Osteoarthritis of the knee joint is one of the most common diseases of the musculoskeletal system and, unfortunately, the most common cause of loss of mobility, disability and sometimes disability.In osteoarthritis, the cartilage that covers the joint surface is irreversibly affected, causing the joint to no longer function properly and causing pain.
Officially, the disease is called “deforming osteoarthritis”;another name is gonarthrosis (from the ancient Greek “goni” - knee).The knee joints are the largest joints in the human body and the most commonly affected by osteoarthritis.Much less commonly, the disease affects the hip and ankle joints.
How does gonarthrosis occur?
Normally, healthy cartilage is elastic and smooth, completely covers the mobile areas of the bone and allows them to glide.Cartilage also softens the stress your bones receive from walking or exercising.
When cartilage is destroyed (this is how osteoarthritis manifests itself), the top layer of this elastic tissue becomes thinner.Sometimes the cartilage delaminates, ruptures appear - this is how the joint loses its main “shock absorber” and “bearing”.The bones begin to rub together, the joint swells, gradually losing its normal appearance, and pain appears.
Causes of gonarthrosis and risk factors
Deforming osteoarthritis is more common in older and overweight women, but this does not mean that young and physically active people do not suffer from this pathology.Sometimes the development of the disease is provoked by heavy physical work or excessive stress in the gym.
Here is a far from complete list of the causes of arthrosis of the knee joint:
- sports injuries – meniscal injuries, fractures and dislocations;
- inflammatory processes in the joints and concomitant diseases;
- metabolic disorders - some diseases lead to the formation of intra-articular deposits;
- excessive stress on the joint, including prolonged standing or physical work associated with lifting weights;
- uneven load on joints due to curvature of the legs - arthrosis manifests itself faster in overloaded areas.
Much depends on genes - a person may have a hereditary predisposition to arthrosis of the knee joints.In these people, the gene responsible for the development and stability of cartilage tissue is disturbed.
There are several factors that increase the risk of gonarthrosis:
- increase in body weight.Due to the increased load on the joint, the cartilaginous tissue wears out faster;
- age over 40 years.Most people at this age have reduced physical activity.Due to physical inactivity, muscles atrophy, weak muscle tissue does not adequately supply joints, and the risk of cartilage damage increases.
Osteoarthritis symptoms
Knee joint osteoarthritis is not a disease that can appear suddenly.It becomes known well in advance: it all starts with a slight pain in the knee when walking.The pain may increase if you need to go up or down stairs.As a rule, the knee hurts at the beginning of the movement, then the pain disappears and returns with prolonged load on the joint.
If you ignore these symptoms and do not consult a doctor about them, the disease will begin to progress.Then the pain will change from temporary to continuous, the knee will begin to hurt more even at rest and will swell.As the cartilage deteriorates, the mobility of the entire joint will be limited.
Some people notice that the knee “reacts” to climate changes.This really happens - the nerve endings in the joint capsule are sensitive to changes in atmospheric pressure.
The following symptoms are characteristic of gonarthrosis:
- knee pain when moving and walking;
- morning stiffness in the knee joint, when the range of motion is minimal;
- knee swelling;
- dry, harsh crunching sound during movement - this sound occurs due to friction of the articular surfaces.
As the disease progresses, symptoms change:
- the pain will bother you even at rest;
- the joint becomes deformed and loses its functions;
- Due to the deformation of the knee, the gait will change.
Degrees of gonarthrosis
There are 3 stages of development of arthrosis of the knee joint.
1st degreedisease - almost asymptomatic.It begins with the first manifestations of the disease - almost painless, for example, tiredness in the legs - and lasts until the first bone deformities appear.If the knee has changed shape due to synovitis - that is, due to the accumulation of fluid in the joint, but the intra-articular cartilage is not damaged, the disease is still at stage 1.
2nd degreecharacterized by progressive changes in bone tissue.Externally, the knee may look the same as in stage 1 - deformed and enlarged.The pain increases: in addition to the pain that occurs during movement, there is crepitus (crushing) in the affected knee.The joint becomes less mobile, it becomes difficult to squat and walk on uneven surfaces.
3rd degreethe degree of gonarthrosis is the most painful.At this stage, there is almost no cartilaginous tissue left and, if the disease is severe, the bones can grow together.Then the joint is completely immobilized and the person only needs to move with the help of a crutch or cane.Typically, at this point, doctors give a verdict on the endoprosthesis of the damaged joint.
