Knee arthritis (gonarthrosis)is a chronic progressive disease of the knee joint with damage, thinning and destruction of the cartilage (articular surface of the femur and tibia), as well as damage to the subchondral bone.Studies (arthroscopy and MRI) have demonstrated that in addition to damage to the articular cartilage, the meniscus and synovial membrane are also involved in this process.Gonorrhea is one of the most common orthopedic conditions.There are its synonyms - osteoarthritis (OA), deforming arthritis.The disease is an important socioeconomic problem, as it is widespread and significantly impairs the patient's quality of life due to constant pain and, moreover, becomes the cause of high disability.
Until the mid-eighties of the last century, there was no unified definition of this disease.It was not until 1995 that the osteoarthritis committee of the American College of Rheumatology described the disease as a result of mechanical and biological factors leading to an imbalance between the degenerative and synthetic processes of the extracellular matrix of articular cartilage.As a result, fibrous breakdown and degeneration occur, cracks, bone sclerosis and compaction of the shell of the subchondral bone are formed, bone spurs develop and subchondral cysts are formed.
Why does knee osteoarthritis occur?
Risk factors for joint disease include:
- chronic injuries (violation of physical activity, overweight);
- endocrine, inflammatory, metabolic and ischemic diseases;
- the presence of congenital or acquired disorders of the relationship, shape or structural organization of the joint ends.
If you notice similar symptoms, consult your doctor.Do not self-medicate - it is dangerous for your health!
Symptoms of knee osteoarthritis
Knee osteoarthritis is characterized by:
- gradual onset;
- mild pain in the joints when moving, especially when going up and down stairs;
- “Tightness”, stiffness and “pain onset” occur during the first steps and gradually decrease or disappear if the patient “changes direction”, after significant physical activity, the patient resumes.
- The appearance of the knee remains the same.Sometimes there is mild swelling or fluid buildup in the joint.At the same time, the knee increases in volume, swells, flattens and feels limited in movement and feels heavy.
Painful feeling
As the disease progresses, the pain becomes more intense, appearing even with light exertion and long walks.Localized along the anteromedial surface of the joint.Prolonged rest often helps the pain go away.
Limited mobility of the knee joint and characteristic crunching sound
With arthritis, the range of motion of the joint may decrease, a cracking sound may appear, and sharp pain may appear when the leg is bent to its maximum extent.
Knee deformity
The shape of the joint changes, as if it is expanding.
Synovitis
Knee synovitis is an inflammation of the inner lining of the joint.The disease manifests itself in the form of knee swelling, red skin, and limited joint movement.With the development of arthritis, synovitis occurs more frequently, lasts longer, and involves large amounts of fluid.
The final stage of gonorrhea is characterized by the fact that the pain is almost constant, causing anxiety not only when walking, but also when resting, and even at night, when the patient has to find a comfortable position to sleep.Movement is more limited: it is difficult to bend and straighten the legs completely.Joints become deformed and increase in volume.Valgus (X-shaped) or varus (O-shaped) deformity of the leg is commonly observed.Gait becomes unstable and waddling.In severe cases, a cane or crutches must be used.
According to researchers, 76% of older adults complaining of knee pain had X-rays showing gonorrhea.According to statistics, women are more likely to suffer from this disease, which is related to hormonal changes after age 45.
Pathogenesis of knee osteoarthritis
There are primary and secondary osteoarthritis.
Primary arthritis of the knee joint
- Articular cartilage is continuously destroyed and regenerated;Normally, these processes are balanced.With age, cartilage regeneration slows down and destruction begins to prevail, this is called degeneration or degeneration.A person's weight plays an important role, since with a mass of 70 kg in 20 steps we carry 700 kg on each leg (70 kg x 10 steps), and with a mass of 120 kg we already carry 1200 kg on each leg.Therefore, weak cartilage will wear out much faster;
- remember: joints receive nutrients and are restored when moving;A sedentary lifestyle reduces metabolism and the necessary elements do not reach the cartilage;
- There is controversial evidence about the role of genetics in the occurrence of the disease.If parents have joint disease, the likelihood of this disease occurring in the child increases;
- occurs due to autoimmune arthritis.
