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

Osteoarthritis of the knee joint (gonarthrosis) is a degenerative lesion of the joint, which eventually leads to its deformation. In it, the cartilage tissue begins to break down. The functionality of the knee gradually decreases and the patient loses the ability to move normally. This disease is very common.

Treatment for knee osteoarthritis is long-term, but cannot provide a complete cure for the problem. However, therapy is needed in order to preserve the mobility and functionality of the joint for as long as possible, as well as to improve the quality of life of the patient.

Types of diseases

Gonatrosis of the knee joint can be classified due to its development. It is primary and secondary. The first type of disease occurs most often. It also has another name - idiopathic osteoarthritis. The exact reason for 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 related to one reason or another. For example, it often occurs after a knee injury due to heavy physical exertion in the knee joint. Such gonarthrosis is often genetically determined. Certain diseases can also cause dystrophic changes in the knee joint: diabetes mellitus, rheumatoid arthritis, congenital deformity of the lower extremities.

Why pathology developed

The knee joint is one of the most complex joints in the human body. It consists of the femur, tibia and patella. The articulation also includes triangular cartilage with curved edges - menisci. Well-coordinated knee work is ensured by the musculoskeletal system. Almost all bone surfaces of the joint are covered with cartilaginous tissue whose thickness is about 0. 5 cm. It feeds on blood vessels, as well as diffusely (receiving useful substances from synovial fluid).

The cartilage in the knee allows the bony surfaces to slide and soften. If the nutrition of this tissue is disturbed, then dystrophic processes begin in it, it becomes thinner. If left untreated, the cartilage disappears completely and the knee joint stops moving. The reason for the development of osteoarthritis can be different. For example, the following factors can cause 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 load should be moderate, especially in old age. The biggest damage comes from squatting and running on hard surfaces (asphalt).
• Knee injury. These may include damage to the meniscus, sprained joints, and fractures. This reason contributes to the development of the disease in young people. After fixing the limb, the blood circulation in it worsens. Damage or removal of the meniscus in 90% of cases leads to arthrosis.
• Too much body weight. Being overweight can damage the meniscus. Knee joint reconstruction is time consuming and difficult. Obesity often causes bilateral knee osteoarthritis. An additional negative point is the presence of varicose veins. In this case, the patient develops the most severe form of knee gonarthrosis.
• Weakness of the ligament apparatus. Therefore, there is too much joint mobility. Despite the fact that a person can sit on the rope without problems, even without warming up, at this moment, the joint receives microtrauma. If 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 pathologies. The presented pathology can be caused 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 cartilaginous tissue in the knee begins to decay.
• Stressful situation. Mood swings, the constant presence of the nervous system in a state of tension can cause osteoarthritis of the knee joint.
• Congenital diseases of muscles, ligaments and dysplasia.
• Chondrocalcinosis (premature deposition of calcium salts in the knee cartilage). The pathology is systemic.
• Osteomyelitis. This is an inflammation of the bone marrow, in which purulent masses form. They negatively affect the surrounding tissues. Over time, the purulent mass crosses the bones of the knee joint. Lack of treatment threatens the development of sepsis.
• Acromegaly. This is an endocrine disease in which the level of growth hormone - growth hormone - increases. A benign tumor in the anterior pituitary usually contributes to an increase in its amount. If such a disease develops during adolescence, the child develops a specific physique. Excessive growth rate of cartilage tissue leads to deformation of the knee joint.
• Diabetes.
• Hypothyroidism. This disease is also endocrine. It occurs due to a lack of thyroid hormones. The person’s weight begins to increase, he moves a little and the cartilage of the knee joint wears out.
• Frostbite. In this case, ice crystals form in the soft tissues that kill living cells.
• Synovitis (inflammation localized in the synovial sac of the joint).

