Arthrosis of the knee joint is a degenerative-dystrophic pathology that leads to deformation and destruction of articular cartilage. Gradually, the limb loses its mobility. According to statistics, almost every third inhabitant of the planet suffers from arthrosis, and this number is not decreasing. Older people are at risk, especially those who are overweight. After the age of 65, osteoarthritis is diagnosed in 70-85% of cases of knee pain treatment.
A rheumatologist helps preserve the quality of life of a patient with joint pathology.
Causes of osteoarthritis
- Destruction of the joint due to natural wear and tear (aging of the body).
- Hormonal disorders (menopause, endocrine diseases).
- Congenital malformations of the musculoskeletal system.
- Injuries, surgical operations on the knee joint.
- Professional sports.
- Monotonous physical labor with increased stress on the knee joints.
- Overweight.
- genetic predisposition.
- Autoimmune diseases.
Disease symptoms
Deforming arthrosis of the knee joint (gonarthrosis) develops slowly and progresses into a chronic form. In the early stages, the disease does not cause pain: a person feels only discomfort, stiffness in the lower limb. Gradually, the motor restrictions increase. Without adequate treatment, the knee is noticeably deformed. Motor functions are so disturbed that it is difficult for a person to walk, sit down, get up. The deforming osteoarthritis evolves towards the invalidity of the patient. To save the joint, it is necessary to consult a doctor as soon as the first symptoms of pathology appear.
Depending on the severity, there are three degrees of osteoarthritis of the knee joint:
- 1 degree. The clinical manifestations of the disease are mild. Most patients ignore the symptoms and continue to lead normal lives. With arthrosis of the 1st degree, a person may feel discomfort in the knee after a long standing, intensive walking, physical exertion. X-ray image shows joint space narrowing, osteophytes growing inside the joint are visible. If arthrosis is accidentally detected at the first stage, for example, during a medical examination, its development can be significantly slowed down and even stopped.
- 2 degrees. The pain in osteoarthritis of the knee becomes intense, it is difficult to ignore it. Especially strongly the leg bothers early in the morning or in the evening. During the day at rest, the pain persists. Degenerative processes in the joint are reflected in the gait: a person begins to limp. During the movement, a crack is heard in the knee. Arthrosis of the 2nd degree can be complicated by "joint mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity. The foreign body causes intense pain that interferes with the movement of the limb. On examination, the knee is deformed. Perhaps the onset of inflammation, swelling. The x-ray shows a narrowed joint space and osteophytes, thickening of the bone.
- 3 degrees. Severe form of the disease that develops in the absence of treatment. Third degree osteoarthritis is the cause of permanent disability. The pain in the knee is very strong, mobility is limited, the person cannot walk alone, every step is painful. The leg is deformed and begins to creak strongly. On the x-ray, the doctor determines the degeneration of cartilage tissue, the destruction of ligaments, menisci and the growth of connective tissue.
Diagnosis of osteoarthritis
To examine the patient, physical, laboratory and instrumental diagnostic methods are used:
- Blood analysis is general, biochemical, immunological.
- Synovial fluid analysis.
- X-ray.
- Knee ultrasound.
- CT or MRI if indicated.
The examination plan is always individual and depends on the patient's condition.
Treatment of osteoarthritis of the knee joint
Therapy includes a complex of procedures, medications, recommendations for lifestyle changes. It is important not to try to treat arthritis on your own. Often, patients in the early stages of the disease use anesthetic ointments and go to the doctor when the joint is already destroyed. The earlier treatment is started, the more effective it is.
Medical treatment
The doctor prescribes drugs to relieve inflammation, swelling, reduce pain, activate metabolic processes and tissue regeneration. Medicines are selected individually.
The following funds are available:
- Nonsteroidal anti-inflammatory drugs(NSAIDs) in the form of tablets, ointments, injections. Means well relieve pain, swelling, improve the patient's well-being.
- Glucocorticosteroidsin the form of injections directly into the knee joint. Injections are indicated in severe cases of the disease, when the limb is practically immobilized.
- Blockages of pain. Helps to cope with symptoms and lessen the progression of the disease.
- Chondroprotectors. Medications contribute to the restoration of cartilage tissue and slow down the destruction of the joint.
Conservative treatment
shock wave therapy
The method is non-invasive, helps remove salt deposits, improves connective tissue trophism. Physiotherapy improves blood circulation, favorably affects the elasticity of ligaments. Shock wave therapy is performed in the course of 4-10 procedures.
Plasmolifting (PRP therapy)
The patient's platelet-rich plasma is injected into the joint. The course of plasmolifting accelerates tissue regeneration.
Phonophoresis
The method combines the effects of ultrasound and therapeutic ointments. Means for physiotherapy usually have a complex composition and are prepared in pharmacies on prescription. Ultrasound increases the penetrating power of the active substance.
Massage
The procedure is contraindicated at the stage of exacerbation of arthrosis. When the inflammation is removed, the pain syndrome is reduced, you can start a massage course. The lymphatic drainage technique helps prevent the buildup of synovial fluid. Massage also improves blood circulation in the knee, relieves muscle spasms. The procedure is most effective after performing special exercises for arthrosis of the knee joint.
Bathing
You can do a course at home as prescribed by a doctor or as part of a spa treatment. With arthrosis, radon, turpentine, hydrogen sulfide baths are indicated. The procedures have a beneficial effect not only on the knee, but also on the hip and ankle joints.
Hirudotherapy
Medicinal leeches are placed around the deformed joint. The saliva of these creatures contains active substances that contribute to the restoration of cartilage. Hirudotherapy is usually prescribed for 1st and 2nd degree osteoarthritis to relieve swelling and reduce pain.
Physiotherapy
Gymnastics for arthrosis of the knee joint is an obligatory part of the complex treatment. Special exercises help maintain muscle tone in the diseased limb, prevent congestion. Gymnastics begin to do in the morning without getting out of bed. Then, during the day, another 3-4 sets of exercises are performed for several minutes. It is useful to supplement therapeutic exercises for arthrosis of the knee joint with swimming.
Operation
Surgical intervention is indicated for arthrosis of 2 and 3 degrees:
- Puncture. Using a syringe, the accumulated fluid is pumped out of the joint cavity. Reduces internal pressure, reduces swelling, inflammation, improves mobility. The operation is performed on an outpatient basis, by appointment of the surgeon.
- Arthroscopy. The method is used for rehabilitation of the knee joint. Arthroscopy is performed through small punctures, therefore the operation is tolerated quite easily, the rehabilitation period is short.
- Corrective osteotomy. The classic technique for the treatment of deforming arthrosis, which consists in correcting the deformed anatomical axis of the lower limb, and then fixing the site of the wedge resection of the bone with a titanium plate. After an osteotomy, the patient needs several months of rehabilitation.
- Stents. The installation of an artificial joint is carried out with an extreme degree of deforming osteoarthritis of the knee joint and allows the knee to return to its previous range of motion without pain. After total arthroplasty, the patient needs a long rehabilitation (about 2-3 months).
Arthroscopy
Minimally invasive method of treatment. A video camera and microsurgical instruments are introduced into the joint cavity. The doctor conducts a thorough examination of the joint, extracts particles of osteophytes, destroyed cartilage, scar tissue. Arthroscopy can temporarily relieve pain and restore joint mobility.