Have you been diagnosed with arthrosis of the knee joint, have severe pain, and have you started to limp?Looking for where to get treatment?Contact the medical center, they will help relieve the pain, find out the causes of the disease and provide the necessary treatment.We have more than 20 effective joint rehabilitation methods in our arsenal.
The disease is also known as gonarthrosis (from the Latin genu knee), osteoarthrosis (as the disease was called before) and osteoarthritis (the term reflects the mechanism of development and modern understanding of the disease).Reducing osteoarthritis of the knee joint has a chronic course and develops over several years.The majority of patients are over 50 years old.Women predominate in 2/3 cases.
How does this disease develop?
Under the influence of external and internal factors, blood supply and tissue nutrition are disturbed, degenerative-dystrophic damage to the articular cartilage develops, with the involvement of the underlying bone in the inflammatory process.Destruction of the articular surface leads to loss of joint function, limiting movement and disrupting the patient's quality of life.
Causes and risk factors
The main reasons for the development of osteoarthritis:
- Hard physical labor.Constant load on the feet leads to cartilage microtraumas and the development of the inflammatory process.At risk are loaders, assemblers, miners, and quarry workers.Osteoarthritis often affects professional athletes (weightlifters, cyclists, tennis players, soccer players, basketball players, hockey players, etc.).
- Injury.Damage to ligaments, tendons, menisci, bruises and fractures cause joint biomechanical disorders.If treated incorrectly, this leads to the development of post-traumatic arthrosis.
- Surgical operations on the knee can lead to the development of pathology of the articular cartilage and surrounding tissue.
- Excess weight increases the pressure on the lower joints of the legs.Up to 80-90% of the development of all osteoarthritis is associated with joint loading.
- old ageIn people over 50-60 years old, the regenerative process slows down, collagen production decreases, and hormone levels suffer.Which leads to the development of pathology.
- Hormonal changes in women.During menopause, estrogen production decreases, which interferes with calcium absorption, causes weakness of the musculoskeletal system, and makes bones brittle.The risk of developing osteoporosis increases.
- Problems with the thyroid gland.Thyroid hormones are involved in the metabolic processes of calcium and phosphorus in the body.Their deficiency or excess can trigger knee arthrosis.
- Genetic predisposition.Collagen mutations can cause disruption in the elements of connective tissue, which causes a deterioration in the shock-absorbing function of articular cartilage.
- Ancestry.There is a high probability of developing this disease if the patient's family has relatives diagnosed with gonarthrosis, especially in the female line.
- Inflammatory diseases.Infectious arthritis, bursitis, synovitis caused by bacterial or viral infections are often complicated by the development of gonarthrosis.
- Vascular disease.Tissues do not receive proper nutrition, blood supply is impaired, which leads to the development of ischemia and degenerative-dystrophic changes in articular cartilage.
- Poor nutrition and metabolic disorders.Eating foods high in purines (proteins) contributes to the deposition of salts in the knees, for example, gouty arthritis.
- Specific diseases gonorrhea, tuberculosis, syphilis, chlamydia, and influenza can cause serious damage to the joints.
- Intoxicate the body with various chemicals, including some drugs.
- Autoimmune disorders are associated with a violation of the body's immune defenses when antibodies are produced against its own cells, for example rheumatoid arthritis.
Disease symptoms
The main symptoms of gonarthrosis:
- Pain in the joints, pain, sometimes at night, in cases of severity, severe stabbing;
- Missing and clicking during movement due to violation of the fit of the articular surface, the presence of osteophytes and cartilage defects;
- Swelling and swelling are associated with the development of the inflammatory process in the soft and surrounding tissues;
- Deformation of the joint space and the axis of the body indicates the development of the disease;
- Atrophy and weakness of the thigh muscles, the amount of quadriceps and biceps muscles decreases;
- Mobility limitations and stiffness in the joints are caused by pain, the development of adhesions, and the appearance of osteophytes (bone spurs).
The first signs of osteoarthritis that you should look out for are pain that occurs during or after exercise.The pain goes away with rest and does not require medication.Morning stiffness in the knees, starting pain, before getting up and walking after sleep, it takes some time to wake up the joints.
Signs of Exacerbation
With the development of the pathology, the symptoms of arthrosis become brighter: the knee begins to hurt at rest and at night, during flexion and extension, external sounds appear - cracking, crunching, clicking.Lameness, stiffness of movement develops, and soft tissue swelling appears.
