Osteoarthritis of the knee joint, also called gonarthrosis, can significantly impair a person's quality of life. During the development of the disease, there is a gradual loss of hyaline cartilage in the joint. Gradually, the cartilage loses its density and height. Its razvlecheniya and thinning are noted, and over time it disappears completely. As a result, there is no soft protective pad in the bone and this leads to an increased load on the end plate of the innervated articular surface of the bone. As a result of this load, pain develops. The code for osteoarthritis of the knee joint according to ICD-10 is M17.
The knee joint is affected quite often, since it is the knee that has a significant load during walking, physical exertion and running. In this case, uncomfortable movements can cause soft tissue injury in the knee and cause osteoarthritis. This is why gonarthrosis is one of the main causes of disability. According to statistics, this disease affects about 20% of people on the planet to varying degrees.
The reason why osteoarthritis develops, how to prevent the development of this disease, which doctor treats osteoarthritis of the knee joint, and what kind of treatment methods the doctor can recommend after diagnosis, will be discussed inthis article.
Pathogenesis
The disease develops against the background of a mismatch between the load on the joint and its ability to withstand. In this case, the properties of cartilage can be determined by genetics or by the change due to the influence of acquired factors, both exogenous and endogenous. The development and progression of gonarthrosis can occur with age, against the background of obesity, due to dysplasia of the patellofemoral joint or changes in the axis of the lower extremities, disorders of the biomechanics of the joint, damage to the menisciand ligaments.
The basis of the pathogenesis is the predominance of catabolic processes over anabolic ones, which is noted in the cartilage and subchondral bones, in the menisci and in the synovium. As a result, structural changes occur and the biological properties of the cartilage are lost. Also, the pathological process spreads to muscles and ligaments.
The basis of articular cartilage is the connective tissue matrix and chondrocytes. The connective tissue matrix contains type II collagen and aggrecan molecules. The cushioning properties of cartilage are provided by the connective tissue matrix.
The inflammatory process in osteoarthritis is not as intense as in arthritis. However, pro-inflammatory mediators are also present in osteoarthritis.
Classification
Based on the origin of gonarthrosis, the following types are distinguished:
- Primary (idiopathic)- develops without the influence of external causes.
- Secondary: some factors lead to the development of the disease. Most often they are associated with injuries, fractures, joint surgery and inflammatory factors: acute and chronic arthritis.
The following degrees of osteoarthritis of the knee are also determined:
- 1st degree arthrosis- is determined in the period from the appearance of the first signs of the disease to the development of bone deformities, visible on X-rays or during examination. During this period, pain of varying intensity appears during movement.
- At grade 2- unpleasant sensations are observed even at the slightest load. When walking and squatting, the knee creaks, the mobility of the joint decreases. The image shows the growth of bone tissue along the edges of the joint, as well as the narrowing of the joint space. On external examination, it can be seen that the knee has increased in size.
- At grade 3there is virtually no cartilage tissue within the joint. If the development of the disease progresses, the bones can grow together, causing complete immobility of the leg. Sleep is disturbed, it becomes impossible to move without a cane or crutch.
The following types of this disease are also distinguished:
- Patellofemoral osteoarthritis of the knee joint- a condition in which degenerative changes are noted in the back of the patella, i. e. the patella. With this form of the disease, the pain is mainly disturbed when descending a ladder or mountain. Patellofemoral osteoarthritis can develop in runners. The disease is often diagnosed in young people.
- Post-traumatic osteoarthritis of the knee joint- a consequence of the injury. The type of post-traumatic disease may not appear initially. But later, a person loses full motor activity in the joint.
Causes of osteoarthritis of the knee joint
Work is currently underway to study the reasons that lead to the development of this pathology.
At the moment, the causes of gonarthrosis are associated with the influence of the following factors:
- Age: At a certain age, degenerative changes in tissues begin in a person, and the ability of cartilage tissue to regenerate itself decreases.
- Arthritis - Over time, arthritis can lead to the development of osteoarthritis.
- Injuries and past overloads: In addition to the injuries sustained, the development of the disease can cause the need to kneel often, squat, lift weights.