Secondary arthritis of the knee joint
- injuries (fractures, torn meniscus and anterior cruciate ligaments).Unfortunately, in any person, regardless of age, these injuries lead to excessive pressure on the cartilage.Fracture of any bone covered with cartilage is accompanied by an uneven formation - a “step”.In this area, when moving, abrasion will occur and arthritis will form;
- rheumatoid arthritis, Koenig's disease (osteochondritis dissecans), consequences of purulent inflammation of the joints (gonaditis), etc.;
- regional vascular disorders;
- Proliferative adhesion and chronic fluid secretion in the joints.
With osteoarthritis, in addition to the gradual destruction of cartilage, losing its elasticity and ability to absorb shock, bones also gradually participate in this process.Under load, sharp edges (exostoses) appear, which are mistakenly considered "salt deposits" - with classic arthritis, salt deposition does not occur.As arthritis progresses, it continues to “eat” the cartilage.Then the bones are deformed, cysts form there, all structures of the joints are affected, and the leg becomes bent.
In addition to the inner or outer part of the knee, arthritis can also affect the surface between the patella and the intercondylar groove of the femur.This option is calledPatellofemoral arthritis.
Its cause is usually a mild dislocation, fracture, or shifting of the kneecap to one side.
Classification and stages of development of knee osteoarthritis
Regardless of the cause, gonorrhea has three stages, or knee joint deformity.
Gonorrhea, stage I
The first stage of the disease is characterized by radical changes in the hyaline cartilage.Bone structure is not affected.The blood supply in blood vessels and capillaries is interrupted.The cartilage surface becomes dry and loses its smoothness.If the disease is accompanied by persistent tension synovitis, a Baker cyst (protrusion from the joint capsule of the popliteal area) develops.After significant stress in the joint, dull pain occurs.There may be mild swelling that goes away after rest.There is no distortion.
Gonorrhea, stage II
In the second stage, the cartilage layer becomes much thinner and in some places is completely absent.Bone spurs appear along the edges of joint surfaces.The qualitative and quantitative properties of the synovial fluid of the joints change - it becomes thicker, more viscous, which leads to a deterioration of its nutritional and lubricating properties.The pain lasts longer and is more intense, often making a cracking sound when moving.There is mild or moderate limitation of movement and mild deformity in the joints.Using pain relievers helps relieve pain.
Gonorrhea, stage III
Lack of cartilage in most affected areas, severe sclerosis (hardening) of bones, multiple bone spurs, and narrowing or absence of joint spaces.The pain is almost constant, gait is impaired.Mobility is significantly limited and joint deformities are noticeable.NSAIDs, physical therapy, and other standard treatments for knee arthritis are ineffective.
Types of gonorrhea
Depending on the number of affected joints, unilateral and bilateral gonorrhea are distinguished.
Complications of knee osteoarthritis
The most common complication of stages II and III is tendonitis of the adductor thigh muscle group.This is manifested by pain along the inner surface of the joint, which increases with movement.The cause is muscle imbalance and deformation.With long-term reduction in range of motion, contractures develop.In addition, synovitis frequently occurs.
Consequences of progressive gonorrhea
Gonorrhea affects the entire musculoskeletal system, disrupting the biomechanics of the spine and other large joints of the lower extremities.This can lead to herniated discs and arthritis in other joints.The second knee joint is overloaded (if the disease is on one side), because the patient forgives the painful leg and transfers weight to the other healthy leg.
Diagnosis of knee osteoarthritis
Tools for diagnosing knee osteoarthritis
In the majority of cases, examination and X-rays of the knee joint in two projections (direct and lateral) are sufficient.Clinical data and images help determine the stage of the disease.
In the early stages of the disease, with minor changes in bone tissue, X-rays are not very valuable.At this stage, gonorrhea can be diagnosed through arthroscopy.The accuracy of the method is very high;only its invasive nature and price can stop it.
Ultrasound does not allow clear visualization of changes in articular cartilage and intra-articular structures.Using MRI, you can detect changes in the bone structure, cartilage and soft tissue of joints as well as subchondral bone with 85% accuracy.Scanning can be used to evaluate the metabolic activity of periarticular bone tissue.
