Osteoarthritis of the knee joint, also called gonarthrosis, can significantly impair a person's quality of life. During the development of the disease there is a gradual loss of hyaline cartilage in the joint. Gradually the cartilage loses its density and height. Its entertainment and thinning is noted and over time it completely disappears. Accordingly, there is no soft protective pad in the bone and this leads to an increased load on the end plate of the innervated articular surface of the bone. As a result of this load, pain develops. The code for osteoarthritis of the knee joint according to ICD-10 is M17.
The knee joint is affected quite often, as it is the knee that has a significant load during walking, physical exertion and running. In this case, awkward movements can injure the soft tissues of the knee and cause osteoarthritis. That is why gonarthrosis is one of the main causes of damage. According to statistics, this disease affects about 20% of people on the planet to varying degrees.
Why does osteoarthritis develop, how to prevent the development of this disease, which doctor treats osteoarthritis of the knee and what methods of treatment can be recommended by the doctor after diagnosis will be discussed in this article.
Pathogenesis
The disease develops against the background of a mismatch between the load on the joint and its ability to withstand it. In this case, the properties of cartilage can be determined by genetics or change due to the influence of acquired factors - both exogenous and endogenous. The development and progression of gonarthrosis can occur with age, against the background of obesity, due to dysplasia of the femoral-patellar joint or changes in the axis of the lower limb, disorders of joint biomechanics, damage to the menisci and ligaments.
The basis of the pathogenesis is the predominance of catabolic over anabolic processes, which is observed in cartilage and subchondral bones, menisci and synovium. As a result, structural changes occur and the biological properties of cartilage are lost. In addition, the pathological process spreads to the muscles and ligaments.
The basis of articular cartilage is the connective tissue matrix and chondrocytes. The connective tissue matrix contains collagen and aggregate type II molecules. The emollient properties of cartilage are provided precisely by the connective tissue matrix.
The inflammatory process in osteoarthritis is not as intense as in arthritis. However, pro-inflammatory mediators are also present in osteoarthritis.
Classification
According to the origin of gonarthrosis, the following types are distinguished:
- Primary (idiopathic)- develops without the influence of any external causes.
- Secondary- certain factors lead to the development of the disease. Most often they are associated with injuries, fractures, joint surgery, as well as inflammatory factors - acute and chronic arthritis.
The following degrees of knee osteoarthritis are also determined:
- Arthrosis of the 1st degree- is determined in the period from the appearance of the first signs of the disease to the development of bone deformities, visible on X-rays or on examination. During this period, pain of varying intensity occurs during movement.
- In grade 2- unpleasant sensations are observed even at the slightest load. When walking and squatting the knee crunches, the mobility of the joint decreases. The picture shows the growth of bone tissue at the edges of the joint, as well as the narrowing of the joint space. On external examination, it may be noted that the knee is enlarged.
- In grade 3there is virtually no cartilage inside the joint. If the disease progresses, the bones can grow together, which provokes complete immobilization of the legs. Sleep is disturbed, it becomes impossible to move without a stick or crutch.
The following types of this disease are also distinguished:
- Patelofemoral osteoarthritis of the knee joint- a condition in which degenerative changes are observed in the back of the patella, ie the patella. In this form of the disease, the pain is disturbed mainly when descending a ladder or from a mountain. Patelofemoral osteoarthritis can develop in runners. The disease is often diagnosed in young people.
- Post-traumatic osteoarthritis of the knee joint- consequence of the injury. The post-traumatic type of disease may not appear at first. But later a person loses full motor activity of the joint.
Causes of osteoarthritis of the knee joint
We are currently working to study the causes leading to the development of such pathology.
Currently, the causes of gonarthrosis are related to the influence of the following factors:
- Age - at a certain age in a person degenerative changes in the tissues begin and the ability of cartilage tissue to regenerate decreases.
- Arthritis - Over time, arthritis can lead to the development of osteoarthritis.
- Past injuries and overloads - in addition to injuries received, the development of the disease can provoke the need to often kneel, squat, lift weights.
