What is osteoarthritis of the knee (knee) joint: causes, symptoms and treatment of the disease?

Osteoarthritis of the knee joint (gonarthrosis) is a degenerative lesion of the joint, which eventually leads to its deformation. In it, the cartilage tissue begins to collapse. Gradually, the functionality of the knee deteriorates and the patient loses the ability to move normally. This disease is very common.

Treatment of osteoarthritis of the knee is long-term, but cannot provide a complete cure for the problem. However, therapy is necessary to preserve joint mobility and functionality for as long as possible, as well as to improve the patient's quality of life.

Types of diseases

It is possible to classify gonarthrosis of the knee joint on the basis of its development. It is primary and secondary. The first type of disease occurs most often. It also has another name: idiopathic osteoarthritis. The exact reason for the development of this form of knee osteoarthritis is difficult to establish, as there are too many influencing factors.

The secondary type of pathology is clearly linked to one reason or another. For example, it often occurs after a knee injury due to severe physical strain on the knee joint. This knee osteoarthritis is usually genetically determined. Certain diseases can also cause dystrophic changes in the knee joint: diabetes mellitus, rheumatoid arthritis, congenital deformity of the lower extremities.

Why the pathology develops

The knee joint is one of the most complex joints in the human body. It is made up of the femur, tibia, and patella. The joint also includes triangular cartilage with curved edges - menisci. The well-coordinated work of the knee is ensured by the musculo-ligamentous apparatus. Almost all the bony surfaces of the joint are covered by cartilaginous tissue, the thickness of which is approximately 0. 5 cm. It feeds on the blood vessels, as well as diffusely (obtaining useful substances from the synovial fluid).

The cartilage of the knee allows the bony surfaces to glide and cushion. If the nutrition of this tissue is disturbed, dystrophic processes begin, it becomes thinner. If left untreated, the cartilage disappears completely and the knee joint stops moving. The reason for the development of arthrosis may be different. For example, the following factors can provoke the appearance of a secondary form of pathology:

• Excessive strain on the knee joint. In this case, changes can occur that the person is not even aware of. Therefore, the burden should be moderate, especially in old age. The greatest damage comes from squatting and running on hard surfaces (asphalt).
• Knee injury. This can include meniscus damage, joint dislocation, fracture. This reason contributes to the development of the disease in young people. After fixing the limb, the blood circulation deteriorates. Damage or removal of the menisci in 90% of cases leads to osteoarthritis.
• Too much body weight. Excessive weight can damage the menisci. Restoring the knee joint is time-consuming and difficult. In obese people, bilateral knee osteoarthritis often occurs. An additional negative point is the presence of varicose veins. In this case, the patient develops the most severe form of knee osteoarthritis.
• Weakness of the ligamentous apparatus. Therefore, there is too high joint mobility. Despite the fact that a person can sit on the thread without any problem even without warming up, at this time the joint receives microtrauma. If the knee is sufficiently damaged, osteoarthritis begins to develop.
• Violation of metabolic processes. In this case, the knee joint does not receive enough nutrients.
• Joint pathologies. The presented pathology can be caused by arthritis of the knee joint (reactive, rheumatoid). It is characterized by the development of inflammation and the accumulation of too much fluid in the joint cavity. The cartilage tissue of the knee begins to deteriorate.
• Stressful situation. Mood swings, the constant presence of the nervous system in a state of tension can lead to osteoarthritis of the knee joint.
• Congenital diseases of muscles, ligaments and dysplasia.
• Chondrocalcinosis (premature deposition of calcium salts in the cartilage of the knee). The pathology is systemic.
• Osteomyelitis. This is an inflammation of the bone marrow, in which purulent masses are formed. They negatively affect the surrounding tissues. Over time, the purulent masses go beyond the bone of the knee joint. Lack of treatment threatens the development of sepsis.
• Acromegaly. This is an endocrine disease in which the level of growth hormone (growth hormone) increases. Most often, a benign tumor in the anterior pituitary gland contributes to an increase in its number. If such a disease develops during adolescence, the child develops a specific physique. The excessive growth rate of cartilage tissue leads to deformation of the knee joint.
• Diabetes.
• Hypothyroidism This disease is also endocrine. It occurs due to a lack of thyroid hormones. The mass of a person begins to increase, it moves little, and the cartilage of the knee joint wears away.
• Freezing. In this case, ice crystals form in soft tissues, which kill living cells.
• Synovitis (inflammation located in the synovial bag of the joint).

All these reasons are capable of provoking knee gonarthrosis, while the person will not even notice when the disease began to develop.

What stages does osteoarthritis go through in its development?

