Knee arthrosis

Arthrosis of the knee joint, also called gonarthrosis, can significantly impair a person's quality of life. During the development of the disease, there is a gradual loss of hyaline cartilage in the joint. Gradually, the cartilage loses its density and height. Its razvlecheniya and thinning is observed, and over time it disappears completely. Consequently, there is no soft protective pad on the bone, and this leads to an increased load on the end plate of the innervated joint surface of the bone. As a result of this burden, painful sensations arise. The code for osteoarthritis of the knee joint according to ICD-10 is M17.

The knee joint is affected quite frequently, as it is the knee that has a significant load during walking, physical effort and running. In this case, improper movements can damage the soft tissues of the knee and cause osteoarthritis. That is why gonarthrosis is a major cause of disability. According to statistics, this disease affects about 20% of people on the planet to varying degrees.

Why arthrosis develops, how to prevent the development of this disease, that the doctor treats knee arthrosis and what kind of treatment methods the doctor can recommend after the diagnosis is made, will be discussed in this article.

Pathogenesis

The disease develops in the context of an incompatibility between the load on the joint and its ability to support it. In this case, cartilage properties can be determined by genetics or by alteration due to the influence of acquired factors - both exogenous and endogenous. The development and progression of gonarthrosis can occur with age, in a context of obesity, due to dysplasia of the patellofemoral joint or changes in the axis of the lower extremity, disorders of the biomechanics of the joint, damage to the menisci and ligaments.

The basis of pathogenesis is the predominance of catabolic processes over anabolic processes, which are noticed in the cartilaginous and subchondral bones, menisci and synovium. As a result, structural changes occur and the biological properties of the cartilage are lost. In addition, the pathological process spreads to the muscles and ligaments.

The base of the articular cartilage is the matrix of connective tissue and chondrocytes. The connective tissue matrix contains type II collagen and agrecan molecules. The cushioning properties of cartilage are provided precisely by the connective tissue matrix.

The inflammatory process in arthrosis is not as intense as in arthritis. However, in osteoarthritis, pro-inflammatory mediators are also present.

Classification

According to the origin of gonarthrosis, the following types are distinguished:

• Primary (idiopathic)- develops without the influence of any external causes.
• Secondary- certain factors lead to the development of the disease. Most of the time, they are associated with injuries, fractures, surgical interventions in the joint, as well as inflammatory factors - acute and chronic arthritis.

The following degrees of knee arthrosis are also determined:

• 1st degree arthrosis- is determined in the period from the appearance of the first signs of the disease to the development of bone deformities visible on radiographs or during the examination. During this period, pain of varying intensity appears during movement.
• At grade 2- unpleasant sensations are observed even with the least charge. When walking and crouching, the knee flexes, the mobility of the joint decreases. The image shows the growth of bone tissue along the edges of the joint, as well as the narrowing of the joint space. On external examination, it can be noted that the knee is enlarged.
• At grade 3there is practically no cartilage tissue inside the joint. If the development of the disease progresses, the bones can grow together, which causes complete immobilization of the leg. Sleep is disturbed, it is impossible to move without a stick or crutch.

The following types of this disease are also differentiated:

• Patellofemoral arthrosis of the knee joint- a condition in which degenerative changes are seen at the back of the patella, that is, the patella. With this form of the disease, the pain is disturbed mainly when descending a ladder or mountain. Patellofemoral arthrosis can develop in runners. The disease is usually diagnosed in young people.
• Post-traumatic arthrosis of the knee joint- a consequence of the injury. The type of post-traumatic illness may not appear initially. Later, however, the person loses all motor activity in the joint.

Causes of knee joint arthrosis

Currently, work is underway to study the reasons that led to the development of this pathology.

At the moment, the causes of gonarthrosis are associated with the influence of the following factors:

• Age - At a certain age, degenerative tissue changes begin in a person and the ability to regenerate cartilage tissue decreases.
• Arthritis - Over time, arthritis can lead to the development of arthrosis.
• Postponed injuries and overloads - in addition to injuries, the development of the disease can cause the need to frequently kneel, squat and lift weights.
• Obesity and excess weight - due to excess body weight, there is an increased load on the leg joints. In addition, the substances that cause its damage enter the blood from pathological adipose tissue and, later, into the joint.
• Heredity - in some cases, the development of the disease is determined by a defective gene responsible for the growth of cartilage tissue. As a consequence, this fabric may have low resistance to damage. If close relatives have already had osteoarthritis, this increases the likelihood.
• Diseases that lead to metabolic disorders - the risk of this pathology increases with atherosclerosis, diabetes mellitus.
• Hormonal disorders - women are more often ill after 55 years of age.
• Sports - people who play certain sports are more likely to develop this disease. This is typical for runners, as well as football, tennis and basketball players.

Symptoms of knee arthrosis

As a rule, the symptoms of arthrosis of the knee joint increase slowly, as its developmental process lasts for years. If multiple joints are affected, the symptoms of polyarthrosis will develop.

The manifestations of the disease depend on severity, age and various other factors.

However, the main symptoms of gonarthrosis are as follows:

• Pain in the knee joint, aggravated by activity. During rest, the knee hurts less.
• Swelling in the knee area.
• A feeling of heat in the joint.
• Unpleasant sensations of stiffness in the joint that appear after a person has been in a static position for a long time.
• Decreased range of motion of the knee joint, making it difficult for a person to get out of a chair, down stairs or out of a car.
• Crunch and crack in the knee, seen more often with sudden joint movements.
• Changes in climate are believed to affect the degree of pain and discomfort.

