What is osteoarthritis of the knee (knee): causes, symptoms and treatment of the disease

Osteoarthritis of the knee (gonarthrosis) is a degenerative lesion of the joint that eventually leads to its deformation. In it the cartilage tissue begins to collapse. Gradually, the functioning of the knee becomes impaired and the patient loses the ability to move normally. This disease is very common.

Treatment for knee osteoarthritis is long-term, but it cannot completely cure the problem. However, therapy is necessary in order to maintain the mobility and functionality of the joint for as long as possible and to improve the patient's quality of life.

Types of diseases

It is possible to classify osteoarthritis of the knee joint based on its development. It's primary and secondary. The first type of disease is the most common. It also has another name - idiopathic osteoarthritis. The exact cause of the development of this form of knee osteoarthritis is difficult to determine because there are too many influencing factors.

The secondary type of pathology is clearly associated with one reason or another. For example, it often occurs after a knee injury due to excessive physical stress on the knee joint. Such osteoarthritis of the knee is often genetic. Certain diseases can also cause dystrophic changes in the knee joint: diabetes mellitus, rheumatoid arthritis, congenital malformations of the lower extremities.

Why the pathology develops

The knee joint is one of the most complex joints in the human body. It is made up of the femur, tibia and patella. The articulation also includes triangular cartilage with curved edges - menisci. The well-coordinated work of the knee is ensured by the muscle-ligament apparatus. Almost all the bone surfaces of the joint are covered with cartilage tissue, the thickness of which is about 0. 5 cm, and feeds both on blood vessels and diffusely (extraction of useful substances from the synovial fluid).

The cartilage in the knee allows the bony surfaces to slide and cushion. When the nutrition of this tissue is disturbed, dystrophic processes begin in it, it becomes thinner. If left untreated, the cartilage disappears completely and the knee joint no longer moves. The reason for the development of osteoarthritis can be different. For example, the following factors can provoke the appearance of a secondary form of pathology:

• Excessive stress on the knee joint. In this case, changes can occur that the person is not even aware of. Therefore, the exposure should be moderate, especially in old age. The greatest damage occurs when crouching and walking on hard surfaces (asphalt).
• Knee injury. This can include damage to the meniscus, dislocation of the joint, fracture. This reason contributes to the development of the disease in young people. After the limb is fixed, the blood circulation deteriorates. Damage or removal of menisci leads to osteoarthritis in 90% of cases.
• Too much body weight. Being overweight can damage the menisci. Recovering the knee joint is lengthy and difficult. Bilateral osteoarthritis of the knee often occurs in obese people. Another negative point is the presence of varicose veins. In this case, the patient develops the most severe form of knee osteoarthritis.
• Ligamentous weakness. This leads to excessive joint mobility. Despite the fact that a person can easily sit on the cord even without warming up, at this point the joint suffers microtrauma. When the knee is damaged enough, osteoarthritis begins to develop.
• Violation of metabolic processes. In this case, the knee joint does not receive enough nutrients.
• Joint disease. The presented pathology can be provoked by arthritis of the knee joint (reactive, rheumatoid). It is characterized by the development of inflammation and the accumulation of too much fluid in the joint cavity. The cartilage tissue in the knee begins to deteriorate.
• Stressful situation. Mood swings and the constant presence of the nervous system in a state of tension can cause osteoarthritis of the knee joint.
• Congenital disorders of muscles, ligaments and dysplasias.
• Chondrocalcinosis (premature deposition of calcium salts in the knee cartilage). Pathology is systemic.
• Osteomyelitis. This is inflammation of the bone marrow that causes purulent masses to form. They have a negative effect on the surrounding tissue. Over time, purulent masses go beyond the bone of the knee joint. Inadequate treatment threatens the development of sepsis.
• Acromegaly. This is an endocrine disorder in which levels of growth hormone - growth hormone - increase. Most often, a benign tumor in the anterior lobe of the pituitary contributes to an increase in its amount. If such a disease develops in adolescence, then the child will develop a certain physique. The excessive rate of growth of cartilage tissue leads to deformation of the knee joint.
• Diabetes mellitus.
• Hypothyroidism. This disease is also endocrine. It occurs due to a lack of thyroid hormones. A person's mass begins to increase, he moves little, and the cartilage of the knee joint wears out.
• Frostbite. Ice crystals form in the soft tissues that kill living cells.
• Synovitis (inflammation localized in the synovial pocket of the joint).

All of these reasons can cause knee osteoarthritis of the knee without even realizing when the disease began to develop.

What stages does osteoarthritis go through in its development?