Important: only a doctor can determine the exact degree of development of the disease.Sometimes, with mild symptoms, the disease severely affects the cartilaginous membrane - therefore, for an accurate diagnosis, additional studies are usually carried out:
- radiography - to check whether the cartilaginous surfaces are deformed and what condition the joint space is in;
- CT or MRI - for more detailed studies.
How is gonarthrosis diagnosed and treated?
The first thing to remember is that timely diagnosis and early treatment will help stop the disease in its tracks.Therefore, the appearance of the first discomfort in the knee joint is a good reason to consult a doctor and undergo an examination.
Doctors diagnose osteoarthritis based not only on medical history, complaints and the current condition of the knee joint.The results of additional studies also play an important role - they are often prescribed to clarify the stage of gonarthrosis and the severity of the disease.
To accurately diagnose osteoarthritis of the knee joint, doctors usually prescribe:
- radiography.If pathological processes began in the knee - for example, deposits of calcium crystals or bone tumors appeared in the joint capsule - these changes will be visible in the photographs.Most often, doctors prescribe X-ray examinations, but without a complete examination of the knee joint, its mobility and the condition of the muscles that support it, the picture is incomplete;
- Ultrasound - can be used to evaluate the condition of the soft tissues surrounding and lining the joint.Ultrasound complements x-ray results so that the doctor can see changes not only in bone structures, but also in tissues;
- MRI - magnetic resonance imaging.An MRI is prescribed for complaints of knee pain if the doctor suspects damage to the meniscus, ligaments or tendons;
- Arthroscopy is an invasive examination in which the joint cavity is examined from the inside using a camera.Cameras are inserted through small incisions in the skin;Through these same incisions, doctors can perform small manipulations - for example, remove a piece of destroyed cartilage, partially smooth out irregularities in the cartilage tissue, etc.
The treatment of osteoarthritis is usually done with medication, seeking first and foremost to alleviate pain, improve joint mobility and restore the ability to move.Arthrosis causes irreversible changes in cartilaginous tissue - therefore it is impossible to talk about a complete cure.But it is possible to stop the progression of the disease – and thus further delay tissue destruction.
This is what standard treatment for gonarthrosis looks like:
- local remedies - patches, creams, ointments and gels;
- analgesics;
- anti-inflammatory medications, especially non-steroidal ones.Their use is considered the “gold standard” of medicine, but such medications destroy the gastric mucosa;
- blockades and chondroprotectors - medicines whose effect only appears after a long period of use;
- rarely - physiotherapy and sanatorium treatment.
There are recommendations for using orthopedic knee braces to support the joint and reduce pain.But all the methods listed above are methods of passive influence on the functioning of the joint.
This treatment only alleviates some symptoms - neutralizes pain, inhibits inflammatory processes, etc.The disease itself continues to progress, gradually destroying the joint.In the final stages of osteoarthritis, a person loses not only the ability to work, but also the ability to move.In these cases, the joint must be prostheticized – that is, an artificial structure must be inserted into the knee.This surgical intervention does not go unnoticed and imposes its own limitations - and therefore reduces quality of life.
Methods of active influence on the joint have a completely different effect, when, using the body's own resources, the tone of the muscles that supply blood and nutrients to the joint is restored.This treatment is most effective if carried out under the supervision of qualified and experienced doctors.
Treatment of gonarthrosis with kinesiotherapy
Kinesiotherapy, that is, movement therapy, activates the body's own strengths.Correctly selected load allows you to effectively work out the necessary muscles and, by strengthening the muscular corset, improve the condition of the joints and cartilage.
Kinesiotherapy treatment begins with a thorough examination and, necessarily, with myofascial tests.A kinesitherapist examines the condition of a sore knee, analyzes the condition of muscle tissue, tendons and ligaments.Taking into account data from ultrasound, computed tomography, magnetic resonance imaging and radiography, the degree of gonarthrosis is determined and a therapeutic exercise program is drawn up.
Classes are held on a multifunctional simulator - a proprietary simulator with a special design.The exercises are performed in such a way as to avoid excessive stress on the joint and only work those muscles that need to be strengthened and developed.In the initial stages, patients are prescribed floor joint gymnastics - it consists of exercises on an exercise mat without weights.
The therapeutic effect of kinesiotherapy is guaranteed by the restoration of blood microcirculation and improvement of lymphatic drainage.The cartilage receives more nutrition, the development of osteoarthritis slows down until it stops completely and the biomechanics of the articular joint are completely restored.
Such a serious disease as arthrosis of the knee joints cannot be ignored.The best way to prevent it is to lead a healthy lifestyle: balanced diet, physical activity.But if joint problems have already begun, you should not wait for serious warning signs - at the first symptoms you should seek help from qualified doctors.