- Obesity and overweight: Due to excessive body weight, there is an increase in the load on the joints of the legs. In addition, substances that cause damage to the joint enter the bloodstream from the pathological adipose tissue and subsequently into the joint.
- Inheritance: 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 fabric can have low resistance to damage. If close relatives have had osteoarthritis, this increases its likelihood.
- Diseases leading to metabolic disorders: the risk of this pathology increases with atherosclerosis, diabetes mellitus.
- Hormonal disorders: more often women get sick after 55 years.
- Sports: People who play certain sports are more likely to develop this disease. This is typical for runners, as well as for football, tennis, basketball players.
Symptoms of knee osteoarthritis
As a rule, the symptoms of osteoarthritis of the knee joint slowly increase, as the process of its development lasts for years. If multiple joints are affected, symptoms of polyarthrosis develop.
The manifestation of the disease depends on its severity, age and a number of other factors.
However, the main symptoms of gonarthrosis are the following:
- Pain in the knee joint, aggravated by activity. During rest, the knee hurts less.
- Swelling in the knee area.
- A feeling of warmth in the joint.
- Unpleasant sensations of stiffness in the joint, which appear after a person has been in a static position for a long time.
- Reduced range of motion of the knee joint, which makes it difficult for a person to get up from a chair, go down stairs, or get out of a car.
- Crunch and crepitus in the knee, most often seen with sudden joint movements.
- Changes in weather are believed to affect the degree of pain and discomfort.
Analysis and diagnostics
To determine whether such a disease can be cured, the diagnosis must be confirmed initially. In the process of diagnosis, the doctor examines and interviews the patient. But the most informative study in this case is a knee x-ray.
In addition, to clarify the diagnosis, it is recommended to undergo an ultrasound, during which arthritis can be ruled out, and measure the height of the articular cartilage.
If necessary, appoint additional exams.
Treatment of osteoarthritis of the knee
In order for the treatment of this disease to be as effective as possible, it is initially necessary to confirm the diagnosis and select the correct scheme of complex therapy. Treatment of arthrosis of the knee joint at home is possible if the patient carefully adheres to all the recommendations of a specialist, practicing both drugs and additional treatment methods. Only in this case can home therapy be effective.
Drug treatment and other methods of therapy for this disease are used depending on the degree of damage. The simplest is the treatment of osteoarthritis of the 1st degree knee joint. In case of first degree disease, a complex therapeutic scheme is used, which allows you to achieve an effect in the shortest possible time. Therefore, if a person is diagnosed with 1st degree osteoarthritis, the disease must be treated immediately.
Regarding the treatment of osteoarthritis of the 2nd degree knee joint, the doctor makes a decision based on the patient's condition. Since changes in cartilage tissue begin at this stage, treatment should be done immediately.
The possibility of treating Grade 3 osteoarthritis of the knee depends on many factors. At grade 3, the cartilage becomes thinner, so treatment at this stage is lengthy and less effective.
Drugs
Medical treatment of osteoarthritis of the knee is aimed at providing an analgesic and anti-inflammatory effect. It is also important to reduce the severity of the cartilage destruction.
The following medicines are used for this purpose:
- Non-steroidal anti-inflammatory drugs - both tablets and local remedies are used - ointments, gels. More effective local and systemic application of these funds.
- Chondroprotectors for osteoarthritis of the knee joint - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfates and others are used. Such drugs for osteoarthritis of the knee joint are prescribed as part of a comprehensive treatment. The price of chondroprotectors depends on the drug and varies significantly.
- For severe diseases, medical treatment includes steroids. Both injections for osteoarthritis of the knee joint can be administered intramuscularly and external agents with steroids can be used.
- External agents with skin irritants. In the description of folk remedies, you can also find annoying compresses.
