Knee osteoarthritis

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

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

Why does osteoarthritis of the knee joint occur?

Very often, people themselves become the culprits for the development of such an intractable disease. Often when pain in the knee joint appears, people ignore the painful sensations and prefer to go to the doctor to use any medicine that simply masks the pain.

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

Symptoms and diagnosis of osteoarthritis of the knee joints.

The disease can be distinguished by the following characteristics:

• Pain syndromePainful sensations usually occur suddenly, but more often with physical exertion, even a slight one. Pain can be of a different nature. These will be weak low back pain at first (unfortunately, few people will pay attention to them). Mild pain that occurs only periodically can last for months, or even years, until the disease progresses to a more serious stage.
• Marked deformity of the knee. A similar symptom is typical of the later stages. And at the beginning of the development of arthrosis, the knee swells and swells a little.
• The appearance of dense formations on the back wall of the knee joints. The accumulation of a large amount of joint fluid in the cavity of the Baker's cyst or in the joint itself.
• A sharp cracking of the joints, which is accompanied by pain.
• Decreased joint mobility. This is especially pronounced in the later stages of osteoarthritis. In this case, flexion and extension of the knee causes severe pain, and in the later stages, movement becomes nearly impossible.

REFERENCE! In a patient with osteoarthritis, the gait changes: it is characterized by drooping of the 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. Articular cartilage is capable of constantly deteriorating and at the same time rapidly renewing itself. Under normal conditions, these two processes must balance. With the passage of age, cartilage destruction occurs at the same rate, but its recovery slows down. The mass of a person plays an important role here. In fact, if the mass of a person is 70 kg, then in 10 steps on one leg he will transfer 700 kg, and the one weighing 120 kg will transfer up to 1200 kg, which will become a significant load on the joints and cartilage, which it will wear out faster because of this.
2. It is important to remember: the joint feeds on useful elements only when it moves. A sedentary lifestyle entails a slowdown in metabolic processes, so that the necessary nutrients do not reach their destination.
3. The probability of developing gonarthrosis increases in people whose parents suffered from this disease.

Secondary osteoarthritis of the knee joint.

It develops for the following reasons:

• Multiple wounds. In a person of any age, they will cause excessive stress on the cartilage. When any cartilage-covered bone breaks, irregularities appear, called "steps. "In this area, now, with any movement, the joint will wear out and cause osteoarthritis.
• 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 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 only be prescribed by a doctor after a full study of the picture of the disease. Self-administered therapy can only aggravate the health situation.

The main classification divides gonarthrosis into four stages of development:

1. Initial stage. At this stage, the disease is just emerging. External symptoms are hardly noticeable or completely absent, the shape of the joint is in a satisfactory state. Symptoms include only mild discomfort or heaviness in the knee after long walks, as well as heavy physical exertion. An x-ray examination will be of little information: an x-ray may show only a slight narrowing of the joint space. Unfortunately, at this stage, a person does not seek medical help due to the insignificance of symptoms.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. Pain intensity decreases at rest. Joint movement becomes difficult. A crunching or cracking of the knees is heard when walking. On the radiograph, the narrowing of the joint space is noted, as well as the osteophytes. The patient begins to limp.
3. When osteoarthritis has passed to the third stage, the pain syndrome will be felt constantly, even in the absence of movement. The deformation and degeneration processes go to an irreversible stage. The distortion of the joint becomes pronounced, the distance between the articular surfaces is markedly reduced, numerous osteophytes increase in size. Painful sensations now disturb the patient even in a state of complete rest. A person becomes dependent on external support (walkers, canes) and requires the help of other people. Conservative treatment at this stage is less effective.
4. The fourth stage is characterized by constant debilitating pain. Osteophytic growths increase in number and size, the cartilage is completely destroyed, the joint space is barely traced or completely absent, the bones are severely deformed. Even weak movements become torture for the patient. At this stage of knee osteoarthritis, the patient is recognized as disabled. In the absence of surgery, the disease can lead to disability.

Complications of osteoarthritis of the knee joints.

Advanced osteoarthritis can lead to dislocations and subluxations of the knee joint. With dislocation, the epiphysis of the femur extends completely outside the joint, whereby movement in the joint becomes impossible and the axis of the leg is shifted substantially to one side. Fortunately, such a negative variant of the development of the disease 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 axis of the tibia. In this case, subluxations are accompanied by severe pain and joint dysfunction.

Neglect of the disease can lead to a complete loss of lower limb functionality.

ATTENTION! The habit of saving a sore leg sometimes causes deformation of the intervertebral discs and the appearance of hernias.

Consequences of neglected knee osteoarthritis

The advanced stage of knee osteoarthritis is almost always characterized by the following unfavorable symptoms:

• pain twenty-four hours a day, from which no painkiller can save;
• loss of support for a limb (it is impossible to stand on a sore leg or at least lean on);
• immobilization of joint blockage;
• pronounced curvature of the bones around the knee;
• severe swelling around the affected area.

Methods for the treatment of osteoarthritis of the knee joint.

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

Hormones

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

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The course of hormone treatment is usually short; injections are made only during a period of severe exacerbation. The hormones are administered with an average frequency of once every 10 days.

Chondroprotectors

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

Medications are intended to restore cartilage, improve metabolic processes, nourish cartilage tissue and protect 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.

Vasodilator drugs

These funds are necessary to eliminate spasm of small vessels, increase blood circulation and supply of nutrients to the affected joint area. Prescribed to take vasodilators together with chondroprotectors.

If joint fluid does not accumulate during knee osteoarthritis (there is no synovitis), it is recommended to use warm ointments.

Hyaluronic acid

Otherwise, this tool is called intra-articular fluid prosthesis, since the composition of the acid is similar in composition to that of intra-articular fluid. When acid is injected into the joint, it forms a film that prevents strong cartilage friction during movement, affects the extracellular matrix, improves metabolic processes in the joint, and also triggers the production of its own hyaluronic acid in the joint, i. e. . returns the function of the joint to normal, stopping the pathological processes that destroy the cartilage. . . .

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

Physiotherapy

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

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

• slow down the development of stiffness;
• prevention of further destruction of cartilage tissue;
• elimination of muscle spasms that cause pain.

Physiotherapy

As additional therapy, various procedures can be prescribed: 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 control his diet and avoid intense physical effort.

Forecast. Prophylaxis

With an advanced stage of the disease, the projections are disappointing. Therefore, it is recommended that if mild symptoms of osteoarthritis occur, you consult a doctor.

People at risk (the elderly, athletes and overweight people) must follow the doctor's recommendations and comply with the following rules:

1. Eat well and control your weight. Follow a diet to lose weight as needed.
2. Reduce the load on the joints while playing sports, constantly monitor.
3. Timely treat infectious diseases, preventing their transition to the chronic stage.
4. Get plenty of rest, avoid stressful situations if possible.
5. Increase the protective functions of the body (periodically take vitamins, temperament).
6. Avoid hypothermia of the body, especially the lower extremities.