis.
The following knee arthrosis rates are also determined:
- Grade 1 osteoarthritis- is defined as the period from the onset of the first symptoms of the disease to the development of bone deformities that appear on X-rays or on examination. During this period, pain of different intensity occurs during movement.
- In the 2nd grade- unpleasant feelings are observed at the slightest intensity. During walking and squatting, the knees shake, the mobility of the joint decreases. The figure shows the growth of bone tissue along the edges of the joint and the narrowing of the joint space. External examination may show an increase in the size of the knee.
- In grade 3there is practically no cartilage inside the joint. If the disease progresses, the bones can grow together, which leads to complete immobility of the leg. Sleep is disturbed, it is impossible to move without a stick or crutch.
The following types of this disease are also selected:
- Patellofemoral arthrosis of the knee jointis a condition in which degenerative changes are noted in the patella, ie the back of the patella. With this form of the disease, the pain is primarily bothersome when descending a staircase or a mountain. Patellofemoral arthrosis can develop in runners. The disease is often diagnosed in young people.
- Post-traumatic osteoarthritis of the knee joint- the result of injury. The type of post-traumatic illness may not appear at first. However, later a person loses full motor function of the joint.
Causes of osteoarthritis of the knee joint
Today, work is underway to study the causes of the development of such pathology.
Currently, the causes of gonarthrosis are associated with the following factors:
- Age - at a certain age, a person begins degenerative changes in the tissues and the ability of cartilage tissue to regenerate decreases.
- Arthritis - Over time, arthritis can lead to the development of osteoarthritis.
- Past injuries and overloads - in addition to the injuries received, the development of the disease can often lead to the need to kneel, squat, lift weights.
- Obesity and overweight - due to excess body weight, there is an increased load on the joints of the legs. In addition, substances that cause joint damage enter the bloodstream from pathological adipose tissue, and then into the joint.
- Heredity - in some cases, the development of the disease is determined by a defective gene responsible for the growth of cartilage tissue. As a result, this tissue may show a low resistance to damage. If your close relatives have osteoarthritis, this increases the likelihood.
- Diseases that cause metabolic disorders - this pathological risk increases with atherosclerosis, diabetes.
- Hormonal disorders - women are more likely to get sick after 55 years.
- Sports - People who do certain sports are more likely to get the disease. This is typical for athletes, football, tennis, basketball players.
Symptoms of Osteoarthritis of the Knee
As a rule, the symptoms of osteoarthritis of the knee joint increase slowly, because the development process lasts for years. If many joints are affected, symptoms of polyarthritis develop.
Manifestations of the disease depend on the severity, age and a number of other factors.
However, the main symptoms of gonarthrosis are:
- Pain in the knee joint aggravated by activity. The knee hurts less at rest.
- Swelling in the knee.
- feeling of warmth in the joint.
- Unpleasant stiffness in the joint that occurs after a person has been in a static position for a long time.
- Decreased range of motion of the knee joint makes it difficult for a person to fall off a chair, descend stairs or get out of a car.
- Kneeling and squeaking in the knee are most often seen with sudden joint movements.
- Changes in the weather are believed to affect the degree of pain and anxiety.
Analyzes and diagnostics
To determine if such a disease can be cured, the diagnosis must first be confirmed. During the diagnosis, the doctor examines the patient and conducts interviews. But in this case, the most informed work is a knee x-ray.
It is also advisable to have an ultrasound to confirm the diagnosis, which can rule out arthritis and measure the height of the joint cartilage.
If necessary, schedule additional examinations.
Treatment of knee osteoarthritis
For the treatment of this disease to be as effective as possible, it is first necessary to confirm the diagnosis and choose the right complex therapy regimen. Treatment of osteoarthritis of the knee at home is possible if the patient carefully follows all the recommendations of a specialist and applies both medications and additional treatments. Only in this case, home therapy can be effective.
Depending on the degree of damage, drug treatment and other therapies are used for this disease. The simplest is the treatment of grade 1 osteoarthritis of the knee joint. In the case of primary disease, a complex therapy scheme is used, which allows to achieve the effect as soon as possible. Therefore, if a person is diagnosed with grade 1 osteoarthritis, the disease should be treated immediately.
When it comes to treating second-degree osteoarthritis of the knee, the doctor decides based on the patient's condition. Treatment should be carried out immediately as changes in cartilage tissue begin at this stage.
Whether it is possible to treat grade 3 osteoarthritis of the knee depends on many factors. In grade 3, the cartilage becomes thinner, so the treatment is longer and less effective.
