Osteoarthritis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease, which is accompanied by the gradual destruction of cartilage with the gradual involvement of periarticular structures in this process.Lack of timely treatment leads to limited mobility and even disability of the patient.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over the age of 65 who consult a doctor complaining of knee pain.The elderly are at risk because with age the articular cartilage thins, microcracks appear and gradually collapses.New pathological changes appear:
- the composition of the synovial fluid changes, becomes less, which is why the surfaces of the bones begin to touch each other and collapse;
- bone growths (osteophytes) appear;
- the joint capsule becomes denser, causing joint stiffness;
- A spasm of the muscles surrounding the joint occurs.
Without treatment, the knee becomes deformed and movement within it is significantly limited.It can affect one or both joints
According to statistics, one in five people in the world suffers from gonarthrosis.Mostly the disease is diagnosed in people over the age of 40, but the age factor is not the only reason for the development of the pathology.
Why does gonarthrosis occur?
In elderly patients, arthrosis of the knee joint occurs due to the natural wear and tear of the cartilaginous tissue.Other causes of the disease:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtraumas;
- previous surgeries;
- autoimmune diseases;
- chronic joint diseases;
- regularly increased loads on the knee joint, for example, running or jumping, constantly standing or kneeling;
- genetic predisposition.
At risk are women over the age of 40, athletes, overweight patients and workers in the construction sector.
How to recognize arthrosis of the knee joint?
The disease develops slowly, over several years and has a chronic course.Its changes are irreversible, so it is important to start treatment as soon as possible when symptoms appear.
The first signs of gonarthrosis:
- knee stiffness;
- discomfort when straightening or bending the knee joint, when going up or down stairs;
- creaking or clicking noises when moving;
- slight pain in the knee, which occurs only after prolonged standing and disappears with rest.
As time passes, the discomfort intensifies.Severe stiffness, motor disorders and severe pain appear, which do not leave the patient even at rest.It is difficult for a person to walk, sit or stand.Without treatment, the knee joint becomes deformed, leading to disability.
The severity of the changes, as well as the likelihood of recovery, depends on the stage of the disease.
Degrees of gonarthrosis
There are 4 degrees of severity of the disease:
- I graduate.At the beginning of the disease there are practically no symptoms.After physical activity there is a slight discomfort in the knee, which does not interfere with leading a normal lifestyle.Pathological changes can only be detected using X-rays.
- II degree.A creaking sound and periodic pain appear during physical activity, walking, climbing stairs, doing squats, or standing for a long time.Radiographic images may reveal narrowing of the joint space and early signs of osteophyte formation.
- III degree.The pain syndrome becomes permanent and does not leave the person even at rest.The knee hurts especially in the morning and evening;during the day the pain is painful and tolerable.Since degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a creaking sound is heard when moving.There is a "joint mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity, causing severe pain.The knee becomes deformed and can become inflamed and swollen.Radiographs show signs of joint deformation, osteophytes, significant narrowing of the joint space, and damage to the meniscus.
- IV degree.Without treatment, the disease becomes extremely serious.Cartilage, ligaments and menisci are completely destroyed, making movement of the joint impossible, the joint surfaces are deformed and numerous osteophytes appear.These changes cause severe pain and disability.
Diagnostics
Diagnosis of arthrosis of the knee joint is not difficult.An orthopedist-traumatologist performs examination and treatment.Examine the patient's knee, evaluate motor activity, study clinical manifestations and palpate to identify areas of swelling and the presence of effusion.
To confirm the preliminary conclusion, he prescribes an instrumental examination:
- X-ray examination: allows you to identify the narrowing of the joint space, the presence of osteophytes;
- CT of the joint is a more informative diagnostic method than X-rays;shows the state of the joint cavity;
- Ultrasound of the joint: allows you to determine the volume of fluid in the joint cavity, the presence of osteophytes, evaluate the condition of the surrounding soft tissues, the thickness of the hyaluronic cartilage;
- MRI - suitable for studying not only bone and cartilaginous tissue, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method;During the procedure, the synovial fluid may be punctured.
In addition, a clinical and biochemical blood test, an immunological study, and a test for rheumatoid factor may be necessary.
Treatment of osteoarthritis
An orthopedist should treat gonarthrosis, taking into account the clinical picture and the degree of damage to the joint.You can't self-medicate.
The doctor may prescribe drugs from the following groups:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, which restore cartilage and prevent its further destruction;
- analgesic blocks that effectively eliminate pain;
- glucocorticosteroids, indicated for serious diseases;
- antispasmodics to eliminate muscle spasms.
Drug therapy is complemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetotherapy, electrophoresis and phonophoresis.Additionally, physical therapy and massage are prescribed.
You definitely need to control your weight and try to get rid of extra pounds, which cause additional stress on the knee joints.It is important to adhere to a dietary diet;the diet should contain foods that nourish cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is necessary.This may be arthroscopy, osteotomy or endoprosthesis.
The most favorable prognosis is that if arthrosis is detected at stage 1, the changes can be slowed down and even stopped.Knee stiffness or pain is not normal;it is worth having yourself examined to understand the cause of the discomfort.