Osteoarthritis of the knee joint: causes, symptoms and treatment.

Arthrosis of the knee joint is understood as a decrease in cartilage performance due to its curvature and destruction. Other terms are used to refer to this disease:gonarthrosisYdeforming osteoarthritis. Currently, various methods are used to treat the disease: a specific option is selected taking into account the individual characteristics of the patient.

Disease specificity

Knee osteoarthritis usually develops progressively. As a rule, it occurs in women and older people who are overweight or have vein defects. The disease can occur in one or both knees at the same time.

The main stages of development of arthrosis in the knee:

1. Initial. There is a decrease in the depreciation parameters of the joint due to the mutual friction of the cartilage and an increase in its roughness. Crack formation is sometimes observed.
2. Second. At this stage, the bone begins to be covered with growths (osteophytes). On the inner surface of the articular bag, the curvature is fixed, stiffness is observed in the work of the limb. As a result, the knee joint gradually reduces its functionality. Due to the decrease in the thickness of the intercartilaginous lining, a reduction in the distance between the tibia and the femur is observed.
3. Third. If nothing is done, the pain in the knee area becomes permanent due to irreversible damage to the cartilage tissue. The patient at this stage can no longer move normally.

The first symptoms of osteoarthritis of the knee joint are reason enough to consult a specialist. Otherwise, there is a real danger of becoming disabled.

Why does osteoarthritis appear?

The main causes of the development of arthrosis of the knee joint:

• hereditary tendency;
• temporary immobility of the knee joint as a result of injury;
• surgical removal of the meniscus;
• high physical activity, constant hypothermia;
• obesity, overweight problems;
• ligament rupture (their weakening);
• other joint diseases (arthritis, swelling, various inflammations);
• failures of normal metabolism, calcium deficiency in the body;
• flat feet (failure of the center of gravity increases pressure on the joint);
• stress, general fatigue, lack of sleep.

Symptoms

Signs of the probable presence of knee osteoarthritis:

• Pain in the knee joint. The pain appears suddenly, against the background of physical exertion. At the first stage, we are talking about almost imperceptible lumbago, then the disease becomes more serious.
• Visual violation of the shape of the knee. It occurs in the later stages.
• Fluid accumulation, Baker's cyst. These are tangible seals in the posterior region of the knee joint.
• The appearance of a crunch of cartilage, against the background of acute pain. This indicates the second or third stage of gonarthrosis.
• Inflammation of the internal region of the joint bag. It is manifested by edema and increased cartilage.
• Knee stiffness due to intense pain, until complete immobilization. This happens in the advanced stages of the disease.

Treatment

Effective treatment of arthrosis of the knee joint is possible only with the use of an integrated approach. Modern medicine is not yet able to offer a specific drug that can eliminate this disorder. The success of treatment procedures depends on the timeliness of detection of the problem, which allows you to start the fight against gonarthrosis in the early stages.

When starting treatment, the specialist pursues several objectives:

• reduce pain symptoms as much as possible;
• to resume the normal flow of nutrients to the joint;
• increase the intensity of blood circulation in the knee area;
• restore the functionality of the supporting muscles in the problem area;
• make the knee as mobile as possible;
• widen the space between the connected bones.

The exact treatment algorithm is determined individually. Distinguish between conservative and surgical techniques.

conservative method

This approach is used in the early stages of the onset of the disease, and involves the use of various medications and therapeutic exercises.

Analgesics, anti-inflammatories

To eliminate or reduce pain in the knee joint, the doctor usually prescribes the use of nonsteroidal anti-inflammatory drugs. In pharmacies, they are represented by tablets, ointments and injections. Heating and anesthetic gels, ointments, and patches demonstrate good efficacy for pain relief.

A positive result in this case is usually achieved in 3-4 days. It should be understood that these drugs do not eliminate the disease, but only reduce pain. It is recommended to take painkillers only on the advice of a specialist and only when excruciating pain is fixed. The fact is that NSAIDs provoke the appearance of various side effects (especially the gastrointestinal tract suffers).

hormonal drugs

In some cases, to relieve the pain of osteoarthritis of the knee, the doctor may prescribe hormone injections. This approach is used when the efficacy of NSAIDs is weak in the setting of progressive disease.

Hormones are prescribed for a short period (1-10 days) during exacerbations of osteoarthritis and fluid accumulation in the knee joint.

Chondroprotectors

To restore and nourish the cartilaginous layer at the beginning of the development of the disease, the so-called. chondroprotectors (glucosamine, chondroitin sulfate). Glucosamine starts the process of cartilage regeneration, corrects metabolism, blocks destructive processes. Chondroitin sulfate disarms dangerous enzymes, increases the amount of collagen (this protein nourishes cartilage with moisture). According to leading doctors, these drugs currently demonstrate the greatest positive effect in the treatment of gonarthrosis.

In especially critical cases, when the cartilage tissue has suffered serious abnormalities, chondroprotectors are ineffective. When prescribing glucosamine and chondroin sulfate, the doctor indicates specific daily doses. Only a systematic approach to taking these drugs gives a chance for positive results. On sale they are represented by tablets, capsules, injections, gels.

Vasodilators

To eliminate spasms of the vascular system, optimize blood flow and metabolism in the knee area, the doctor prescribes means for vasodilation. As a rule, they are prescribed in combination with chondroprotectors. If, against the background of arthrosis, the fluid in the knee is not collected, it is allowed to rub the joint with a warming ointment and attend therapeutic massage sessions.

