Osteoarthritis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease accompanied by the gradual destruction of cartilage with the gradual involvement of periarticular structures in this process.Lack of timely treatment leads to reduced mobility and even disability of the patient.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over 65 years of age who consult a doctor with complaints of knee pain.Older people are at risk because the articular cartilage becomes thinner with age, micro-tears appear in it and it gradually collapses.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes less, which is why the bone surfaces begin to touch each other and collapse;
- Bone growths (osteophytes) appear;
- the joint capsule becomes denser, leading to joint stiffness;
- The muscles surrounding the joint spasm.
Without treatment, the knee deforms and movements in the knee are significantly restricted.May affect one or both joints
According to statistics, every fifth person in the world suffers from gonarthrosis.Most often the disease is diagnosed in people over 40 years old, but the age factor is not the only reason for the development of pathology.
Why does gonarthrosis occur?
In older patients, osteoarthritis of the knee joint occurs due to natural wear and tear of the cartilage tissue.Other causes of illness:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine disorders;
- Knee injuries, including common microtraumas;
- previous surgical procedures;
- autoimmune diseases;
- chronic joint diseases;
- regular increased stress on the knee joint, for example running or jumping, constant standing or kneeling;
- genetic predisposition.
Women over 40, athletes, overweight patients and people in construction jobs are at risk.
How do you recognize osteoarthritis of the knee joint?
The disease develops slowly, over several years, and is chronic.Because the changes are irreversible, it is important to start treatment as early as possible if symptoms appear.
The first signs of gonarthrosis:
- Stiffness in the knee;
- Discomfort when stretching or bending the knee joint, climbing or climbing stairs;
- Crunching or clicking noises when moving;
- Mild pain in the knee that only occurs after standing for a long time and disappears with rest.
Over time, the symptoms worsen.Severe stiffness, motor disorders and severe pain occur that do not leave the patient even at rest.It is difficult for a person to walk, sit down or stand up.Without treatment, the knee joint deforms and leads to disability.
The severity of the changes and the likelihood of recovery depend on the stage of the disease.
Degrees of gonarthrosis
There are 4 levels of severity of the disease:
- I'm graduating.At the beginning of the disease there are practically no symptoms.After training, slight discomfort occurs in the knee, which does not interfere with leading a normal lifestyle.Pathological changes can only be detected with X-rays.
- II degree.A grinding sound and periodic pain occurs during physical activity, walking, climbing stairs, squatting, or standing for long periods.X-ray images show a narrowing of the joint space and the first 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 bearable.Since degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a crunching 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 joint cavity and causes severe pain.The knee becomes deformed and can become inflamed and swollen.On the X-ray, signs of joint deformation, osteophytes, significant narrowing of the joint space and damage to the meniscus can be seen.
- IV degree.Without treatment, the disease is extremely severe.Cartilage, ligaments and menisci are completely destroyed, making movement in the joint impossible, articular surfaces are deformed and a large number of osteophytes appear.These changes cause severe pain and disability.
diagnosis
Diagnosing osteoarthritis of the knee joint is not difficult.An orthopedist-traumatologist carries out the examination and treatment.He examines the patient's knee, assesses motor activity, examines clinical manifestations, and palpates 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 detect narrowing of the joint space and the presence of osteophytes;
- CT examination of the joint is a more informative diagnostic method than X-rays;it shows the condition of the joint cavity;
- Ultrasound of the joint – allows you to determine the volume of fluid in the joint cavity, the presence of osteophytes, assess the condition of the surrounding soft tissues and the thickness of hyaluronic cartilage;
- MRI – suitable for examining not only bone and cartilage tissue, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method;During the procedure, synovial fluid can be punctured.
In addition, a clinical and biochemical blood test, an immunological examination and a test for rheumatoid factor may be required.
Treatment of osteoarthritis
The treatment of gonarthrosis should be carried out by an orthopedist, taking into account the clinical picture and the extent of the joint damage.You can't treat yourself.
The doctor can prescribe drugs from the following groups:
- anti-inflammatory nonsteroidal drugs;
- chondroprotectors, which restore cartilage and prevent its further destruction;
- analgesic blocks that effectively eliminate pain;
- glucocorticosteroids, indicated for serious illnesses;
- antispasmodics to eliminate muscle spasms.
Drug therapy is complemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetic field therapy, electro- and phonophoresis.Additionally, physiotherapy and massage are prescribed.
You definitely need to control your weight and try to get rid of extra pounds that put additional strain on your knee joints.It is important to follow a dietary diet;The diet should contain foods that nourish the cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.This can be an arthroscopy, osteotomy or arthroplasty.
The most favorable prognosis is if osteoarthritis is detected in stage 1, then changes can be slowed and even stopped.Stiffness or pain in the knee is not normal;It is worth getting examined to understand the cause of the symptoms.