The effectiveness of knee treatment depends on the degree of development of the osteoarthritis diagnosed in the patient:

• First degree knee osteoarthritis. The pain at this stage is not felt much. The patient can endure discomfort for years while in no hurry to contact specialists or perform any treatment. A person needs help during an exacerbation. A sharp onset of pain is not typical of knee osteoarthritis.
• Arthrosis of the knee joint 2nd degree. The intensity of the complaints increases. Pain occurs not only in the knee joint after physical exertion, but also at rest. To get rid of unpleasant sensations, you need to rest more. Swelling occurs in the area of the knee joint, the patient hears a crunch. The x-ray shows a narrowing of the joint space, a slight deformation of the knee joint.
• Arthrosis of the knee joint 3rd degree. In this case, knee mobility is severely restricted and sometimes the leg cannot be fully extended. Joint pain becomes severe and constant and occurs in response to changing weather conditions. The discomfort is inherently painful and difficult to get rid of even at rest. Often times, the patient's sleep is disturbed, and to alleviate his condition at least a little, he uses NSAIDs. A person develops lameness, and the deformity of the joint is very noticeable.

Treatment for osteoarthritis should be started as early as possible before bone tissue destruction becomes critical. In the case of irreversible changes, only surgery can help the patient.

Knee osteoarthritis symptoms

Osteoarthritis does not develop overnight. As it progresses, the symptoms become more intense. The following manifestations are characteristic of osteoarthritis of the knee:

• The crunch and click that can be heard with a certain movement. The patient may notice this symptom quite late. However, he says the articular surfaces are damaged, grooves and bone growths have appeared.
• Swelling and enlargement of the knee.
• Painful sensations. In the first stage of osteoarthritis development, they are invisible and can only appear after a strong static load on the knee joint. Dynamic training, in turn, improves the condition of the joint, its nutrition and the subsequent prognosis. Since the topmost layer of cartilage is erased in osteoarthritis, the nerve endings are exposed. After a while (after rest) the fibers are covered with a small layer of fibrin and become less sensitive - the pain in the knee goes away. If the knee joint continues to collapse, the discomfort doesn't even leave the person alone. Edema occurs in the bursa, which compresses the nerves even more. The inflammatory process begins.
• Limited mobility. This symptom allows you to distinguish osteoarthritis from other pathologies of the knee joint. Stiffness occurs in the morning after sleeping and disappears after half an hour. If this condition lasts longer, it indicates an inflammatory process.
• Reduced range of motion. The patient is unable to straighten the limb to the end. Since the patient is constantly in pain, he tries to reduce the range of motion, and the ligaments adapt to it. That is, they are shortened and do not allow the knee joint to fully perform its function.
• Common pinching. It arises from a strong change in the joint surfaces.
• Dislocations and subluxations. They occur in the last stage of the development of osteoarthritis, when the joint is severely deformed.

Over time, a person experiences muscle atrophy, proliferation of osteophytes, and weakening of the lateral ligaments. The consequences of osteoarthritis are severe as a person becomes disabled.

How do you properly define osteoarthritis?

To begin proper treatment for osteoarthritis, the patient must undergo a thorough examination. The diagnosis should be differentiated and include the following studies:

1. X-ray of the knee joint. With osteoarthritis of the knee, it is carried out in two projections. The specialist will need an x-ray of both the damaged and healthy knee. Radiography can reveal the following signs of osteoarthritis: narrowing of the joint space, osteophytes, subchondral sclerosis. The presented study of the knee joint also shows subluxations, ossification sites of the cartilage tissue.
2. Arthroscopy. This is a minimally invasive procedure that is used not only to diagnose osteoarthritis, but also to treat it. It foresees the use of a special LED conductor with a camera on the end. It is inserted through a small opening on the side of the knee. The entire picture of the internal state of the joint is displayed on the monitor. However, the procedure has a disadvantage: the joint is depressurized and pathogenic microorganisms can penetrate.

3. Ultrasonic. This diagnostic method is completely safe. The procedure helps examine the soft tissues of the knee, as well as cartilage, synovium, and blood vessels.
4. CT. This is an X-ray examination method, but it allows you to see not only bone structures, but also soft tissues. Thanks to the computer equipment, the specialist can create a three-dimensional model of the knee. However, in order to get accurate information, the patient must receive a significant dose of radiation.
5. Scintigraphy. This is an X-ray examination with contrast agent
6. MRI. In this case, magnetic beams are used to obtain information. The picture shows soft tissues more clearly.

