Have you been diagnosed with osteoarthritis of the knee joint, are you experiencing severe pain and have you started to limp?Looking for where to get treatment?Contact a medical center, they will help relieve the pain, discover the causes of the disease and provide the necessary treatment.We have more than 20 effective joint restoration methods in our arsenal.
The disease is also known as gonarthrosis (from the Latin genu - knee), osteoarthrosis (as the disease was called before) and osteoarthritis (the term reflects the mechanism of development and the modern meaning of the disease).Deformative osteoarthritis of the knee joint has a chronic course and develops over several years.Most patients are over 50 years old.Women predominate in 2/3 of the cases.
How does the disease develop?
Under the influence of external and internal factors, blood supply and tissue nutrition is interrupted, degenerative-dystrophic damage to the articular cartilage develops, with the subsequent involvement of the underlying bone in the inflammatory process.The destruction of the articular surfaces leads to the loss of joint function, limits movement and interferes with the patient's quality of life.
Causes and risk factors
The main reasons for the development of osteoarthritis:
- Heavy physical work.Constant loads on the feet lead to cartilage microtrauma and the development of the inflammatory process.At risk are loaders, installers, miners and quarry workers.Often deforming osteoarthritis affects professional athletes (weightlifters, cyclists, tennis players, soccer players, basketball players, hockey players, etc.).
- Injuries.Damage to ligaments, tendons, meniscus, contusions and fractures lead to disruption of joint biomechanics.If treated incorrectly, this leads to the development of post-traumatic arthrosis.
- Surgical operations on the knee can lead to the development of pathology of the articular cartilage and surrounding tissues.
- Excess weight increases the stress on the joints of the lower extremities.Up to 80-90% of the progression of all osteoarthritis is associated with joint overload.
- old age.In people over 50-60 years old, regenerative processes slow down, collagen production decreases and hormonal levels suffer.That leads to the development of pathology.
- Hormonal changes in women.During menopause, estrogen production decreases, which disrupts calcium absorption, leads to weakening of the musculoskeletal system and makes bones fragile.The risk of developing osteoporosis increases.
- Problems with the thyroid gland.Thyroid hormones are involved in the metabolic processes of calcium and phosphorus in the body.Their lack or excess can provoke knee arthrosis.
- Genetic predisposition.Mutation of collagen can cause disturbances in the elements of the connective tissue, which leads to a deterioration of the shock absorption function of the articular cartilage.
- Inheritance.There is a high probability of developing the disease if the patient's family has relatives diagnosed with gonarthrosis, mainly in the female line.
- Inflammatory diseases.Infectious arthritis, bursitis, synovitis caused by bacterial or viral infection are often complicated by the development of gonarthrosis.
- Vascular diseases.The tissues do not receive proper nutrition, the blood supply is impaired, which leads to the development of ischemia and degenerative-dystrophic changes in the articular cartilage.
- Poor nutrition and metabolic disorders.Eating foods rich in purines (protein) contributes to the deposition of salts in the knee, for example, gouty arthritis.
- Specific diseases gonorrhea, tuberculosis, syphilis, chlamydia and influenza can cause serious joint damage.
- Intoxication of the body with various chemicals, including some medications.
- Autoimmune disorders are associated with a violation of the body's immune defense when antibodies are produced against its own cells, for example rheumatoid arthritis.
Symptoms of the disease
The main symptoms of gonarthrosis:
- Pain in the joints, pain in nature, sometimes at night, in case of aggravation, severe stabbing;
- Crackling and clicking during movement are caused by a violation of the congruence of the articular surfaces, the presence of osteophytes and cartilage defects;
- Swelling and swelling are associated with the development of an inflammatory process in the joints and surrounding soft tissues;
- Deformation of the joint space and the axis of the limbs indicates the progress of the disease;
- Atrophy and weakness of the thigh muscles, the volume of the quadriceps and biceps muscles decreases;
- Limitation of mobility and stiffness in the joint is caused by pain, the development of adhesions and the appearance of osteophytes (bone ridges).
The first signs of osteoarthritis that you should pay attention to are pain that appears during or after exercise.The pain goes away with rest and does not require medication.Morning stiffness in the knee, the onset of pain, before getting up and walking after sleep, it takes some time to develop the joint.
Signs of irritation
With the development of the pathology, the symptoms of arthrosis become brighter: the knees begin to hurt at rest, and at night, when bending and extending the joint, extraneous sounds appear - crackling, cracking, clicking.Lameness develops, stiffness of movement and soft tissue swelling occurs.
