Arthrosis of the knee joint is a degenerative-dystrophic pathology that leads to deformation and destruction of articular cartilage. Gradually, the limb loses mobility. According to statistics, almost one in three inhabitants of the planet suffers from osteoarthritis, and that number is not decreasing. At risk are the elderly, especially those who are overweight. After 65 years, osteoarthritis is diagnosed in 70-85% of knee pain treatment cases.
A rheumatologist helps preserve the quality of life of a patient with joint pathology.
Causes of osteoarthritis
- Destruction of the joint due to natural wear and tear (aging of the body).
- Hormonal disorders (menopause, endocrine disorders).
- Congenital defects of the musculoskeletal system.
- Injuries, surgical operations on the knee joint.
- Professional sports.
- Monotonous physical work with increased stress on the knee joints.
- Overweight.
- genetic predisposition.
- Autoimmune diseases.
disease symptoms
Arthrosis deforming the knee joint (gonarthrosis) develops slowly and continues chronically. In the early stages, the disease does not cause pain: the person feels only discomfort, stiffness in the lower limb. Gradually, motor restrictions increase. Without proper treatment, the knee becomes visibly deformed. Motor functions are so disturbed that it is difficult for a person to walk, sit, or stand. Arthrosis deformans progresses to patient disability. To save the joint, it is necessary to consult a doctor when the first symptoms of the pathology appear.
According to the severity, there are three grades of osteoarthritis of the knee joint:
- 1 degree. The clinical manifestations of the disease are mild. Most patients pay no attention to symptoms and continue to lead normal lives. With 1st degree osteoarthritis, a person may experience knee discomfort after long standing, intense walking, physical exertion. The x-ray image shows a narrowing of the joint space, osteophytes growing inside the joint are visible. If osteoarthritis is accidentally detected at the first stage, for example, during a medical examination, its development can be significantly slowed down and even stopped.
- 2 degrees. The pain in knee osteoarthritis becomes intense, it is difficult to ignore. Especially strongly the leg disturbs early in the morning or in the evening. During the day at rest, the aching pain persists. Degenerative processes in the joint are reflected in gait: a person begins to limp. During the movement, a popping sound is heard in the knee. 2nd degree osteoarthritis can be complicated by the "joint mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity. The foreign body causes severe pain that interferes with limb movement. On examination, the knee is deformed. Perhaps the adhesion of inflammation, swelling. The radiograph shows a narrowed joint space and osteophytes, thickening of the bone.
- 3 degrees. A severe form of the disease that develops in the absence of treatment. 3rd degree osteoarthritis is the cause of permanent disability. Knee pain is very severe, mobility is limited, the person cannot walk independently, each step is painful. The leg is deformed and starts to crack strongly. On radiography, the doctor determines the degeneration of cartilaginous tissue, destruction of ligaments, menisci, and growth of connective tissue.
Osteoarthritis diagnosis
To examine the patient, physical, laboratory and instrumental diagnostic methods are used:
- Blood analysis is general, biochemical, immunological.
- Analysis of synovial fluid.
- X-ray.
- Knee ultrasound.
- CT or MRI, if indicated.
The examination plan is always individual and depends on the patient's condition.
Treatment of osteoarthritis of the knee joint
Therapy includes a set of procedures, medications, recommendations for lifestyle changes. It is important not to try to treat arthritis on your own. Often, patients in the early stages of the disease use anesthetic ointments and go to the doctor when the joint is already destroyed. The sooner treatment is started, the more effective it will be.
Medical treatment
The doctor prescribes drugs to relieve inflammation, swelling, reduce pain, activate metabolic processes and tissue regeneration. Medications are selected individually.
The following funds are available:
- Non-steroidal anti-inflammatory drugs(NSAIDs) in the form of pills, ointments, injections. It means well to relieve pain, swelling, improve the patient's well-being.
- glucocorticosteroidsin the form of injections directly into the knee joint. Injections are indicated in severe cases of the disease, when the limb is practically immobilized.
- pain blocks. Help to deal with symptoms and ease the course of the disease.
- chondroprotectors. Medications contribute to the restoration of cartilage tissue and delay joint destruction.
Conservative treatment
shock wave therapy
The method is non-invasive, helps to remove salt deposits, improves connective tissue trophism. Physiotherapy improves blood circulation, favorably affects the elasticity of ligaments. Shockwave therapy is performed in courses of 4-10 procedures.
Plasmolifting (PRP therapy)
The patient's own platelet-rich plasma is injected into the joint. The plasmolifting course accelerates tissue regeneration.
phonophoresis
The method combines the effects of ultrasound and therapeutic ointments. Means for physiotherapy, as a rule, have a complex composition and are prepared in a pharmacy by prescription. Ultrasound increases the penetrating power of the active substance.
Massage
The procedure is contraindicated in the phase of exacerbation of arthrosis. When the inflammation is removed, the pain syndrome is reduced, you can start a massage course. The lymphatic drainage technique helps to prevent the accumulation of synovial fluid. Massage also improves blood circulation in the knee, relieves muscle spasm. The procedure is most effective after performing special exercises for osteoarthritis of the knee joint.
Bathing
You can take a course at home as prescribed by a doctor or as part of a spa treatment. With arthrosis, radon, turpentine and hydrogen sulfide baths are indicated. The procedures have a beneficial effect not only on the knee, but also on the hip and ankle joints.
hirudotherapy
Medicinal leeches are placed around the deformed joint. The saliva of these creatures contains active substances that contribute to the restoration of cartilage. Hirudotherapy is usually prescribed for 1st and 2nd degree osteoarthritis to relieve swelling and reduce pain.
Physiotherapy
Gymnastics for osteoarthritis of the knee joint is a mandatory part of complex treatment. Special exercises help to maintain muscle tone in the diseased limb, prevent congestion. Gymnastics starts doing in the morning without getting out of bed. Then, during the day, another 3-4 sets of exercises are performed for several minutes. It is useful to complement therapeutic exercises for osteoarthritis of the knee joint with swimming.
Surgery
Surgical intervention is indicated for 2nd and 3rd degree osteoarthritis:
- Puncture. With the help of a syringe, the accumulated fluid is pumped out of the joint cavity. Reduces internal pressure, reduces swelling, inflammation, improves mobility. The procedure is performed on an outpatient basis, by appointment by the surgeon.
- arthroscopy. The method is used for the rehabilitation of the knee joint. Arthroscopy is performed through small punctures, so the operation is quite easily tolerated, the rehabilitation period is short.
- corrective osteotomy. The classic technique for the treatment of deforming arthrosis, which consists of correcting the deformed anatomical axis of the lower limb, followed by fixation of the wedge resection site of the bone with a titanium plate. After an osteotomy, the patient needs rehabilitation for several months.
- endoprostheses. The installation of an artificial joint is performed with an extreme degree of deforming arthrosis of the knee joint and allows the knee to return to its previous range of motion without pain. After total arthroplasty, the patient needs a long rehabilitation period (about 2-3 months).
arthroscopy
Minimally invasive method of treatment. A video camera and microsurgical instruments are introduced into the joint cavity. The doctor performs a thorough examination of the joint, extracts osteophyte particles, destroyed cartilage, scar tissue. Arthroscopy helps temporarily relieve pain and restore joint mobility.