Medications
Medical treatment of osteoarthritis of the knee aims to have analgesic and anti-inflammatory effects. It is also important to reduce the severity of cartilage destruction.
The following drugs are used for this:
- Non-steroidal anti-inflammatory drugs - both tablets and topical medications are used - ointments, gels. The most effective local and systematic application of such funds.
- Chondroprotectors - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfates and others are used for osteoarthritis of the knee joint. Such drugs for osteoarthritis of the knee joint are prescribed as part of a complex treatment. The cost of chondroprotectors depends on the drug and varies significantly.
- Medical treatment for serious illnesses includes steroids. For osteoarthritis of the knee joint, both injections can be given intramuscularly and steroids can be used.
- Skin irritants. In the description of folk remedies, you can also find boring compresses.
- During treatment, the doctor may prescribe injections into the knee. Different medications can be used for injections in the knee joint for osteoarthritis. Corticosteroids are injected to relieve especially severe inflammation. Reviews of injections show that steroids are in this form in the fastest and most effective way. Knee blockade can be performed not only with glucocorticosteroids, but also with anesthetics. A review of the blockade shows that this method effectively eliminates even severe pain. In addition, an injection may be given to the knee during treatment with chondroprotectors. Improves metabolic processes, activates collagen production. But you need to inject at least five needles to get the effect. In addition, hyaluronic acid is injected into the joint, which improves the quality of the intra-articular fluid and provides effective protection of cartilage tissue. Vitamins can also be administered intra-articularly.
- Plasmolifting method - the essence is the introduction of platelet-rich blood plasma into the affected knee.
- Used for medical bile-compresses for osteoarthritis of the knee joint. It should be noted that the use of medical bile can be an effective tool only if it is prescribed by a doctor according to a certain scheme. For this reason, the option of "treatment at home" without consulting a doctor is unacceptable in this situation.
Procedures and Operations
Non-drug therapies are also used for osteoarthritis and polyarthritis, which are less effective.
Physiotherapy. Various techniques are used, including shock wave therapy, myostimulation, phonophoresis, ozone therapy, kinesitherapy, and more. Physiotherapy can reduce pain and eliminate inflammation. Any physiotherapy prescribed by a doctor should be carried out in a complex recommended by a doctor.
Laser therapy- has decongestant, analgesic, anti-inflammatory effects.
Ozone therapy- relieves pain, has anti-inflammatory effect, which allows you to reduce the amount of hormonal substances used.
Knee pads for osteoarthritis of the knee joint- Wearing such devices reduces the severity of pain. In addition, the knee support protects it from instability. But to get the desired effect, you need to choose the right knee pads or knee pads. There are many general tips on how to choose knee pads for knee osteoarthritis. In addition, many different models of such knee pads are offered - motion limiters, amplifiers, etc. However, those who want to buy knee pads for osteoarthritis are advised to rely on the doctor's advice, not user feedback. The price of an orthopedic knee pad depends on different features - material, quality. Knee pads are especially relevant if the patient develops post-traumatic osteoarthritis. However, patellofemoral arthrosis and other diseases can also be treated in this way.
Therapeutic gymnastics for osteoarthritis of the kneeis an effective way to improve the condition and prevent surgery, provided that the person regularly and continuously exercises for osteoarthritis of the knee joint. Physiotherapy exercises help to strengthen the muscles of the legs and stop the development of the pathological process. However, for osteoarthritis of the knee joint, a number of exercises must be performed in a certain sequence, and such gymnastics is selected individually. Therefore, it is best to have a series of exercises prepared by a doctor, rather than a video of basic gymnastics for lessons. In this case, not only recharging, but a full-fledged exercise therapy is important.
Different types of sports therapy can be applied with a similar pathology.
Special gymnastics.Such exercises are recommended for people over 40, both during treatment and for prevention. Knee exercises should be done every day. These exercises are suitable for older adults as they can be done at a calm pace.
Massage and manual therapy- suitable for patients with limited mobility, can be combined with exercise therapy. If you do not have the opportunity to visit a masseur, self-massage can be performed according to the scheme indicated by a specialist.
Additional methods to improve the patient's condition and active rehabilitation may include yoga, acupuncture, joint stretching, special exercises in simulators (sports bike, etc. ).
Surgical treatment is used if conservative methods are ineffective.
The following methods can be used:
- Puncture- Getting rid of excess fluid in the joint can reduce the symptoms of inflammation and restore mobility.