The effectiveness of knee treatment depends on the degree of development of osteoarthritis diagnosed in the patient:

• First degree of knee osteoarthritis. The pain at this stage is not felt much. The patient can endure the discomfort for years, while in no rush to contact specialists or perform any type of treatment. A person needs help during an exacerbation. An acute onset of pain is not typical for osteoarthritis of the knee.
• Osteoarthritis of the knee joint of the second degree. The intensity of the discomfort increases. Pain occurs not only after physical exertion on the knee joint, but also at rest. To get rid of unpleasant sensations, you have to rest more. In the area of the knee joint, swelling appears, the patient hears a cracking sound. X-ray shows a narrowing of the joint space, a slight deformation of the knee joint.
• Osteoarthritis of the knee joint of the third degree. In this case, the mobility of the knee is very limited, and sometimes the leg cannot be fully straightened. Joint pain becomes severe and constant, appears as a response to changing weather conditions. The discomfort is painful in nature and it is difficult to get rid of even at rest. Often the patient's sleep is disturbed, and to alleviate her condition at least a little, he uses NSAIDs. A person develops a limp and the joint deformity is very noticeable.

Treatment of osteoarthritis should begin as soon as possible, before destruction of bone tissue is critical. In case of irreversible changes, only surgery will help the patient.

Symptoms of knee osteoarthritis

The development of osteoarthritis does not happen overnight. With its progression, the symptoms become more intense. For gonarthrosis, the following manifestations are characteristic:

• Crackles and clicks that are heard with some movement. The patient may notice this symptom quite late. However, he says that the articular surfaces are damaged, grooves and bone growths have appeared on them.
• Swelling and enlargement of the knee.
• Painful sensations. At the first stage of the development of arthrosis, they are invisible and may appear only after severe static load on the knee joint. Dynamic exercise, in turn, improves the condition of the joint, its nutrition, and the subsequent prognosis. Since the top layer of cartilage is erased in osteoarthritis, the nerve endings are exposed. After a while (after rest), the fibers are covered with a small layer of fibrin and become less sensitive; knee pain goes away. If the knee joint continues to collapse, the discomfort does not leave the person even at rest. Edema appears in the bursa, further compressing the nerves. The inflammatory process begins.
• Restricted mobility. This symptom allows you to differentiate osteoarthritis from other pathologies of the knee joint. The stiffness appears in the morning after sleeping and disappears after half an hour. If this condition lasts longer, this indicates the presence of an inflammatory process.
• Decreased range of motion. The patient cannot straighten the limb all the way. Since the patient is constantly in pain, he tries to reduce the range of motion and the ligaments adapt to this. That is, they are shortened and do not allow the knee joint to fully fulfill its function.
• Joint jam. It arises as a result of a strong change in the articular surfaces.
• Dislocations and subluxations. They appear in the last stage of the development of osteoarthritis, when the joint is severely deformed.

Over time, a person experiences muscle atrophy, proliferation of osteophytes, and weakening of the lateral ligaments. The consequences of osteoarthritis are serious, since a person is disabled.

How to correctly define osteoarthritis?

To begin the correct treatment of osteoarthritis, the patient must undergo a comprehensive examination. Diagnoses must be differential and include the following studies:

1. X-ray of the knee joint. With gonarthrosis, it is performed in two projections. The specialist needs an X-ray of both the damaged and the healthy knee. Radiography allows you to determine the following signs of arthrosis: narrowing of the joint space, osteophytes, subchondral sclerosis. In addition, the presented study of the knee joint reveals subluxation, places of ossification of cartilaginous tissue.
2. Arthroscopy. This is a minimally invasive procedure that is used not only to diagnose osteoarthritis, but also to treat it. It provides for the use of a special LED driver with a camera at the end. It is inserted through a small opening in the side of the knee. The complete picture of the internal state of the joint is reflected on the monitor. However, the procedure has a drawback: the joint is depressurized and pathogenic microorganisms can enter.

3. Ultrasound. This diagnostic method is absolutely safe. The procedure helps examine the soft tissues of the knee, as well as the cartilage, synovium, and blood vessels.
4. CONNECTICUT. This is an X-ray examination method, however, it allows you to see not only bone structures, but also soft tissues. Thanks to the computer equipment, the specialist can build a three-dimensional model of the knee. However, to obtain accurate information, the patient must receive a significant dose of radiation.
5. ScintigraphyThis is an x-ray exam that uses a contrast medium.
6. Magnetic resonance. In this case, magnetic rays are used to obtain information. The image shows the soft tissues more clearly.