- Obesity and overweight - due to being overweight there is an increased load on the joints of the legs. In addition, substances that cause damage to the joint get into the blood from the pathological adipose tissue, and later into the joint.
- Heredity - in some cases the development of the disease is determined by a defective gene responsible for the growth of cartilage tissue. As a result, this tissue may have low resistance to damage. If close relatives have had osteoarthritis, this increases the likelihood of it.
- Diseases leading to metabolic disorders - the risk of this pathology increases with atherosclerosis, diabetes mellitus.
- Hormonal disorders - women are more likely to get sick after 55 years.
- Sports - People who play certain sports are more likely to develop this disease. This is typical for runners, as well as football players, tennis players, basketball players.
Symptoms of knee osteoarthritis
As a rule, the symptoms of osteoarthritis of the knee joint increase slowly, as the process of its development lasts for years. If multiple joints are affected, symptoms of polyarthritis develop.
The manifestation of the disease depends on its severity, age and a number of other factors.
However, the main symptoms of gonarthrosis are as follows:
- Pain in the knee joint, aggravated by activity. During rest, the knee hurts less.
- Swelling in the knee area.
- Feeling of warmth in the joint.
- Unpleasant sensations of joint stiffness that occur after a person is in a static position for a long time.
- Reduced range of motion of the knee joint, which makes it difficult for a person to get out of a chair, get down the stairs or get out of a car.
- Crunching and cracking in the knee, most often seen in sudden movements of the joints.
- It is believed that changes over time affect the degree of pain and discomfort.
Analyzes and diagnostics
To determine if such a disease can be cured, the diagnosis must first be confirmed. In the process of diagnosis, the doctor examines and interviews the patient. But the most informative test in this case is an X-ray of the knee.
It is also recommended to undergo an ultrasound scan to clarify the diagnosis, during which the arthritis can be ruled out and the height of the articular cartilage measured.
If necessary, schedule additional tests.
Treatment of knee osteoarthritis
In order for the treatment of this disease to be as effective as possible, it is first necessary to confirm the diagnosis and choose the right regimen of complex therapy. Treatment of osteoarthritis of the knee at home is possible if the patient carefully adheres to all the recommendations of a specialist practicing both drugs and additional methods of treatment. Only in this case, home therapy can be effective.
Drug treatment and other methods are used to treat this disease depending on the degree of damage. The simplest treatment is osteoarthritis of the knee of the 1st degree. In the case of first-degree disease, a complex regimen of therapy is used, which allows you to get the effect in the shortest possible time. Therefore, if a person is diagnosed with grade 1 osteoarthritis, the disease should be treated immediately.
Regarding how to treat 2nd degree knee osteoarthritis, the doctor makes a decision based on the patient's condition. As cartilage changes begin at this stage, treatment should be performed immediately.
Whether it is possible to cure grade 3 knee osteoarthritis depends on many factors. In grade 3, the cartilage thins, so treatment at this stage is prolonged and least effective.
Medicines
Medical treatment of osteoarthritis of the knee is aimed at providing analgesic and anti-inflammatory effect. It is also important to reduce the severity of cartilage destruction.
The following drugs are used for this purpose:
- Non-steroidal anti-inflammatory drugs - both tablets and topical drugs are used - ointments, gels. The most effective local and systemic application of such funds.
- Chondroprotectors for osteoarthritis of the knee - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfates and others are used. Such drugs for osteoarthritis of the knee are prescribed as part of a comprehensive treatment. The cost of chondroprotectors depends on the drug and varies considerably.
- In severe illness, medications include steroids. Both injections for osteoarthritis of the knee can be given intramuscularly and external steroids can be used.
- External agents with skin irritants. In the description of folk remedies you can also find annoying compresses.