All these reasons can cause gonarthrosis of the knee, while the person will not even notice 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 osteoarthritis diagnosed in the patient:

• First degree osteoarthritis of the knee. The pain at this stage is not felt much. The patient may suffer discomfort for years, until he is in no hurry to contact specialists or carry out any treatment. The person needs help during the worsening. A sharp attack of pain is not typical of osteoarthritis of the knee.
• Osteoarthritis of the knee joint II degree. The intensity of discomfort increases. Pain occurs not only after physical exertion on the knee joint, but also at rest. To get rid of unpleasant sensations, you need to rest more. Swelling appears in the area of the knee joint, the patient hears a crunch. X-ray shows a narrowing of the joint space, a slight deformation of the knee joint.
• Osteoarthritis of the knee joint of III degree. In this case, the mobility of the knee is very limited, and sometimes the leg cannot be fully straightened. Joint pain becomes strong and constant, occurring in response to changing weather conditions. Discomfort is a pain in nature, and it is difficult to get rid of even at rest. The patient's sleep is often disturbed, and in order to alleviate his condition at least a little, he uses NSAIDs. The man develops lameness, and the deformation of the joint is very noticeable.

Osteoarthritis treatment should be started as soon as possible, before the destruction of bone tissue becomes critical. In case of irreversible changes, only surgery will help the patient.

Symptoms of knee osteoarthritis

The development of osteoarthritis does not occur overnight. As it progresses, the symptoms become more intense. The following manifestations are characteristic of gonarthrosis:

• Crunching and clicking that is heard with a certain movement. The patient may notice this symptom quite late. However, he says that the joint surfaces were damaged, and grooves and bone growths appeared on them.
• Swelling and enlargement of the knee.
• Painful sensations. In the first stage of arthrosis development, they are invisible and can appear only after a serious static load on the knee joint. Dynamic exercise in turn improves the condition of the joint, its nutrition and subsequent prognosis. Since the upper layer of cartilage is erased in arthrosis, 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 passes. If the knee joint continues to collapse, then the discomfort does not leave the person even at rest. Edema appears in the bursa, which further compresses the nerves. 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 sleep and disappears after half an hour. If this condition lasts longer, it indicates the presence of an inflammatory process.
• Reduced range of motion. The patient is unable to straighten the limb completely. Because the patient is constantly feeling pain, he tries to reduce the range of motion, and the ligaments adjust accordingly. That is, they are shortened and do not allow the knee joint to fully fulfill its function.
• Joint obstruction. It occurs as a result of a strong change in the articular surfaces.
• Dislocations and subluxations. They appear in the last stage of the development of arthrosis, when the joint is seriously deformed.

Over time, a person experiences muscle atrophy, osteophyte proliferation, and weakening of the lateral ligaments. The consequences of osteoarthritis are serious, because a person becomes disabled.

How to properly define osteoarthritis?

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

1. X-ray of the knee joint. In gonarthrosis it is performed in two projections. The specialist needs an X-ray of the damaged and healthy knee. Radiography allows you to determine the following signs of arthrosis: narrowing of the joint space, osteophytes, subchondral sclerosis. Also, the presented study of the knee joint reveals subluxation, the place of ossification of the cartilage tissue.
2. Arthroscopy. This is a minimally invasive procedure that is used not only for the diagnosis of arthrosis, but also for its treatment. It envisages the use of a special LED guide with a camera at the end. It is inserted through a small opening on the side of the knee. The whole image of the internal condition of the joint is reflected on the monitor. However, the procedure has a drawback: the joint is under pressure and pathogenic microorganisms can enter it.

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

7. Thermography. The procedure is based on the registration of thermal radiation from the surface of the patient's body. So you can recognize tumors, foci of inflammation. The study was assigned for the purpose of differential diagnosis.
8. General blood test. It helps in determining the severity of the inflammation and determining its nature.
9. General examination of urine. Thanks to him, it is possible to determine the systemic nature of the pathology.
10. Blood chemistry.

Thanks to these diagnostic measures, experts can accurately determine osteoarthritis of the knee and prescribe a truly effective treatment.

