Arthrosis of the knee joint is a degenerative-dystrophic pathology that leads to the deformation and destruction of the articular cartilage. Gradually, the limb loses mobility. According to statistics, almost one in three inhabitants of the planet suffers from osteoarthritis and this number is not decreasing. At risk are the elderly, especially those who are overweight. After age 65, osteoarthritis is diagnosed in 70-85% of knee pain treatment cases.
A rheumatologist helps preserve the quality of life of a patient with joint disease.
Causes of osteoarthritis
- Destruction of the joint due to natural wear and tear (aging of the body).
- Hormonal disorders (menopause, endocrine diseases).
- Congenital defects of the musculoskeletal system.
- Injuries, knee joint surgery.
- Professional sports.
- Monotonous physical work with increased stress on the knee joints.
- Overweight.
- genetic predisposition.
- Autoimmune Diseases.
Symptoms of the disease
Deforming osteoarthritis of the knee joint (gonarthrosis) develops slowly and proceeds in a chronic form. In the early stages, the disease does not cause pain: a person feels only discomfort, stiffness in the lower limb. Gradually, the motor restrictions increase. Without proper treatment, the knee is significantly deformed. Motor functions are so disturbed that it is difficult for a person to walk, sit down, get up. Deforming osteoarthritis progresses towards patient disability. To save the joint, it is necessary to consult a doctor when the first symptoms of pathology appear.
Based on the severity, there are three degrees of osteoarthritis of the knee joint:
- 1 degree. Clinical manifestations of the disease are mild. Most patients do not pay attention to the symptoms and continue to lead normal lives. With 1st degree osteoarthritis, a person can experience knee discomfort after a long standing, brisk walking, physical exertion. The X-ray image shows a narrowing of the joint space, osteophytes are visible growing inside the joint. If osteoarthritis is accidentally detected in the first stage, for example during a medical examination, its development can be significantly slowed down and even stopped.
- 2 degrees. The pain in osteoarthritis of the knee becomes intense, it is difficult to ignore. Especially strong the leg disturbs in the early morning or evening. During the day at rest, the aching pain persists. Degenerative processes in the joint are reflected in the gait - a person begins to limp. During the movement, a crunch is heard in the knee. 2nd degree osteoarthritis can be complicated by the "joint mouse": this is a condition in which a particle of bone or a destroyed cartilage enters the synovial cavity. The foreign body causes severe pain that interferes with the movement of the limb. On examination, the knee is deformed. Perhaps the accession of inflammation, swelling. The x-ray shows a narrow 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 arthrosis causes permanent disability. The pain in the knee is very severe, the mobility is limited, the person cannot walk independently, each step is painful. The leg is deformed and starts to crack strongly. On the x-ray, the doctor determines the degeneration of cartilage tissue, the destruction of ligaments, menisci, and the growth of connective tissue.
Diagnosis of arthrosis
Physical, laboratory and instrumental diagnostic methods are used to examine the patient:
- The blood test is general, biochemical, immunological.
- Synovial fluid analysis.
- X-ray.
- Knee ultrasound.
- CT or MRI if indicated.
The visit plan is always individual and depends on the patient's condition.
Treatment of osteoarthritis of the knee joint
Therapy includes a number of procedures, medications, recommendations for lifestyle changes. It is important not to try to cure 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 earlier the treatment is started, the more effective it is.
Medical treatment
The doctor prescribes drugs to relieve inflammation, swelling, reduce pain, activate metabolic processes and tissue regeneration. Medicines are selected individually.
The following funds are available:
- Non-steroidal anti-inflammatories(NSAID) in the form of tablets, ointments, injections. Means can 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. Helps to cope with symptoms and alleviate the course of the disease.
- Chondroprotectors. Medicines contribute to the restoration of cartilage tissue and slow down the destruction of the joint.
Conservative treatment
shock wave therapy
The method is non-invasive, it helps to remove salt deposits, improves the trophism of the connective tissue. Physiotherapy improves blood circulation, favorably affects the elasticity of the ligaments. Shockwave therapy is performed in cycles of 4-10 procedures.
Plasmolifting (PRP therapy)
The patient's platelet-rich plasma is injected into the joint. The course of plasmolifting 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. Ultrasounds increase the penetrating power of the active ingredient.
Massage
The procedure is contraindicated in the stage 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 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.
Take a bath
You can conduct a course at home as prescribed by a doctor or as part of a spa treatment. With arthrosis, baths of radon, turpentine, hydrogen sulfide 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 an obligatory part of a complex treatment. Special exercises help maintain muscle tone in the diseased limb, prevent congestion. Gymnastics begins to do 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 supplement therapeutic exercises for osteoarthritis of the knee joint with swimming.
Surgery
Surgery is indicated for osteoarthritis of 2 and 3 degrees:
- Sting. With the help of a syringe, the accumulated liquid 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 of the surgeon.
- Arthroscopy. The method is used for rehabilitation of the knee joint. Arthroscopy is performed through small punctures, so the operation is tolerated quite easily, the rehabilitation period is short.
- Corrective osteotomy. The classic technique for the treatment of deforming osteoarthritis, which consists in correcting the deformed anatomical axis of the lower limb, followed by fixing the wedge resection site of the bone with a titanium plate. After an osteotomy, the patient needs rehabilitation for several months.
- Endoprosthesis. The installation of an artificial joint is performed with an extreme degree of deforming osteoarthritis 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 (about 2-3 months).
Arthroscopy
Minimally invasive treatment method. A video camera and microsurgical instruments are introduced into the joint cavity. The doctor performs a thorough examination of the joint, extracts particles of osteophytes, destroyed cartilage, scar tissue. Arthroscopy helps to temporarily relieve pain and restore joint mobility.