- During treatment, your doctor may prescribe injections in the knee. Several medications can be used for injections into the knee joint for osteoarthritis. Specifically, corticosteroids are injected to relieve severe inflammation. Reviews of injections indicate that it is in this form that steroids work most quickly and effectively. Knee block can be performed not only with glucocorticosteroids, but also with anesthetics. Reviews of the blockade indicate that this method also effectively relieves severe pain. In addition, an injection into the knee may be performed during treatment with chondroprotectors. Improves metabolic processes, activates the production of collagen. But to get the effect, it is necessary to make at least five injections. In addition, hyaluronic acid is injected intra-articularly, which improves the quality of intra-articular fluid and provides effective protection of the cartilage tissue. Vitamins can also be administered intra-articularly.
- Plasmolifting method: its essence consists in the introduction of blood plasma rich in platelets into the affected knee.
- Medical bile for osteoarthritis of the knee joint - used for tablets. It should be noted that medical bile can be an effective remedy only if its use is prescribed by a doctor according to a certain scheme. Therefore, the option "we treat at home" without consulting a doctor is unacceptable in this case.
Procedures and operations
For osteoarthritis and polyarthrosis, non-drug methods of treatment are also used, the use of which is no less effective.
Physiotherapy. Various techniques are used, including the shock wave therapy method, myostimulation, phonophoresis, ozone therapy, kinesitherapy and others. Physiotherapy can reduce pain, relieve inflammation. Any physiotherapy prescribed by a doctor should be done exactly in the complex recommended by the doctor.
Laser therapy- produces decongestant, analgesic and anti-inflammatory effects.
Ozone therapy- relieves pain, produces an anti-inflammatory effect, which allows to reduce the amount of hormonal agents used.
Knee pads for osteoarthritis of the knee joint: Wearing such devices reduces the severity of pain. In addition, the knee brace protects it from instability. But to achieve the desired effect, you need to choose the right knee pads or a knee pad. There are many general tips on choosing knee pads for osteoarthritis of the knee. In addition, many different models of such knee pads are offered, with movement restrictions, amplifiers and the like. However, for those wishing to buy knee braces for osteoarthritis, it is advisable to rely not on user reviews, but on the doctor's recommendations. The price of an orthopedic knee brace depends on several characteristics: material, quality. Knee pads are particularly important if the patient develops post-traumatic osteoarthritis. But patellofemoral osteoarthritis, as well as other types of the disease, can be treated with this method.
Therapeutic gymnastics for osteoarthritis of the kneeis an effective method that improves the condition and prevents surgery, provided that the person regularly and consistently performs physical therapy for thearthrosis of the knee joint. Physiotherapy exercises help strengthen the muscles of the legs and stop the development of the pathological process. However, a set of exercises for osteoarthritis of the knee joint must be performed in a certain sequence, and such gymnastics is selected individually. Therefore, it is better that the basis for classes is not a gymnastics video, but a set of exercises developed by a doctor. In this case, it is not just recharging that is important, but full-fledged physical therapy.
With a similar pathology, different types of physical therapy can be practiced.
Special gymnastics.Such exercises are recommended both during treatment and for people over the age of 40 for prevention. Knee exercises should be done every day. These exercises are also suitable for older adults, as they can be performed calmly.
Massage and manual therapy- suitable for patients with reduced mobility, can be combined with physical therapy. In the absence of an opportunity to visit a masseur, self-massage can be performed according to the scheme that the specialist will demonstrate.
As additional methods of improving the patient's condition and active rehabilitation, yoga, acupuncture, joint stretching, special exercises on simulators (exercise bikes and others) can be practiced.
If conservative methods prove ineffective, surgical treatment is practiced.
You can use the following techniques:
- Puncture: Eliminating excess fluid in the joint can reduce symptoms of inflammation and restore mobility.
- Arthroscopy- can be performed using endoscopy. Using this technique, the joint surfaces are cleaned of fragments of destroyed cartilage tissue.
- Periarticular osteotomy- during such an operation, one of the bones that forms the knee joint is sawed off and fixed again at a different angle. As a result, the severity of the pain decreases and the mobility of the knee increases. The intervention is effective in the first and second degree of the disease.
- Endoprosthesis- replacement of the knee joint with a special biocompatible construction. This is a very complex intervention, which is performed with the third degree of the disease.
