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.With osteoarthritis, the cartilage lining the joint surface is irreversibly affected, leading to joint dysfunction and pain.
Officially, the disease is called “osteoarthritis deformans”;another name is gonarthrosis (from the ancient Greek “goni” – knee).The knee joints are the largest joints in the human body and are the most commonly affected by osteoarthritis.Much less commonly, the disease affects the hip and ankle joints.
How does knee osteoarthritis occur?
Normally, healthy cartilage is elastic and smooth, it completely covers the moving areas of the bone and allows them to slide.Cartilage also alleviates the stress bones experience when walking or exercising.
When cartilage is destroyed (this is how osteoarthritis manifests itself), the upper layer of this elastic tissue becomes thin.Sometimes the cartilage delaminates, tears appear - this is how the joint loses its main “shock absorber” and “bearing”.The bones begin to rub against each other, the joint swells, gradually losing its normal appearance, and pain appears.
Causes of knee osteoarthritis 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 intense physical work or excessive stress in the gym.
Here is a far from complete list of causes of osteoarthritis 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 labor associated with heavy lifting;
- uneven load on the joints due to curvature of the legs - osteoarthritis manifests itself more quickly in overloaded areas.
Much depends on genes - a person may have a hereditary predisposition to osteoarthritis of the knee joints.In these people, the gene responsible for the development and stability of cartilage tissue is disrupted.
Several factors increase the risk of knee osteoarthritis:
- increased body weight.Due to the increasing 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 properly supply joints, and the risk of cartilage damage increases.
Symptoms of osteoarthritis
Knee osteoarthritis is not a disease that can appear suddenly.This becomes known well in advance: it all starts with a slight pain in the knee when walking.The pain may increase if you have to go up or down stairs.As a rule, the knee hurts at the beginning of movement, then the pain disappears and returns with prolonged load on the joint.
If you ignore these symptoms and do not consult a doctor, the disease will begin to progress.Then the pain will go from temporary to continuous, the knee will begin to hurt even 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 “responds” to weather changes.This actually happens: the nerve endings in the joint capsule are sensitive to changes in atmospheric pressure.
The following symptoms are characteristic of knee osteoarthritis:
- knee pain when moving and walking;
- morning stiffness in the knee joint, when the range of motion is minimal;
- knee swelling;
- dry, rough cracking sound when moving - this sound is caused by friction of the joint surfaces.
As the disease progresses, the symptoms will change:
- the pain will bother you even when resting;
- the joint becomes deformed and loses its functions;
- Due to the knee deformity, the gait will change.
Degrees of knee osteoarthritis
There are 3 stages of development of osteoarthritis of the knee joint.
1st degreedisease - almost asymptomatic.It begins at the first manifestations of the disease - almost painless, for example fatigue 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 stage 1.
2nd degreecharacterized by progressive changes in bone tissue.Outwardly, the knee may look the same as in stage 1: deformed and enlarged.The pain increases: in addition to the incoming pain that occurs during movement, crepitus (crunching) in the affected knee is added.The joint becomes less mobile, it becomes difficult to squat and walk on uneven surfaces.
3rd degreethe degree of knee osteoarthritis is the most painful.At this stage, there is almost no cartilage tissue left and if the disease is severe, the bones may clump together.The joint then becomes completely immobilized and the person must only move with the help of a crutch or a stick.Usually, at this stage, doctors decide on endoprostheses of the damaged joint.
Important: only a doctor can determine the exact degree of progression of the disease.Sometimes, with mild symptoms, the disease seriously affects the cartilage membrane.Therefore, for an accurate diagnosis, additional studies are usually carried out:
- x-ray - to see if the cartilaginous surfaces are deformed and what condition the joint space is in;
- CT or MRI - for more detailed studies.
How is knee osteoarthritis 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 make a diagnosis of 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:
- x-ray.If pathological processes have begun in the knee - for example, calcium crystal deposits or bone tumors have appeared in the joint capsule - these changes will be visible in the images.Doctors most often prescribe x-ray examinations, but without a thorough examination of the knee joint, its mobility and the condition of the muscles supporting it, the picture is incomplete;
- Ultrasound – this can be used to assess the condition of the soft tissues surrounding and lining the joint.Ultrasound complements the results of the x-ray 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 during which the joint cavity is examined from the inside using a camera.The cameras are inserted through small incisions in the skin;through these same incisions, doctors can carry out minor manipulations - for example, remove a piece of destroyed cartilage, partially smooth out irregularities in cartilage tissue, etc.
Treatment of osteoarthritis is usually carried out with medications, first trying to relieve pain, improve joint mobility and restore movement ability.Osteoarthritis causes irreversible changes to the cartilage tissue.It is therefore impossible to speak of complete healing.But it is possible to stop the progression of the disease and thus slow down tissue destruction.
This is what the standard treatment for knee osteoarthritis looks like:
- local remedies - patches, creams, ointments and gels;
- pain relievers;
- anti-inflammatory drugs, especially non-steroidal drugs.Their use is considered the “gold standard” in medicine, but these drugs destroy the gastric mucosa;
- blockages and chondroprotectors - drugs whose effect appears only after prolonged use;
- rarely - physiotherapy and sanatorium treatment.
There are recommendations for wearing orthopedic knee braces to support the joint and reduce pain.But all of the methods listed above are methods of passive influence on the functioning of the joint.
This treatment relieves only certain symptoms - neutralizes pain, inhibits inflammatory processes, etc.The disease itself continues to progress, gradually destroying the joint.In the later stages of osteoarthritis, a person not only loses the ability to work, but also the ability to move.In such cases, the joint must be prosthetic, that is, an artificial structure must be inserted into the knee.Such surgery does not pass without a trace and imposes its own limitations - and therefore reduces the 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 the joint with blood and nutrients is restored.Such treatment is most effective if carried out under the supervision of qualified and experienced doctors.
Treatment of knee osteoarthritis by physiotherapy
Physiotherapy, that is to say movement therapy, activates the body's own forces.A correctly selected load allows you to effectively work with the necessary muscles and, by strengthening the muscle corset, improve the condition of joints and cartilage.
Physiotherapy treatment begins with a thorough examination and, necessarily, a myofascial test.A physiotherapist examines the condition of a painful knee, analyzes the condition of muscle tissue, tendons and ligaments.Taking into account data from ultrasound, CT, MRI and X-ray, the degree of gonarthrosis is determined and a therapeutic exercise program is drawn up.
Classes are conducted 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 to work only on the muscles that need to be strengthened and developed.In the early stages, patients are prescribed joint gymnastics on the floor - it consists of exercises on a mat without weights.
The therapeutic effect of physiotherapy is ensured by the restoration of blood microcirculation and improvement of lymphatic drainage.The cartilage receives more nutrition, the development of osteoarthritis slows down to a complete stop, and the biomechanics of the articular joint are fully restored.
Such a serious disease as osteoarthritis 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.