The following facts indicate the progression of the disease:
- the appearance of deformation of the limb axis in the form of an O-shaped leg;
- persistent nature of pain, pain at night and when the weather changes (meteosensitivity);
- deterioration of joint mobility, with the development of flexion contractures;
- weakness and atrophy of the thigh muscles.
Types and forms of the disease
There are:
- MainIt develops as an independent disease.Often, gonarthrosis of the knee is associated with changes related to age and heredity.
- Secondary.Occurs against the background of certain diseases or injuries, for example post-traumatic osteoarthritis.
Depending on the causes, the following types of arthrosis are distinguished:
- Ischemic, which is associated with problems with blood supply to tissues and vascular disorders;
- Post-infectious caused by infection, virus, autoimmune process;
- The idiopathic nature of the development of the pathology is still unclear;
- Metabolic associated with metabolic disorders - gout, hemochromatosis, chondrocalcinosis;
- Involutional, as a result of age-related changes in the body;
- After trauma, history of trauma;
- Dyhormonal - As a result of hormonal imbalance in the body.
Stage of development
I. Arthrosis of the First Degree - The initial stage is associated with the deterioration of the quality and quantity of synovial fluid (articular fluid, provides nutrition to the cartilage, has shock-absorbing properties, promotes sliding of the articular surface).Malnutrition causes wear and degradation of cartilage tissue, and the appearance of the first signs of inflammation.In the early stages, movement is not affected.The patient experiences some pain, tingling, and sometimes the joint may crack when moving.Symptoms occur during and after physical activity.Outwardly, the knee looks quite healthy.
II.Osteoarthritis of the 2nd degree-leads to the thinning of cartilage to 1.5-2.0 mm (normal 2.5-3.0 mm), narrowing of the joint space is observed, and the growth of small single bones (osteophytes) appears.The inflammatory process is wave-like, alternating between phases of remission and exacerbation.Grade 1-2 gonarthrosis is accompanied by swelling and weakness of the thigh muscles.Pain bothers me at rest, when the weather changes, and after walking I feel tired.Movements become more rigid, morning stiffness and crunching in the joints appear.At this stage the patient most often consults with the doctor.
Iii.Gonarthrosis of the 3rd degree is indicated by external deformation of the joint, curvature of the axis of the limb.Cartilage tissue is severely damaged, thinned to 1-1.5 mm, and exposed bone can be seen in some places.Bony growth can be easily felt under the skin, and range of motion is reduced.At 2-3 degrees of osteoarthritis, the joint space is narrow, joints cannot bend and unbend, all movements are accompanied by pain and crunching, and morning stiffness is increasing.Contracts with evolving features.I am worried about a sharp pain in the knee, even at rest.Patients often suffer from insomnia due to the fact that they cannot take a comfortable position that does not cause pain, and they feel a change in the weather.
IV.Grade 4 gonarthrosis is characterized by complete destruction of the articular surface, exposed bone is visible, and cartilage is represented by rare "islands".The common space is almost invisible.A pronounced O-shaped deformity of the lower legs and swelling is noticeable.Mobility is almost completely gone.Treatment with non-surgical methods at this stage is ineffective;Joint replacement with endoprosthesis is indicated.
Orthopedic Doctor's Comment: To accurately determine the degree of arthrosis of the knee joint, in addition to examining the patient, it is very important to carry out an instrumental examination (ultrasound, radiography or MRI of the joint).Bilateral gonarthrosis is very common, so it is recommended to examine both the left and right knee joints.This will help you choose the optimal treatment, and therefore prevent the further development of the disease.
Diagnostics
To make a diagnosis, it is usually enough to do an X-ray or ultrasound of the knee joint.In difficult cases, laboratory tests and magnetic resonance imaging (MRI) are prescribed.If pathological fluid accumulates in the joint, it may require surgery and subsequent examination.
Ultrasound diagnostics
Helps identify diseases at an early stage.Allows you to measure the thickness of the cartilage layer, joint clearance, the presence of joint fluid, the size of osteophytes and ossifications.
Radiography
Carry out to assess the level of damage, condition of bones and cartilage tissue.It will indicate the presence of osteophytes, narrowing of the joint space, and joint deformation.In the early stages of the disease, the examination is not informative.
Analysis
General blood and urine tests, blood biochemistry show signs of inflammation, the presence of infection, and disorders in bone and cartilage tissue.They allow you to assess the general condition of the body, determine the cause of the disease, gonarthrosis, and exclude pathologies with similar symptoms.
MRI
Magnetic resonance imaging A very accurate diagnostic method that helps to visualize the smallest changes.It will help to make a diagnosis at an early stage and in complex cases before surgical treatment.
Which doctor treated you?