7. ThermographyThe procedure is based on recording thermal radiation from the surface of the patient's body. So that you can identify tumors, foci of inflammation. A study is assigned for differential diagnosis purposes.
8. General blood test. It helps to determine the severity of inflammation, to determine its nature.
9. General urine test. Thanks to him, it is possible to determine the systemic nature of the pathology.
10. Chemistry of the blood.

Thanks to these diagnostic measures, specialists can accurately determine knee osteoarthritis and prescribe a truly effective treatment.

Treatment of knee osteoarthritis

The treatment of osteoarthritis must be versatile and long-term. Since it will not be possible to completely stop the destruction of the joint, therapy will have to be carried out constantly to improve the quality of life of the patient.

Medications in the treatment of osteoarthritis.

The doctor may prescribe the following medications:

• Non-hormonal anti-inflammatory drugs. They are used in the form of tablets and ointments. However, in case of severe pain syndrome, which cannot be eliminated by standard methods, an injection is used. It helps to quickly soothe pain, relieve swelling, and reduce the intensity of inflammation. These remedies can only eliminate the symptom, but they cannot cure osteoarthritis. Only a doctor should prescribe these funds. The course of treatment lasts no more than 14 days, and relief already comes in 2-3 days.
• Chondroprotectors for osteoarthritis of the knee joint. Each of these drugs contains useful substances that can regenerate cartilage. However, it will only be effective if your application is started on time. If the cartilage is completely removed, then the use of chondroprotectors will be useless. Treatment with such means will be long-term (at least 6 months). Pills and topical medications are used most often, although injections may be done.
• Vasodilators. They help relieve spasms and pain syndrome, restore normal blood circulation, and improve the nutrition of the knee joint.
• Glucocorticosteroids. Most often they are used in the most difficult cases, when other drugs do not give a positive effect. Intra-articular injections in the knee are used for osteoarthritis. Its use is allowed only once a year.
• Enzymes Provide the regeneration of the cartilage structure in the initial stages of the development of knee osteoarthritis. They are also prescribed for injection into the joint.
• Hyaluronic acid. Provides smooth movement of the knee joint as it can replace synovial fluid.
• Local preparations: ointments, creams, gels. They also only relieve symptoms.
• Medication compresses. In this case, a drug is used that can penetrate the skin, helps eliminate muscle clamps, and has a resorbing effect. The compress can be made from medical bile.

Pharmacotherapy in the treatment of osteoarthritis is essential. However, the drugs should be used strictly in the dosage prescribed by the doctor. It is impossible to independently increase or decrease the rate, change the daily rate without the knowledge of a specialist.

Features of physiotherapy treatment and exercise therapy.

You can also treat osteoarthritis of the knee joint through physical therapy procedures:

• Massage. Helps restore normal blood circulation in tissues, eliminates muscle spasms.
• Drug electrophoresis allows you to remove inflammation in the joint, and also produces an analgesic effect.
• Magnetic therapy. With the help of specific radiation, the tissues surrounding the affected right or left joint are stimulated. Metabolic processes in cells are improved.
• UHF. The waves promote the production of synovial fluid, which lubricates the knee.
• Corticosteroid phonophoresis.
• Electrotherapy helps to eliminate not only pain, but also swelling.

• Mud therapy.
• Hirudotherapy.
• Shock wave therapy.
• Heat treatment. This includes paraffin therapy. Thanks to this procedure, local blood circulation is improved.
• SMV therapy. This physical therapy stimulates blood circulation, relieves swelling and helps improve the nutrition of cartilage tissue.

Physical therapy is extremely helpful. It is necessary to restore the elasticity of muscle tissue and ligaments, improve the mobility of the knee joint. The following exercises will be helpful:

1. Lying on your stomach, you need to take turns lifting your legs. In this case, they should not bend at the knee. The lifting height is about 20cm.
2. Lying on your left side, you need to bend your left leg and lift it 30 degrees. It is necessary to hold the limb in this position for up to 30 seconds. The same exercise should be done with the right leg.
3. Sitting on a chair, the legs should be straightened and raised in turn as high as possible.

The set of exercises is selected individually by the attending physician. Gymnastics is best done after a small massage with medicinal ointments. Physiotherapy is an effective additional method of treating osteoarthritis, enhancing the effect of medications.

Is surgery necessary?