The following facts indicate the progression of the disease:
- the appearance of deformation of the axis of the limbs in the form of O-shaped legs;
- constant nature of pain, pain at night and when the weather changes (meteosensitivity);
- further deterioration of joint mobility, with the development of flexion contracture;
- weakness and atrophy of the thigh muscles.
Types and forms of the disease
There are:
- elementary.It develops as an independent disease.Most often, such gonarthrosis of the knee is associated with changes related to age and heredity.
- Medium.It occurs against the background of certain diseases or injuries, for example post-traumatic osteoarthritis.
Depending on the causes, the following types of arthrosis are distinguished:
- Ischemic, associated with problems with tissue blood supply and vascular disorders;
- Post-infectious is caused by infections, viruses, autoimmune processes;
- The idiopathic nature of the development of the pathology remains unclear;
- Metabolic is associated with metabolic disorders - gout, hemochromatosis, chondrocalcinosis;
- Involutional, as a result of age-related changes in the body;
- Post-traumatic, history of trauma;
- Dyhormonal - a consequence of hormonal imbalance in the body.
Stages of development
I. Grade 1 arthrosis - the initial stage is associated with a deterioration in the quality and quantity of synovial fluid (articular fluid, provides cartilage nutrition, has shock-absorbing properties, promotes sliding of articular surfaces).Malnutrition leads to wear and tear of cartilage tissue and the first signs of inflammation.In the initial stage, the movements are not damaged.Patients experience mild pain, tingling, and sometimes the joints may crack when moving.Symptoms appear during and after physical activity.Outwardly, the knee looks quite healthy.
II.Osteoarthritis of the 2nd degree - leads to the thinning of the cartilage to 1.5-2.0 mm (normal 2.5-3.0 mm), a narrowing of the joint space is observed and small single bone growths (osteophytes) appear.The inflammatory process is wave-like, alternating between phases of remission and exacerbation.Grade 1-2 gonarthrosis is associated with swelling and weakness of the thigh muscles.The pain bothers me at rest, when the weather changes and after walking I feel tired.Movements become more rigid, stiffness in the morning and cracking in the joints appear.It is at this stage that patients most often consult a doctor.
III.Gonarthrosis of the 3rd degree is manifested by external deformation of the joint, curvature of the axis of the limbs.Cartilage tissue is severely damaged, thinned to 1-1.5 mm and exposed bone is visible in some places.Bony growths can easily be felt under the skin and range of motion is significantly reduced.At 2-3 degrees of osteoarthritis, the joint space narrows, the joints cannot bend and bend, all movements are accompanied by pain and creaking, and stiffness in the morning intensifies.A characteristic joint contracture develops.I am concerned about sharp pains in my knee, even at rest.Patients often suffer from insomnia due to the fact that they cannot take a comfortable position that does not cause pain and feel changes in the weather.
IV.Grade 4 gonarthrosis is characterized by complete destruction of the articular surfaces, exposed bone is visible and cartilage is represented by rare "islands".The common space is almost invisible.A pronounced O-shaped deformity of the lower extremities and swelling is noted.Mobility is almost completely lost.Treatment with non-surgical methods at this stage is ineffective;joint replacement with endoprosthesis is indicated.
An orthopedic doctor comments: In order to accurately determine the degree of arthrosis of the knee joint, in addition to examining the patient, it is extremely important to perform an instrumental examination (ultrasound, X-ray or MRI of the joint).Bilateral gonarthrosis is very common, so examination of the left and right knee joints is recommended.This will help you choose the optimal treatment, and therefore prevent further progression of the disease.
Diagnosing
To make a diagnosis, it is usually enough to carry out an X-ray or ultrasound of the knee joint.In difficult cases, laboratory examination and magnetic resonance imaging (MRI) are prescribed.If pathological fluid accumulates in the joint, it may require drilling and subsequent examination.
Ultrasound diagnostics
It helps to identify the disease at an early stage.It allows you to measure the thickness of the cartilage layer, the relief of articulation, the presence of joint fluid, the size of osteophytes and ossification.
X-rays
Perform to assess the degree of damage, the condition of bones and cartilage tissue.It will show the presence of osteophytes, joint space narrowing and joint deformity.In the initial stages of the disease, the examination is not informative.
analyzes
General blood and urine tests, blood biochemistry show signs of inflammation, presence of infection and disorders in bones and cartilage tissue.They allow you to assess the general condition of the body, determine the causes of the disease, gonarthrosis and exclude pathologies with similar symptoms.
MRI
Magnetic resonance imaging A highly accurate diagnostic method that helps visualize the smallest changes.It will help establish a diagnosis both at an early stage and in complex cases before surgical treatment.
Which doctor treats you?
The following specialists treat knee gonarthrosis:
- Orthopedic doctor - diagnoses the disease, intra-articular injections, plasma therapy, provides high-tech assistance and surgical treatment.