The following specialists treat knee gonarthrosis:
- Orthopedic Doctor-Diagnosis of diseases, intra-articular injections, plasma therapy, providing high-tech assistance, and surgical treatment.
- Physiotherapist - Responsible for instrumental physiotherapy treatment.
- Rheumatologist - will help if the disease is associated with an autoimmune disorder.
- Sports Doctor - will be needed in case of sports history of disease.
- A nutritionist is needed if the patient is overweight.
At the rehabilitation stage, the attending physician may involve other specialists:
- Masseur - Massaging the lower leg, restoring muscle tone, thereby stimulating blood circulation and helping to restore joint mobility.
- Doctor of Physiotherapy - Selects Special Exercises and controls their implementation.
- Rehabilitation Specialist - helps with the patient's social adjustment;The specialist is especially in demand after severe reconstructive surgery on the knee.
What treatment is prescribed?
The earlier the disease is detected and treatment for osteoarthritis symptoms is started, the greater the chance of recovery.Otherwise, the disease can cause irreversible consequences and significantly worsen the quality of life.
Therefore, the treatment of knee joint arthrosis 1-2 degrees has a good chance to restore the function of the knee joint.Unfortunately, patients do not always seek medical help in the early stages.
How to quickly relieve pain and how to treat it?
First of all, it is necessary to eliminate pain and inflammation.Determined:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers.These drugs allow you to quickly get rid of inflammation in arthrosis and help reduce pain and swelling.
- Corticosteroids are used when NSAIDs and analgesics do not help, for example, in the treatment of grade 3-4 arthrosis of the knee joint.The patient is given a drug block - the drug is injected directly into the joint cavity.This helps relieve pain and achieve relief within minutes of the injection.
- Special ointments and pain relief patches.
Orthopedic Doctor's Comment: Treatment of knee joint arthrosis of 2-3 degrees is always complex, as a rule, it includes more than 15 (!) points of recommendation in the prescription sheet.It's not just drugs and injections.This is a series of rehabilitation measures aimed at correcting the biomechanics of the joints and the patient's lifestyle.Only this approach will help preserve the joints and stop the progression of the disease.
Preparations that strengthen bone tissue and cartilage:
- Chondroprotectors based on chondroitin and glucosamine are the basis of nutrition for chondrocytes.
- Hyaluronic acid preparations function as synovial fluid analogues.
- Drugs that increase microcirculation and blood supply to articular cartilage.
- Calcium and vitamin D supplements strengthen the bones that make up the knee joint.
- Intra-articular injection of hyaluronic acid preparation, a synthetic analogue of synovial fluid, helps to lubricate the articular surface.
- Drug block helps to quickly relieve swelling, pain and inflammation.As a rule, the effect can be seen the next day.
Treatment of osteoarthritis of the knee joint also includes physiotherapy:
- Electrophoresis.Using an electric current, the medicine penetrates the affected area.Electrophoresis is used to treat knee pain due to gonarthrosis.
- Phonophoresis.This drug enters the inflamed area under the influence of sound waves.An additional advantage of the method in the treatment of gonarthrosis deformation is the thermal effect.
- Shock Wave Therapy.This procedure improves blood circulation, stimulates tissue nutrition, and is used to destroy osteophytes and scar tissue.
- Traction therapy (joint traction) - helps unload the joint space, stretching it by a few millimeters, thereby reducing joint pressure on the articular surface.
- Electromyostimulation - stimulates blood flow and muscle function using electric current, restores muscle tone.
- Mechanotherapy helps develop movement in joint contractions and fights using special robotic simulators.
- Laser therapy creates deep tissue heating and reduces the inflammatory response.
- Magnetotherapy.The therapeutic effect is based on the properties of the magnetic field to reduce pain, inflammation, and tissue swelling.
Orthobiological methods aim to stimulate regeneration and replace defects in cartilage tissue:
- Plasmolifting is a plasma-based drug, made from the patient's own blood, which triggers the regeneration process and contains growth factors.
- PRP therapy - Plasma obtained from the patient's blood is used as medicine.Platelet-rich plasma stimulates the regeneration of chondrocytes and reduces the inflammatory process.
- SVF therapy is based on the use of stromal vascular fraction cells obtained from the patient's own adipose tissue.
- SVF Therapy + PRP Therapy - The simultaneous use of plasma cells and progenitors allows you to achieve the best results.
- Stem cell treatment.This method is based on the use of bone marrow cells and is currently being developed.
Each case is individual and requires the development of a separate rehabilitation program for the treatment of arthrosis of the knee joint.
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