Hyaluronic acid

In its chemical composition, this substance is very close to intra-articular fluid. After being introduced into the joint, the acid creates a film that protects the cartilage from rubbing against each other. It is allowed to use the drug after the cessation of exacerbation.

therapeutic exercise

For osteoarthritis of the knee, resort to exercise therapy, but only under the strict supervision of the attending physician or an experienced trainer. Self-medication is strictly prohibited, given the enormous risks of any careless movements and loads. Proper use of physiotherapy exercises helps keep the joint in working condition, eliminates muscle spasms and relieves unpleasant symptoms. It is strictly forbidden to perform physiotherapy exercises during exacerbations or in unsuitable conditions.

Physiotherapy

Correctly applying physical therapy techniques, you can significantly reduce pain in the knee area, relieve inflammation and improve the flow of nutrients to the joint tissue. Before prescribing physiotherapy, the orthopedist makes a detailed diagnosis of the problem area, prescribes general and special tests, sends an ultrasound or x-ray. This approach allows you to draw a true picture of the problem and select the best methods.

The following types of physiotherapy have a good analgesic effect:

• ultraviolet irradiation. Due to exposure to ultraviolet rays, there is a decrease in the sensitivity of the nerve endings and a decrease in pain. As a rule, it is prescribed in the later stages of the disease. The standard duration of treatment is 7-8 sessions.
• Local magnetotherapy. It improves the general health of the patient by reducing pain, inflammation and muscle spasms. Magnetotherapy is usually prescribed at the first fixation of symptoms of osteoarthritis of the knee. The standard number of procedures is 20 to 25 sessions of 30 minutes each.
• Infrared laser therapy, UHF, SMW devices, ultrasound, therapeutic baths, etc.

If the disease has passed to the stage of dystrophic and deforming changes, the doctor recommends a health spa treatment. A specific list of procedures is compiled after a careful study of the patient's history.

Surgery

This approach, with proper implementation, can partially or completely resume the work of the knee joint. The formation of the surgical intervention algorithm takes into account the level of destruction of cartilage tissue, the degree of inflammation, the amount of fluid collected, etc. As a general rule, surgical intervention is practiced in the last stages of gonarthrosis. This approach involves a partial or complete replacement of the affected joint with an endoprosthesis.

The main approaches to surgical treatment:

1. Arthrodesis of the joint. During surgery, the surgeon fixes the leg in the most comfortable position for the patient, followed by immobilization of the knee joint. The defective cartilage is completely removed. Such a radical approach is relevant only in extreme cases.
2. Arthroscopic debridement. It is used in the second stage of the development of osteoarthritis of the knee. Surgical removal of damaged cartilage tissues is carried out, which allows you to save a person from pain for several years (usually for 2-3 years).
3. endoprosthesisIn this case, the knee joint or its separated part is replaced with a plastic, ceramic or metal implant that completely repeats the anatomical configuration of the natural joint. Today, endoprostheses are considered the most effective way to return a full lifestyle to a knee suffering from osteoarthritis for the next 15 to 20 years.

Competent planning and implementation of surgical treatment allows to improve the patient's well-being and restore her mobility (partially or completely). At the same time, it should be understood that after the operation a long recovery period will be required, attending physiotherapy exercises, mechanotherapy, diet, etc.

Rehabilitation

On average, the rehabilitation period after surgical treatment lasts 90 days:

The main rehabilitation tasks:

• the resumption of the patient's ability to move normally;
• optimization of the functioning of muscles and joints;
• creation of a protective block for the prosthesis.

The drain is removed 2-3 days after the operation, after which you can try to walk carefully. To relieve pain, the doctor prescribes drugs with a cooling effect. Minor pain symptoms sometimes persist for a year after the operation: this is because the prosthesis needs time to heal. Elderly patients recover longer - to alleviate their condition, NSAIDs are prescribed. In some situations, the attending physician prescribes hormonal agents that have a pronounced effect.

A week later, the patient enters the rehabilitation center under the care of an experienced physical therapist. When developing an exercise therapy course, the individual characteristics of the body are taken into account. Classes are held regularly (daily), with a gradual increase in loads - this protects against injuries and tissue ruptures.

Period after discharge

At the end of the stay in the rehabilitation center, the patient is discharged, providing detailed recommendations regarding her future lifestyle. Dancing and light gymnastics are allowed after 6 months from the date of the operation. As for serious loads (sprints, jumps, sports games, squats with heavy weights), they should be completely excluded. Otherwise, the prosthesis will quickly fail.

Do not lift heavy objects weighing more than 25 kg. Inside the dwelling, it is necessary to install supporting handrails: they are placed on the stairs, in the bathroom and in the bathroom. All furniture must be fully functional (especially chairs). These and other measures will maximize the useful life of the prosthesis. You should also be prepared for postoperative osteoarthritis of the knee joint, which can last up to 3 years.

Prevention of the onset of the disease.

The best way to deal with any illness is to prevent it from occurring.

effective waysprevention of knee osteoarthritis:

• Adequate nutrition, maintaining a normal weight. It is better to eliminate fatty and fried foods, alcohol, coffee, etc. from the diet. . An experienced nutritionist can give you detailed advice on this.
• Be careful when playing sports. It is desirable to reduce the load on the joints as much as possible.
• Watch for any illnesses (especially infectious ones), treat them properly, and avoid chronic stages.
• Take care of your posture, do not be negligent with diseases of the bones and spine.
• Include light physical activity (biking, swimming, walking, joint-strengthening exercises) in your daily routine.
• Avoid any self-treatment options for knee arthritis. At the first symptoms of the disease, you should immediately contact the clinic.
• Lead a calm lifestyle without stress or lack of sleep.
• Take measures to strengthen immunity (hardening, taking vitamins).
• Dress warm in the cold season.

By applying the principles of a healthy lifestyle in your life and seeking medical help in a timely manner, you can minimize the risks of developing osteoarthritis of the knee joints. When choosing a clinic, preference should be given to proven treatment centers equipped with modern equipment.