- During treatment, your doctor may prescribe injections into your knee. Various drugs can be used for injections in the knee joint in osteoarthritis. In particular, corticosteroids are injected to relieve severe inflammation. Injection reviews show that it is in this form that steroids work most quickly and effectively. Knee blockage can be performed not only with glucocorticosteroids but also with anesthetics. Examinations of the blockade show that this method effectively relieves even severe pain. Also, an injection in the knee can be performed during treatment with chondroprotectors. Improves metabolic processes, activates collagen production. But to get the effect, it is necessary to make at least five injections. Also, hyaluronic acid is injected intra-articularly, which improves the quality of intra-articular fluid and provides effective protection of cartilage tissue. Vitamins can also be administered intra-articularly.
- Plasmolifting method - its essence consists in the introduction of platelet-rich blood plasma into the affected knee.
- Medical bile for osteoarthritis of the knee - used for compresses. It should be noted that medical bile can be an effective remedy only if its use is prescribed by a doctor according to a certain scheme. Therefore, the option of "treating at home" without consulting a doctor is unacceptable in this case.
Procedures and Operations
Non-drug methods of treatment are also used for arthrosis and polyarthritis, the use of which is no less effective.
Physiotherapy. Various techniques are used, including the method of shock wave therapy, myostimulation, phonophoresis, ozone therapy, kinesitherapy and others. Physiotherapy can reduce pain, relieve inflammation. Any physiotherapy prescribed by a doctor should be performed exactly in the complex that the doctor has advised.
Laser therapy- produces decongestant, analgesic, anti-inflammatory effects.
Ozone therapy- relieves pain, produces anti-inflammatory effect, which makes it possible to reduce the amount of hormonal agents used.
Knee pads for osteoarthritis of the knee- wearing such devices reduces the severity of pain. In addition, the knee brace protects it from instability. But to achieve the desired effect, it is necessary to choose the right knee pads or knee pads. There are many general tips on how to choose knee pads for osteoarthritis of the knee. In addition, many different models of such knee pads are available - with motion limiters, amplifiers and the like. However, those who want to buy knee pads for osteoarthritis, it is advisable to rely not on user reviews, but on the doctor's recommendations. The price of the orthopedic knee pad depends on different characteristics - material, quality. Knee pads are especially suitable if the patient develops post-traumatic osteoarthritis. But patellofemoral osteoarthritis, as well as other types of disease, can be treated with this method.
Therapeutic gymnastics for osteoarthritis of the kneeis an effective method that allows you to improve the condition and prevent surgery, provided that the person regularly and persistently performs exercises for osteoarthritis of the knee joint. Physiotherapy exercises help to strengthen the muscles of the legs and to stop the development of the pathological process. However, a set of exercises for osteoarthritis of the knee joint must be performed in a certain sequence and such gymnastics is chosen individually. Therefore, it is best that the basis for the classes is not a video of gymnastics, but a set of exercises developed by a doctor. In this case, it is important not only the charge, but the full exercise therapy.
In such pathology, different types of exercises can be practiced.
Special gymnastics.Such exercises are recommended both during treatment and for people over 40 for prevention. Knee exercises should be done every day. These exercises are also suitable for older people, as they can be done at a leisurely pace.
Massage and manual therapy- suitable for patients with limited mobility, can be combined with exercise therapy. If it is not possible to visit a masseur, a self-massage can be performed according to the scheme that the specialist will demonstrate.
Yoga, acupuncture, joint stretching, special exercises on simulators (bicycle ergometer, etc. ) can be practiced as additional methods for improving the patient's condition and active rehabilitation.
If conservative methods prove ineffective, surgical treatment is practiced.
The following techniques can be used:
- Puncture- Removing excess fluid in the joint can reduce the symptoms of inflammation and restore mobility.
- Arthroscopy- can be performed using endoscopy. Using this technique, the joint surfaces are cleaned of fragments of destroyed cartilage tissue.
- Periarticular osteotomy- during such an intervention, one of the bones forming the knee joint is excised and fixed again at a different angle. As a result, the severity of the pain decreases and the mobility of the knee increases. The intervention is effective in the first and second degree of the disease.
- Endoprosthesis- replacement of the knee joint with a special biocompatible construction. This is a very complex intervention that is performed with the third degree of the disease.