- Physiotherapist - responsible for instrumental physiotherapeutic treatment.
- Rheumatologist - will help if the disease is accompanied by autoimmune disorders.
- Sports doctor - will be required in case of sports history of the disease.
- A nutritionist is needed if the patient is overweight.
In the recovery phase, the attending physician may include other specialists:
- Massager - massages the lower extremities, restores muscle tone, thus stimulating blood circulation and helping to restore joint mobility.
- Physiotherapy doctor - selects specific exercises and controls their implementation.
- Rehabilitation specialist - helps in social adjustment of the patient;the specialist is especially in demand after major reconstructive knee surgery.
What treatment is prescribed?
The earlier the disease is detected and treatment for the symptoms of osteoarthritis is started, the greater the chances of recovery.Otherwise, the disease can lead to irreversible consequences and significantly worsen the quality of life.
Thus, the treatment of knee joint arthrosis 1-2 degrees has a good chance to fully restore the function of the knee joint.Unfortunately, patients do not always seek medical help in the initial stages.
How to quickly relieve pain and how to treat it?
First of all, it is necessary to eliminate pain and inflammation.Described:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers.Medicines allow you to quickly remove inflammation in arthrosis and help reduce pain and swelling.
- Corticosteroids are used when NSAIDs and analgesics do not help, for example, in the treatment of arthrosis of the knee joint of degree 3-4.The patient is given a drug block - drugs are injected directly into the joint cavity.this helps relieve pain and achieve relief within minutes of injection.
- Special ointments and patches that relieve pain.
An orthopedic doctor comments: Treatment of knee joint arthrosis of 2-3 degrees is always complex, as a rule, it includes more than 15 (!) points of recommendations in the prescription sheet.It's not just medications and injections.This is a whole series of rehabilitation measures aimed at correcting the biomechanics of the joint and the patient's lifestyle.Only this approach will help preserve the joint and stop the progression of the disease.
Preparations that strengthen bones and cartilage tissue:
- Chondroprotectors based on chondroitin and glucosamine are the nutritional basis of chondrocytes.
- Preparations of hyaluronic acid serve as analogues of synovial fluid.
- Medicines that improve microcirculation and blood supply of joint cartilage.
- Calcium and vitamin D supplements strengthen the bones that make up the knee joint.
- Intra-articular injections of hyaluronic acid preparations, an artificial analogue of synovial fluid, help lubricate the articular surfaces.
- Drug blocks help quickly relieve swelling, pain and inflammation.As a rule, the effect is visible the next day.
Treatment of osteoarthritis of the knee joint also includes physiotherapy:
- Electrophoresis.Using an electric current, the drug penetrates the affected area.Electrophoresis is used to treat knee pain due to gonarthrosis.
- Phonophoresis.The drug enters the area of inflammation under the influence of sound waves.An additional advantage of the method in the treatment of deforming gonarthrosis is the thermal effect.
- Shock wave therapy.The procedure improves blood circulation, stimulates tissue nutrition and is used to destroy osteophytes and scar tissue.
- Traction therapy (joint traction) - helps unload the joint space, stretching it by a few millimeters, thus reducing the mutual pressure of the articular surfaces.
- Electrostimulation - stimulates blood flow and muscle function using electric current, restores muscle tone.
- Mechanotherapy helps to develop joint movements and combat contractures using special robotic simulators.
- Laser therapy creates deep tissue heating and reduces the inflammatory response.
- Magnetotherapy.The therapeutic effect is based on the properties of the magnetic field to reduce pain, inflammation and tissue swelling.
Orthobiology methods are aimed at stimulating regeneration and replacing defects in cartilage tissue:
- Plasmolifting is a medicine based on plasma, produced from the patient's own blood, which promotes regeneration processes and contains growth factors.
- PRP therapy - plasma taken from the patient's blood is used as medicine.Platelet-rich plasma stimulates the regeneration of chondrocytes and alleviates the inflammatory process.
- SVF therapy is based on the use of stromal vascular fraction cells obtained from the patient's own adipose tissue.
- SVF therapy + PRP therapy - the simultaneous use of concentrated plasma and progenitor cells allows you to achieve the best results.
- Stem cell treatment.The method is based on the use of bone marrow cells and is currently under development.
Each case is individual and requires the development of a special rehabilitation program for the treatment of arthrosis of the knee joint.
Don't know where to treat arthrosis?Do you want to get professional help and undergo treatment without surgery?Register for a health center.We offer to undergo an examination and start restoring your health the day you contact us.Benefit from modern treatment for knee arthrosis at competitive prices.