7. Thermography. The procedure is based on the registration of the heat radiation from the body surface of the patient. So you can identify tumors, foci of inflammation. A study is assigned based on differential diagnosis.
8. General blood analysis. It helps determine the severity of the inflammation, determine its type.
9. General urine test. Thanks to him, it is possible to determine the systemic nature of the pathology.
10. Blood chemistry.

Thanks to these diagnostic measures, specialists can accurately determine knee osteoarthritis and prescribe really effective treatment.

Knee osteoarthritis treatment

The treatment of osteoarthritis must be versatile and long-term. Since the destruction of the joint cannot be completely stopped, therapy must be carried out continuously in order to improve the patient's quality of life.

Medicines used to treat osteoarthritis

The doctor can prescribe the following drugs:

• Non-hormonal anti-inflammatory drugs. They are used in the form of tablets and ointments. However, with a severe pain syndrome that cannot be eliminated using standard methods, injection is used. It helps relieve pain quickly, relieve swelling, and reduce the intensity of inflammation. These remedies can only eliminate the symptom, but not cure the osteoarthritis. Only a doctor should prescribe these funds. The course of treatment lasts no more than 14 days, and relief occurs as early as 2-3 days.
• Chondroprotectors for osteoarthritis of the knee joint. Each of these medicines contain beneficial substances that can regenerate cartilage. However, it will only take effect if its application is started in a timely manner. When the cartilage is completely erased, the use of chondroprotectors is useless. Treatment with such agents is long-term (at least 6 months). Pills and topical medications are most commonly used, although injections are possible.
• Vasodilators. They help relieve spasm and pain syndrome, restore normal blood circulation, and improve nutrition to the knee joint.
• Glucocorticosteroids. Most often they are used in the most difficult cases, when other drugs do not have a beneficial effect. For osteoarthritis, intra-articular injections are used in the knee joint. They can only be used once a year.
• Enzymes. They ensure the regeneration of the cartilage structure in the initial stages of knee osteoarthritis. They are also prescribed for injection into the joint.
• Hyaluronic acid. It ensures smooth movement of the knee joint as it is able to replace synovial fluid.
• Local preparations - ointments, creams, gels. They also only alleviate the symptoms.
• Medication compresses. In this case, a drug is used that can penetrate the skin, eliminate muscle clamps and have an absorbent effect. The compress can be done with medical bile.

Drug therapy in the treatment of osteoarthritis is indispensable. However, drugs must be used strictly in the dosage prescribed by the doctor. It is impossible to independently increase or decrease the tariff, change the daily rate without the knowledge of a specialist.

Features of physiotherapy treatment and exercise therapy

You can also treat osteoarthritis of the knee joint with physiotherapeutic procedures:

• Massage. It helps restore normal blood flow to tissues and relieve muscle spasms.
• Electrophoresis with drugs allows you to get rid of inflammation in the joint, and also has an analgesic effect.
• Magnetic Therapy. Targeted radiation stimulates the tissue around the affected right or left joint. Metabolic processes in cells are improved.
• UHF. The waves encourage the production of synovial fluid that lubricates the knee.
• Phonophoresis with corticosteroids.
• Electrotherapy not only helps to remove pain, but also to remove swelling.

• Mud therapy.
• Hirudotherapy.
• Shock wave therapy.
• Heat treatment. This also includes paraffin therapy. Thanks to this procedure, local blood circulation is improved.
• SMV therapy. This physiotherapy stimulates blood circulation, relieves swelling and helps to improve the nutrition of the cartilage tissue.

Physiotherapy is very useful. It is necessary to restore the elasticity of muscle tissue and ligaments and improve the mobility of the knee joint. The following exercises will be useful:

1. Lying on your stomach, you need to take turns lifting your legs. In this case, they should not be bent at the knee. The lifting height is approx. 20 cm.
2. Lying on your left side, you need to bend your left leg and raise it 30 degrees. It is necessary to hold the limb in this position for up to 30 seconds. The same exercise should be done with the right leg.
3. Sitting in a chair, legs should be stretched and, one at a time, raised as high as possible.

The practice set is selected individually by the attending physician. Gymnastics is best done after a small massage with medicinal ointments. Physiotherapy is an effective additional method of treating osteoarthritis that increases the effects of medication.

Do you need an operation?