Treatment of osteoarthritis of the knee with folk remedies
Numerous reviews of folk remedies for the treatment of this disease confirm that such methods can be used as an adjunct, facilitating the patient's condition. However, such methods should not replace basic treatment. Folk remedies are used for rubbing, compresses, baths, ingestion. Each thematic forum contains a lot of advice on this subject.- Rub with garlic. A few cloves of garlic should be peeled and chopped. Mix the resulting slurry with 200 ml of vegetable oil and insist in a dark place for a week. Apply on the knee overnight with a film and a warm towel on top.
- Mustard grind. To prepare the drug, take 50 g of camphor and mustard powder, 500 ml of vodka, the protein of one egg. All mixed and stored in a jar in a dark place for a week. The product should then be rubbed into the knee three times a day.
- Elecampane Grind. Pour 50 g of elecampane root with 125 ml of vodka and leave for two weeks. Rub twice a day.
- Burdock compresses. Burdock is a popular folk remedy for the treatment of osteoarthritis. A few burdock leaves should be folded with the fleecy side and smeared with vegetable oil. Attach them to the knee and cover with cellophane and a warm towel on top. Also, burdock leaves can be smeared with vodka. The compress is applied at night. Horseradish leaf treatment is performed in the same way.
- Cabbage Leaf. It is also applied to the sore spot at night. Pre-lubricated with honey, cologne or vodka.
- Honey compress. It is necessary to mix equal parts copper, ammonia (10%), glycerin and medical bile, add a few drops of iodine. Leave the finished product in a dark place for 10 days. Heat before applying the compress.
- Onion decoction. Accepted internally. To prepare the broth, you need to take two large onions, cut them and pour 1 liter of water. Cook until the onion is soft. Take a decoction of 100 ml three times a day.
- Celery juice. Grind celery stalks in a blender, squeeze the juice. Drink 100 ml of juice three times a day.
- Gelatin. In osteoarthritis, it is recommended to eat foods that contain gelatin. Jelly, jelly and other gelatin dishes are recommended to be included in the menu.
- Bath with pine needles. Pour boiling water 1 kg of pine needles and leave for several hours. Add to a warm bath in which you can also dissolve 0, 5 kg of salt. Take a bath for 20-30 minutes.
Prevention
To prevent the development of osteoarthritis of the knee joint, the following preventive measures must be observed:
- Eat right and include a variety of foods containing vitamins and minerals.
- Avoid overloading the knee joint, protect it from injury.
- Stop bad habits.
- Monitor weight, prevent obesity.
- Treat all diseases in time, undergo preventive examinations.
- Do sports with a preference for gentle physical activity.
- Wear high quality shoes that are as comfortable as possible.
- Ensure proper posture.
Diet for osteoarthritis of the knee joints
- Efficacy: healing effect
- Conditions: permanent
In the process of treatment and rehabilitation, diet is quite important. First of all, food should be healthy and light - it is important to prevent overweight, which can worsen the condition and provoke acute osteoarthritis. But the acute course of the disease requires not only treatment but also weight loss.
It is also important to include in your diet foods that contain components important for cartilage tissue:
- Birds, rabbit.
- Sea fish.
- Soy products.
- Eggs.
- Greens, zucchini, carrots, pumpkin.
- Nuts.
- Fruits, fruits.
- Vegetable oils.
- Dishes with gelatin.
At the same time you should limit the consumption of such products:
- Beans, sorrel, spinach, tomatoes.
- Flour dishes.
- Animal fats.
- Spices, vinegar.
- Alcohol.
- Red meat
You should eat often, in small portions. You should also drink about 2 liters of fluid a day.
Consequences and complications
If treatment is not carried out in a timely manner, osteoarthritis can lead to the development of such complications:
- Inflammatory process of the surrounding tissues.
- Restriction of joint mobility.
- Change the shape of the joints.
- Degeneration of the hip joint.
Such complications can lead to the development of damage and irreversible changes.
Forecast
It is important to treat the disease in a timely manner. The most favorable prognosis will be if you start treatment in stages 1 or 2 of the disease.