Treatment of arthrosis of the knee joint with folk remedies
Numerous reviews of the treatment of folk remedies for this disease confirm that such methods can be used as an auxiliary, relieving the patient's condition. However, such methods should not replace the main treatment. Folk remedies are used for rubbing, compresses, baths, ingestion. Any thematic forum contains a lot of advice on this topic.
- Rub with garlic. Several cloves of garlic should be peeled and chopped. Mix the resulting gruel with 200 ml of vegetable oil and insist in a dark place for a week. Apply to the knee overnight with a film and a warm washcloth on top.
- Ground mustard. To prepare the remedy, take 50 g of camphor and mustard powder, 500 ml of vodka, the protein of one egg. All of them are mixed and stored in a jar in a dark place for a week. Subsequently, the product must be rubbed on the knee three times a day.
- Elecampane Grind. Pour 50 g of elecampane root with 125 ml of vodka and leave for two weeks. Scrub twice a day.
- Burdock compresses. Burdock is a popular folk remedy for the treatment of arthrosis. Several sheets of burdock should be folded down with the fluffy side and greased with vegetable oil. Attach them to your knee and cover them with cellophane and a warm cloth on top. Also, burdock leaves can be greased with vodka. The compress is applied at night. Similarly, treatment with horseradish leaves is carried out.
- Cabbage leaf. It is also applied to the sore spot at night. It is pre-lubricated with honey, cologne or vodka.
- Honey pack. It is necessary to mix equal parts of honey, ammonia (10%), glycerin and medical bile, add a few drops of iodine. Leave the premixed product in the dark for 10 days. Warm up before applying the compress.
- Onion decoction. It is taken internally. To prepare the broth, you need to take two large onions, cut them and pour 1 liter of water. Cook until the onions are tender. Take a 100 ml decoction three times a day.
- Celery juice. Grind the celery stalks in a blender, squeeze the juice. Drink 100ml of juice 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 jelly in the menu.
- Bath with pine needles. Pour boiling water on 1 kg of pine needles and leave for several hours. Add to a warm bath, in which you can also dissolve 0. 5 kg of salt. Take a bath for 20-30 minutes.
Prevention
In order to prevent the development of osteoarthritis of the knee joint, the following preventive measures should be observed:
- Eat well and include a variety of foods containing vitamins and minerals in your diet.
- Avoid excessive loads on the knee joint, protect it from injury.
- Give up bad habits.
- Track weight, prevent obesity.
- Promptly cure all diseases, undergo preventive examinations.
- Play sports, preferring light physical activity.
- Wear high quality footwear that is as comfortable as possible.
- Ensure correct posture.
Diet for osteoarthritis of the knee joints
- Efficacy: curative effect
- Terms: permanently
In the course of treatment and rehabilitation, diet is very important. First of all, food should be healthy and light - it is important to prevent excess weight gain, which can aggravate the condition and lead to acute osteoarthritis. But the acute course of the disease requires not only treatment, but also weight loss.
It is also important to include foods that contain components that are important for cartilage tissue in the diet:
- Poultry, rabbit.
- Sea fish.
- Soy-based products.
- Eggs.
- Vegetables, courgettes, carrots, squash.
- Nuts.
- Fruits, berries.
- Vegetable oils.
- Dishes with jelly.
At the same time, it is necessary to limit the consumption of such products:
- Beans, sorrel, spinach, tomatoes.
- Flour dishes.
- Animal fat.
- Spices, vinegar.
- Alcohol.
- Red meat
You have to eat often, in small portions. You should also drink about 2 liters of fluids per day.
Consequences and complications
If treatment is not carried out in a timely manner, osteoarthritis can lead to the development of such complications:
- Inflammatory process of the periarticular tissues.
- Limitation of joint mobility.
- Changing the shape of the joints.
- Degeneration of the hip joint.
Such complications can lead to the development of disabilities and irreversible changes.
Forecast
It is important to treat the disease in a timely manner. The most favorable prognosis will be if you start treatment in 1 or 2 stages of the disease.