Laboratory diagnosis of knee osteoarthritis
Increased levels of phosphorus and calcium in dehydrated synovial fluid are evidence of destruction of bone and cartilage tissue of the joint and accumulation of degenerative products.Blood is also examined - general analysis and erythrocyte sedimentation rate (ESR);Determine the concentration of fibrinogen, urea and other biochemical parameters of blood and urine.
Can deformed knee osteoarthritis be completely cured?
Gonorrhea can only be completely cured in the earliest stages of the disease.
Which doctor treats knee osteoarthritis due to deformity?
A traumatologist-orthopedist or rheumatologist will diagnose and prescribe treatment.
Treatment of knee osteoarthritis
Conservative - anti-inflammatory drugs, analgesics, muscle relaxants, blood vessels, cartilage protective drugs, compression, mobilization, physiotherapy, physiotherapy, orthopedic devices.
Minimally invasive- paraarticular blockade (Novocain + pain and inflammation reliever), injection of artificial lubricants into the joint itself, lifting with plasma.
Surgery — Arthroscopy (a less traumatic method to treat pathologies in the joint and remove damaged structures), arthroscopy.
Drug treatment (drugs to treat knee osteoarthritis)
Conservative methods are most effective in the early stages of the disease.They help relieve pain and temporarily slow cartilage destruction.In phase II, more effective methods are needed.The introduction of hyaluronic acid preparations into the joint cavity is used to reduce friction and trauma to the cartilage.There is no clear evidence of cartilage repair but it has a good lubricating effect on surfaces.“PRP therapy” (plasmolifting) is the injection of platelet-rich plasma into the knee joint, obtained from the patient's own blood by centrifugation.It nourishes cartilage and promotes its recovery, since platelets themselves contain many growth factors and cytokines that promote the regeneration of damaged tissues.
Surgical and endoscopic treatment
Endoscopic replacement is a popular and effective surgical method for treating severe gonorrhea, allowing you to maintain limb mobility and the ability to live a full life afterward.This is a high-tech operation that lasts about an hour and a half.In the postoperative period, long-term recovery and joint development are necessary.After 25-30 years, when the artificial joint wears out, it needs to be replaced.
Physical therapy and occupational therapy
Physical therapy and occupational therapy methods to treat knee osteoarthritis are not effective.
Diet therapy
A diet is only necessary to maintain a normal weight;There are no restrictions on the consumption of certain foods for gonorrhea.
Does lockdown help treat gonorrhea?
For knee arthritis, para-articular anesthesia is used - injecting medicine into the soft tissue around the joint.During the procedure, the area of inflammation and pain near the joint is identified, the skin is treated with alcohol, and hydrocortisone with anesthesia is injected into this area.
Therapeutic exercises for arthritis
Therapeutic exercises are useful both for patients with gonorrhea and for the prevention of this disease.Effective exercises:
- fully flex and extend the legs, lying on the back;
- Raise your legs straight up while lying on your back.
Forecast.prevent
You need to understand that if arthritis begins to develop, it must be treated immediately.If you are at risk of this condition, you may be able to delay its onset as this is recommended:
- reduces stress on knee joints;
- swim - water relieves stress;
- personally massage the muscles of the legs and thighs;
- avoid hypothermia and overwork;
- maintain normal weight;
- quit smoking and alcohol;
- women wear comfortable low-heeled shoes;
- practice physical therapy
Before starting therapeutic exercises, you should definitely consult your doctor.Exercises are performed at a slow pace.If pain or discomfort occurs while exercising, the exercise should be stopped.
Just use effective medicine.Rubbing, compresses and other folk methods are ineffective;They do not affect the cause of the disease, but only help distract from the pain.Avoid injuries and overloads - jumping, carrying heavy objects, standing for long periods of time or sitting in uncomfortable positions.This accelerates the progression of the disease.
It is also necessary to promptly diagnose and treat rheumatoid arthritis, gout and systemic diseases.
What factors affect the long-term prognosis of knee arthritis?
Prognosis depends on the stage at which the patient sees the doctor and the exact treatment.The sooner you begin appropriate treatment, the better your chances of avoiding surgery.