In the most difficult cases, when the joint is severely damaged by osteoarthritis, the patient is prescribed an operation. There are different types of interventions:

1. Articulation traction. The joint damaged by osteoarthritis is stretched in order to enlarge the cartilage gap. This can prevent further tissue destruction and its gradual recovery.
2. Endoprosthetics are the complete replacement of a joint that has been destroyed by osteoarthritis. It is done as a last resort. The exchange can take place in whole or in part. The prosthesis must be changed in 10-15 years.
3. Osteotomy. Such treatment of osteoarthritis makes it possible to mechanically correct the deviations of severely deformed bones. In this case, solid elements break at a precisely defined point. Next, the bones are properly positioned and fused.
4. Arthroscopy. With its help, the restoration of the cartilage surface destroyed by osteoarthritis is carried out. In addition, foreign bodies and bone fragments can be removed from the joint using an arthroscope. Such an operation is used for the hypermobility of the joint. Arthroscopy is considered a less traumatic procedure, so rehabilitation does not take long afterwards.

It is better not to bring it to surgery. Treatment should be started at the first stage of osteoarthritis development. Orthopedic devices help to consolidate the result: a walking stick, an orthosis for relief, knee orthoses with infrared radiation.

The use of folk remedies

It is impossible to completely cure osteoarthritis as the degenerative process gradually progresses. However, you can get rid of the symptoms and stop the destruction of the knee joint in osteoarthritis. Folk remedies can be used both during an exacerbation and during relative rest. But first you need professional advice. The following recipes will be useful for osteoarthritis:

1. Chopped horseradish root should be cooked in a little water over low heat. After that, the pulp must be filtered and placed around the knee affected by osteoarthritis. The compress must be fixed with a bandage. You need to do the procedure every day for a month. The compress improves blood circulation and tissue repair.
2. Rubbing vegetable oil on the knee joint area in osteoarthritis will help relieve pain. However, it has to be warmed up a bit.
3. The mummy makes for a good effect. It is necessary to mix 3-4 g of raw materials with 100 g of honey and mix everything thoroughly. You must rub the medicine into the sore area in the evening before going to bed. Then wrap the affected area with a warm scarf. The reception of the mummy inside is also welcome. You can use it at 0. 2 g per day.
4. Fresh dandelion flowers can be washed thoroughly and consumed 5-6 pieces a day. Also dry raw materials in the amount of 1 tbsp. You should pour a glass of boiling water, insist and drink 1/3 cup three times a day.
5. Grate aloe leaves. It is necessary to twist 10 leaves of the plant and push them through a cheesecloth. The juice is mixed with half a glass of honey and 150 ml of red wine. The resulting product is poured into a dark glass container and applied daily for a month.

Cabbage and burdock leaves help reduce inflammation in osteoarthritis. Folk remedies cannot be considered a panacea, but they increase the effectiveness of other types of therapy.

Dietary rules for osteoarthritis

The treatment of osteoarthritis does not require a particularly strict diet, but you still have to observe some nutritional rules:

• Reduce your salt intake. The total amount per day should not exceed 2 g. It is better to salt the dish just before use, and not while it is cooking.
• The amount of spices used during treatment for osteoarthritis should also be reduced. The same goes for fermented foods, pickles. Marinades and canned foods are generally better to exclude from the diet.
• Animal fats are not recommended.
• The menu should not include sweets, pastries and bread made from wheat flour.

• With osteoarthritis, alcohol and nicotine are strictly forbidden.
• Dishes with gelatin content are useful: aspic, jellied meat, beef bone broth.
• With osteoarthritis, it is important to consume milk protein (products should not be fatty), fish, seafood.
• The diet should include vegetable oils, vegetables and fruits, and freshly squeezed juices.
• A person should drink a sufficient amount of fluids each day.

Proper nutrition for osteoarthritis should be developed by a specialist. You cannot go to extremes even if the patient is overweight. Dramatic and improper weight loss will only worsen your health. In this case, the treatment is significantly delayed.

Osteoarthritis prevention

To avoid the possibility of osteoarthritis and not lose the ability to walk, you need to follow the following expert advice:

• We must not forget the movement. Go to the swimming pool, ride a bike, go hiking in the fresh air. You can also go dancing.
• It is advisable to avoid lesions and hypothermia of the knee joint, as this provokes post-traumatic osteoarthritis.
• With prolonged exertion, it is better to use knee pads or other orthopedic aids.
• It is advisable to wear comfortable shoes.

• It is important to eat properly - osteoarthritis has no chance if the joint is regularly supplied with all the necessary nutrients.
• If you are overweight, get rid of it.
• It is better to avoid stress, as well as properly organize the work and rest routine.
• It is necessary to strengthen the body's defenses.
• All inflammatory or infectious pathologies that can provoke the development of osteoarthritis should be eliminated in a timely manner.

Proper prevention can significantly delay joint destruction, which under normal conditions is a natural aging process in the body.

Knee osteoarthritis is an incurable disease, but its progression can be slowed down and even stopped by improving the quality of life.