In the most difficult cases, when the joint is severely destroyed by arthrosis, an operation is prescribed to the patient. There are several types of interventions:

1. Articulation traction. It involves stretching the joint damaged by osteoarthritis to increase the space between the cartilage. This will prevent further tissue destruction and gradual recovery.
2. The endoprosthesis is a complete replacement of a joint destroyed by osteoarthritis. It is done as a last resort. The replacement can be total or partial. The prosthesis will need to be changed in 10-15 years.
3. Osteotomy. Such treatment for osteoarthritis makes it possible to mechanically correct the deviations of severely deformed bones. In this case, the solid elements break in a strictly defined place. The bones are then correctly positioned and fused.
4. Arthroscopy. With its help, the restoration of the cartilage surface destroyed by arthrosis is carried out. In addition, foreign bodies and bone fragments can be removed from the joint using an arthroscope. Such an operation is used for hypermobility of the joint. Arthroscopy is considered a low-traumatic procedure, so subsequent rehabilitation does not take long.

It is better not to take it to surgery. Treatment should be started in the first stage of the development of osteoarthritis. Orthotics will help consolidate the result: a cane, an orthosis to reduce the load, knee pads with infrared radiation.

The use of home remedies.

It is impossible to completely cure osteoarthritis, as the degenerative process will progress gradually. However, it can eliminate the symptoms and stop the destruction of the knee joint in osteoarthritis. Home remedies can be used during an exacerbation, as well as during relative calm. But first you need a specialized consultation. The following recipes will be useful for arthrosis:

1. Chopped horseradish root should be boiled in a small amount of water over low heat. After that, the porridge should be filtered and placed around the knee affected by osteoarthritis. The compress should be fixed with a bandage. You need to do the procedure every day for a month. The compress improves blood circulation and tissue repair.
2. Rubbing any vegetable oil into the osteoarthritis knee joint area will help eliminate pain. However, you need to warm it up a bit.
3. The mummy provides a good effect. It is necessary to mix 3-4 g of raw materials with 100 g of honey and mix everything thoroughly. You should rub the medicine on the painful area at night, before going to bed. Then wrap the affected area with a warm scarf. The reception of the mummy inside is also welcome. You can use it at the rate of 0. 2g per day.
4. Fresh dandelion flowers can be thoroughly washed and consumed 5-6 pieces per day. Also dry the raw materials in the amount of 1 tbsp. you need to pour a glass of boiling water, insist and drink 1/3 cup three times a day.
5. Rubbing aloe leaves. It is necessary to twist 10 leaves of the plant and squeeze through cheesecloth. The juice is mixed with half a glass of honey and 150 ml of red wine. The resulting product is poured into a dark glass container and applied every day for a month.

Cabbage and burdock leaves will help relieve inflammation in osteoarthritis. Home remedies cannot be considered a panacea, but they increase the effectiveness of other types of therapy.

Nutritional rules for osteoarthritis.

Treatment of osteoarthritis does not require a particularly strict diet, but you still need to adhere to some nutritional rules:

• Reduce your salt intake. Your total daily amount should not exceed 2 g. It is better to salt the dish just before use and not during cooking.
• The amount of spices used during the treatment of osteoarthritis should also be reduced. The same applies to fermented, pickled foods. Marinades and canned foods are generally better to exclude from the diet.
• Animal fats are not recommended.
• The menu should not contain sweets, pastries or bread made with wheat flour.

• With osteoarthritis, alcohol and nicotine are strictly prohibited.
• Dishes with gelatin content are useful: aspic, jellied meat, broths from beef bones.
• It is important for osteoarthritis to consume milk protein (the products should not be fatty), fish, shellfish.
• The diet should contain vegetable oils, vegetables and fruits, freshly squeezed juices.
• A person should consume a sufficient amount of fluids per day.

The proper diet for osteoarthritis must be developed by a specialist. You cannot go to extremes, even if the patient is overweight. Dramatic and improper weight loss will only aggravate your health. In this case, the treatment will be significantly delayed.

Prevention of osteoarthritis

To avoid the possibility of developing osteoarthritis, as well as not to lose the ability to walk, you should follow the following expert advice:

• We must not forget about movement. It is better to go to the pool, ride a bike, go hiking in the fresh air. You can also go to dances.
• It is advisable to avoid injury and hypothermia of the knee joint, as it causes post-traumatic osteoarthritis.
• It is better to wear protective knee pads or other orthopedic devices for prolonged exertion.
• It is advisable to wear comfortable shoes.

• It is important to eat well: osteoarthritis will not stand a chance if all the necessary nutrients are regularly supplied to the joint.
• If you are overweight, you need to get rid of it.
• It is better to avoid stress, as well as to correctly organize the routine of work and rest.
• It is necessary to strengthen the body's defenses.
• All inflammatory or infectious pathologies that can provoke the development of arthrosis must be eliminated in time.

Proper prevention can significantly delay joint destruction, which under normal conditions is a natural aging process in the body.

Osteoarthritis of the knee joint is an incurable disease, but its progression can be slowed down and even stopped, improving the quality of life.