- Arthroscopy- can be done with endoscopy. With the help of this technique, the joint surfaces are cleaned of pieces of destroyed cartilage tissue.
- Periarticular osteotomy- During such an intervention, one of the bones that make up the knee joint is sawn and re-fixed at a different angle. As a result, the severity of pain decreases and knee mobility increases. The intervention is effective in the first and second degree of the disease.
- Endoprosthetic- replacement of the knee joint with a special biostructure. This is a very complex intervention performed with the third degree of the disease.
Treatment of osteoarthritis of the knee joint with folk remedies
Numerous studies on the treatment of folk remedies for this disease confirm that such methods can be used as adjuvant methods and ease the patient's condition. However, such methods should not replace basic treatment. Folk remedies are used to rub, compress, take a bath, swallow. There are many recommendations on this topic in any thematic forum.
- rub with garlic. A few cloves of garlic should be peeled and chopped. Mix the resulting mixture with 200 ml of vegetable oil and insist in a dark place for a week. Apply to your knee with a film and a warm cloth on top overnight.
- Mustard Grinding. To prepare the drug, take 50 g of camphor and mustard powder, 500 ml of vodka, one egg white. All mixed and stored for a week in a jar in a dark place. Then the product should be rubbed into the knee three times a day.
- Elecampane Grind. Pour 50 g of elecampane root with 125 g of vodka and leave for two weeks. Rub twice a day.
- burdock compresses. Burdock is a popular folk remedy for the treatment of osteoarthritis. Several layers of burdock should be folded on the hairy side and lubricated with vegetable oil. Attach them to your knees and cover with cellophane and a warm cloth. In addition, burdock leaves can be lubricated with vodka. The compress is applied at night. Similarly, treated with horseradish leaves.
- Cabbage leaf. It is also applied to painful areas at night. Pre-stained with honey, cologne or vodka.
- Honey compression. Mix equal parts of honey, ammonia (10%), glycerin and medical bile, add a few drops of iodine. Keep the mixed product in the dark for 10 days. Warm up before applying the compress.
- Onion decoction. Internal is accepted. To prepare the broth, you need to take two large onions, cut them and pour 1 liter of water. Cook until onion is tender. Take a mixture of 100 ml three times a day.
- Celery Water. Grind celery stalks in a blender, squeeze the juice. Drink 100 ml of water three times a day.
- Gelatin. For osteoarthritis, it is recommended to consume foods that contain gelatin. It is recommended to include jelly, jelly and other dishes with gelatin in the menu.
- Bath with pine needles. Pour boiling water over 1 kg of pine needles and leave for several hours. Add 0. 5 kg of salt to a warm bath in which you can dissolve. Take a bath for 20-30 minutes.
Prevention
The following preventive measures should be taken to prevent osteoarthritis of the knee joint:
- Eat right and include a variety of vitamins and minerals in your diet.
- Avoid excessive loads on the knee joint, protect it from damage.
- Get rid of bad habits.
- Track weight, prevent obesity.
- Treat all diseases in time, undergo preventive examinations.
- Do sports, preferring gentle physical activity.
- Wear high quality shoes that are as comfortable as possible.
- Ensure proper posture.
Diet for osteoarthritis of the knee joints
- Effectiveness: healing effect
- Terms: permanent
Diet is very important during treatment and rehabilitation. First of all, food should be healthy and light - it is important to prevent excess weight gain, which can aggravate the condition and provoke acute osteoarthritis. However, the acute course of the disease requires not only treatment, but also weight loss.
It is also important to include foods that are important components for cartilage tissue in the diet:
- Poultry, rabbit.
- sea fish.
- Soy products.
- Eggs.
- Greens, pumpkins, carrots, squash.
- Nuts.
- Fruits, berries.
- Vegetable oils.
- Dishes with gelatin.
At the same time, you should limit the consumption of such products:
- Beans, sorrel, spinach, tomatoes.
- Flour dishes.
- Animal fat.
- Spices, vinegar.
- Alcohol.
- Red Meat
Often, you need to eat in small portions. You should also drink about 2 liters of fluid a day.
Consequences and complications
If left untreated, osteoarthritis can lead to the following complications:
- Inflammatory process of periarticular tissues.
- Restriction of joint mobility.
- Changing the shape of the joints.
- Degeneration of the hip joint.
Such complications can lead to the development of disability and irreversible changes.
Forecast
Timely treatment of the disease is important. The best prognosis is if you start treatment in stage 1 or 2 of the disease.