Arthrosis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease, which is accompanied by gradual destruction of cartilage with gradual involvement of periarticular structures in this process.Lack of timely treatment leads to limited mobility and even disability of the patient.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over 65 years of age who consult a doctor with complaints of knee pain.Elderly people are at risk because with age the articular cartilage becomes thinner, microcracks appear and gradually collapses.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes smaller, as a result of which the surfaces of the bones begin to touch each other and crumble;
- bone growths (osteophytes) appear;
- the joint capsule becomes denser, which causes joint stiffness;
- A spasm of the muscles around the joint occurs.
Without treatment, the knee becomes deformed and movement is significantly limited.May affect one or both joints
According to statistics, one in five people in the world has gonarthrosis.Mostly the disease is diagnosed in people over 40 years old, but the age factor is not the only reason for the development of the pathology.
Why does gonarthrosis occur?
In elderly patients, arthrosis of the knee joint occurs due to the natural wear and tear of the cartilaginous tissue.Other causes of the disease:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtraumas;
- previous surgical interventions;
- autoimmune diseases;
- chronic joint diseases;
- regular increase in loads on the knee joint, for example, running or jumping, constant standing or kneeling;
- genetic predisposition.
At risk are women over 40 years of age, athletes, overweight patients and people working in construction.
How to recognize osteoarthritis of the knee joint?
The disease develops slowly, over several years, and has a chronic course.Its changes are irreversible, so it is important to start treatment as soon as possible when symptoms appear.
The first signs of gonarthrosis:
- knee stiffness;
- discomfort when straightening or bending the knee joint, going up or down stairs;
- grinding or clicking noises when moving;
- mild knee pain, which occurs only after standing for a long time and disappears with rest.
Over time, the discomfort intensifies.Intense stiffness, motor disturbances and intense pain appear, which do not even allow the patient to rest.It is difficult for a person to walk, sit or stand.Without treatment, the knee joint becomes deformed, leading to disability.
The severity of the changes, as well as the likelihood of recovery, depends on the stage of the disease.
Degrees of gonarthrosis
There are 4 degrees of severity of the disease:
- I graduated.At the beginning of the disease there are practically no symptoms.There is minor discomfort in the knee after exercise, which does not interfere with a normal lifestyle.Pathological changes can only be detected using X-rays.
- II degree.A grinding sound and periodic pain appear during physical activity, walking, climbing stairs, squatting or standing for a long time.Radiographic images may reveal narrowing of the joint space and early signs of osteophyte formation.
- III degree.The pain syndrome becomes permanent and does not even leave the person at rest.The knee hurts especially in the morning and at night;During the day the pain is strong and tolerable.As degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a squeaky sound is heard during movement.There is a “joint rat” - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity, causing severe pain.The knee becomes deformed and can become inflamed and swollen.Radiographs show signs of joint deformation, osteophytes, significant narrowing of the joint space and damage to the meniscus.
- IV degree.Without treatment, the disease becomes extremely serious.Cartilage, ligaments and menisci are completely destroyed, which makes movement of the joint impossible, the articular surfaces are deformed and a large number of osteophytes appear.These changes cause intense pain and disability.
Diagnosis
Diagnosing osteoarthritis of the knee joint is not difficult.An orthopedist-traumatologist carries out examinations and treatment.He examines the patient's knee, evaluates motor activity, studies clinical manifestations and palpates to identify areas of swelling and the presence of effusion.
To confirm the preliminary conclusion, he prescribes an instrumental examination:
- Radiographic examination - allows you to identify narrowing of the joint space, the presence of osteophytes;
- Computed tomography of the joint is a more informative diagnostic method than x-rays;shows the state of the joint cavity;
- Ultrasound of the joint - allows you to determine the volume of fluid in the joint cavity, the presence of osteophytes, assess the condition of the surrounding soft tissues, the thickness of the hyaluronic cartilage;
- magnetic resonance imaging - suitable for studying not only bone and cartilaginous tissue, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method;During the procedure, synovial fluid may be punctured.
Additionally, a clinical and biochemical blood test, an immunological study and a test for rheumatoid factor may be required.
Osteoarthritis treatment
The orthopedist must treat gonarthrosis, taking into account the clinical picture and the degree of joint damage.You cannot self-medicate.
The doctor may prescribe medications from the following groups:
- nonsteroidal anti-inflammatory medications;
- chondroprotectors, which restore cartilage and prevent further destruction;
- analgesic blockades that effectively eliminate pain;
- glucocorticosteroids, indicated for serious illnesses;
- antispasmodics to eliminate muscle spasms.
Drug therapy is complemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetotherapy, electro- and phonophoresis.Additionally, physiotherapy and massage are prescribed.
You definitely need to control your weight and try to get rid of extra pounds, which cause additional stress on your knee joints.It is important to follow a diet;the diet should contain foods that nourish cartilaginous tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.It can be arthroscopy, osteotomy or endoprosthesis.
The most favorable prognosis is if arthrosis is detected at stage 1, changes can be slowed down and even stopped.Knee stiffness or pain is not normal;It is worth having an exam to understand the cause of the discomfort.