Treatment of osteoarthritis of the knee

Treatment of osteoarthritis must be comprehensive and long-term. Since it will not be possible to completely stop the destruction of the joint, the therapy will have to be carried out constantly in order to improve the quality of life of the patient.

Drugs in the treatment of osteoarthritis

Your doctor may prescribe the following medications:

• Non-hormonal anti-inflammatory drugs. They are used in the form of tablets and ointments. However, in the case of severe pain syndrome, which cannot be removed by standard methods, an injection is used. It helps to quickly soothe pain, relieve swelling and reduce the intensity of inflammation. These medications can only eliminate the symptom, but they cannot cure osteoarthritis. These remedies should only be prescribed by a doctor. The course of treatment lasts no more than 14 days, and relief comes in 2-3 days.
• Chondroprotectors for osteoarthritis of the knee joint. Each such drug contains beneficial substances that can restore cartilage. However, it will only be effective if its application is started on time. If the cartilage is completely erased, then the use of chondroprotectors will be useless. Treatment with such agents will be long-term (at least 6 months). Tablets and topical medications are most commonly used, although injections are possible.
• Vasodilators. They help relieve spasms and pain syndromes, restore normal blood circulation and improve the nutrition of the knee joint.
• Glucocorticosteroids. They are most often used in the most severe cases, when other drugs do not give a positive effect. Intra-articular injections into the knee are used for osteoarthritis. It is allowed to use them only once a year.
• Enzymes. They provide regeneration of the cartilage structure in the initial stages of the development of knee arthrosis. They are also prescribed for injections into the joint.
• Hyaluronic acid. It provides smooth movement of the knee joint, because it is able to replace synovial fluid.
• Topical preparations - ointments, creams, gels. They also only relieve symptoms.
• Medication wraps. In this case, a drug that can penetrate the skin, helps to remove muscle contractions and has a resorption effect is used. The compress can be done with medical bile.

Drug therapy in the treatment of osteoarthritis is necessary. However, medications must be used strictly in the dose prescribed by the doctor. It is impossible to increase or decrease the rate on your own, to change the daily rate without the knowledge of experts.

Characteristics of physiotherapy treatment and exercise therapy

You can also treat osteoarthritis of the knee with physiotherapy procedures:

• Massage. It helps to restore normal blood circulation in the tissues, eliminates muscle spasms.
• Drug electrophoresis allows you to remove inflammation in the joint and also produces an analgesic effect.
• Magnetic therapy. With the help of specific radiation, the tissues surrounding the affected right or left joint are stimulated. Metabolic processes in cells are improved.
• UHF. The waves promote the production of synovial fluid that lubricates the knee.
• Phonophoresis with corticosteroids.
• Electrotherapy helps to remove not only pain but also swelling.

• Blatotherapy.
• Hirudotherapy.
• Shock wave therapy.
• Heat treatment. This includes paraffin therapy. Thanks to this procedure, the local blood circulation improves.
• SMV therapy. This physiotherapy stimulates blood circulation, alleviates swelling and helps improve the nutrition of cartilage tissue.

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

1. Lying on your stomach, you should alternately raise your legs. In this case, they must not be bent at the knee. The lifting height is approximately 20 cm.
2. Lying on your left side, you must bend your left leg and raise it by 30 degrees. It is necessary to keep the limb in this position for up to 30 seconds. The same exercise should be done with the right leg.
3. Sitting on a chair, the legs should be straightened and raised in turn as much as possible.

The set of exercises is selected individually by the doctor. Gymnastics is best done after a small massage with healing ointments. Physiotherapy is an effective additional method of treating osteoarthritis that enhances the effect of medications.

Is surgery needed?

In the most severe cases, when the joint is seriously destroyed by arthrosis, the patient is prescribed surgery. There are several types of interventions:

1. Articulated traction. It involves stretching a joint damaged by arthrosis to increase the gap between the cartilage. This will prevent further destruction of the tissue and its gradual recovery.
2. Endoprosthetics is the complete replacement of a joint destroyed by arthrosis. It is performed as a last resort. Replacement can be complete or partial. The prosthesis will have to be changed in 10-15 years.
3. Osteotomy. Such treatment of arthrosis enables mechanical correction of deviations of severely deformed bones. In this case, the solid elements break in a strictly defined place. Next, the bones are properly positioned and fused.
4. Arthroscopy. With its help, the cartilage surface destroyed by arthrosis is restored. In addition, foreign bodies and bone fragments can be removed from the joint with an arthroscope. Such surgery is used for joint hypermobility. Arthroscopy is considered a poorly traumatic procedure, so rehabilitation after it does not take long.

It is better not to bring her for surgery. Treatment should be started in the first stage of osteoarthritis development. Orthopedic devices will help consolidate the results: a stick, an orthosis to reduce the load, and knee braces with infrared radiation.

Use of folk remedies

It is impossible to completely cure osteoarthritis, because the degenerative process will gradually progress. However, you can eliminate the symptoms and stop the destruction of the knee joint in osteoarthritis. Folk remedies can be used during exacerbations, as well as during relative calm. But first you need a specialist consultation. The following recipes will be useful for osteoarthritis:

1. Chopped horseradish root should be boiled in a small amount of water over low heat. After that, the porridge must be filtered and placed around the knee affected by osteoarthritis. The lining must be fixed with a bandage. You need to do the procedure every day for a month. The compress improves blood circulation and tissue regeneration.
2. Rubbing any vegetable oil into the knee joint area due to osteoarthritis will help relieve the pain. However, it needs to be warmed up a bit.
3. The mummy provides a good effect. It is necessary to mix 3-4 g of raw material with 100 g of honey and mix everything thoroughly. You need to rub the medicine on the sore spot in the evening, before going to bed. Then wrap the affected area with a warm scarf. Receiving the mummy inside is also welcome. You can use it with 0, 2 g per day.
4. Fresh dandelion flowers can be thoroughly washed and consumed 5-6 pieces a day. Also dry the raw materials in the amount of 1 tbsp. one should pour a glass of boiling water, insist and drink 1/3 cup three times a day.
5. Rubbing aloe leaves. It is necessary to wrap 10 leaves of the plant and squeeze through gauze. 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 every day for a month.

Cabbage and burdock leaves will help alleviate inflammation in osteoarthritis. Folk remedies can not be considered a remedy for protection, but increase the effectiveness of other types of therapy.

Nutritional rules for osteoarthritis

Treatment of osteoarthritis does not require a particularly strict diet, but you still need to adhere to some dietary rules:

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

• In osteoarthritis, alcohol and nicotine are strictly forbidden.
• Dishes with gelatin content are useful: aspic, meat jellies, beef bone soups.
• For osteoarthritis it is important to eat milk protein (products should not be greasy), fish, seafood.
• The diet should include vegetable oils, vegetables and fruits, freshly squeezed juices.
• The person should ingest a sufficient amount of fluids daily.

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

Prevention of osteoarthritis

To avoid the possibility of developing osteoarthritis, as well as not to lose the ability to walk, you must adhere to the following expert advice:

• We must not forget to move. Better to go to the pool, ride a bike, hike in the fresh air. You can also go dancing.
• It is advisable to avoid any lesions and hypothermia of the knee joint, as this causes post-traumatic osteoarthritis.
• For longer efforts, it is better to use knee pads or other orthopedic devices.
• It is recommended to wear comfortable shoes.

• It is important to eat properly - osteoarthritis will not stand a chance if all the necessary nutrients are brought to the joint regularly.
• If you are overweight, you should get rid of it.
• It is better to avoid stress, as well as properly organize work and rest.
• It is necessary to strengthen the body's defenses.
• All inflammatory or infectious pathologies that can cause the development of osteoarthritis should be eliminated in time.

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

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