Analysis and diagnostics

To determine whether this disease can be cured, the diagnosis must be confirmed initially. In the diagnostic process, the doctor examines and interviews the patient. But the most informative study in this case is an X-ray of the knee.

In addition, to clarify the diagnosis, it is advisable to have an ultrasound exam, during which arthritis can be excluded and the height of the articular cartilage can be measured.

If necessary, schedule additional exams.

Treatment for knee arthrosis

For the treatment of this disease to be as effective as possible, it is necessary to initially confirm the diagnosis and choose the correct scheme of complex therapy. The treatment of knee arthrosis at home is possible if the patient carefully follows all the recommendations of a specialist, practicing both drugs and additional methods of treatment. Only in this case can home therapy be effective.

Drug treatment and other therapy methods for this disease are used depending on the degree of damage. The simplest is the treatment of 1st degree knee joint arthrosis. In the case of first-degree disease, a complex therapeutic regimen is used, which allows the effect to be obtained in the shortest possible time. Therefore, if a person is diagnosed with 1st degree arthrosis, the disease must be treated immediately.

On how to treat grade 2 knee joint arthrosis, the doctor makes a decision based on the patient's condition. Once changes in cartilage tissue begin at this stage, treatment should be carried out immediately.

Whether it is possible to cure grade 3 knee arthrosis depends on many factors. At grade 3, the cartilage gets thinner, so treatment at this stage is time-consuming and less effective.

Medicines

The medical treatment of knee arthrosis aims to provide an analgesic and anti-inflammatory effect. It is also important to reduce the severity of cartilage destruction.

The following drugs are used for this purpose:

• Nonsteroidal anti-inflammatory drugs - both pills and local medicines are used - ointments, gels. The most effective local and systemic application of such funds.
• Chondroprotectors for osteoarthritis of the knee joint - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfates and others are used. These drugs for knee arthrosis are prescribed as part of a complex treatment. The price of chondroprotectors depends on the drug and varies significantly.
• For serious illnesses, medical treatment includes steroids. Injections for osteoarthritis of the knee joint can be administered intramuscularly, just as external agents with steroids can be used.
• External agents with skin irritants. In the description of folk remedies, you can also find irritating compresses.
• During treatment, the doctor may prescribe injections in the knee. Different medications can be used for injections in the knee joint for osteoarthritis. In particular, corticosteroids are injected to relieve severe inflammation. Injection evaluations indicate that this is how steroids work most quickly and effectively. Knee block can be performed not only with glucocorticosteroids, but also with anesthetics. Assessments of the blockade indicate that this method effectively relieves even severe pain. In addition, an injection into the knee can be performed during treatment with chondroprotectors. In addition, it improves metabolic processes, activates collagen production. But, to get the effect, it is necessary to give at least five injections. In addition, hyaluronic acid is injected intra-articularly, which improves the quality of intra-articular fluid and provides effective protection of cartilage tissue. Vitamins can also be administered intra-articularly.
• Plasmolifting method - its essence consists of the introduction of platelet-rich blood plasma in the affected knee.
• Medical bile for knee joint arthrosis - used for compresses. It should be noted that medical bile can be an effective remedy only if its use is prescribed by a doctor according to a given schedule. Therefore, the option “we treat at home” without consulting a doctor is unacceptable in this case.

Procedures and operations

In the case of arthrosis and polyarthrosis, non-drug treatment methods are also used, the use of which is no less effective.

Physiotherapy. Several techniques are used, including the shockwave therapy method, myostimulation, phonophoresis, ozone therapy, kinesiotherapy and others. Physical therapy can reduce pain, relieve inflammation. Any physiotherapy prescribed by a doctor must be performed exactly in the complex that the doctor advised.

Laser therapy- produces decongestant, analgesic and anti-inflammatory effects.

Ozonotherapy- relieves pain, produces an anti-inflammatory effect, which allows reducing the amount of hormonal agents used.

Knee pads for arthrosis of the knee joint- the use of such devices reduces the intensity of pain. In addition, the knee protector protects you from instability. However, to obtain the desired effect, it is necessary to choose the right knee pads or knee pads. There are many general tips on choosing knee pads for knee arthrosis. In addition, many different models of knee pads are offered - with motion limiters, amplifiers and the like. Even so, whoever wants to buy knee arthrosis braces, it is advisable to rely not on user reviews, but on the doctor's recommendations. The price of an orthopedic knee brace depends on different characteristics - material, quality. Knee pads are especially relevant if the patient develops post-traumatic arthrosis. But patellofemoral arthrosis, like other types of the disease, can be treated with this method.

Therapeutic gymnastics for knee arthrosisis ​​an effective method that improves the condition and prevents surgery, provided that the person regularly and persistently undergoes exercise therapy for osteoarthritis of the knee joint. Physical therapy exercises help to strengthen the leg muscles and prevent the development of the pathological process. However, a series of exercises for osteoarthritis of the knee joint must be performed in a certain sequence, and such gymnastics is selected individually. Therefore, it is better that the basis of the classes is not a gymnastic video, but a set of exercises prepared by a doctor. In this case, it is not just the load that is important, but complete exercise therapy.

With a similar pathology, different types of exercise therapy can be practiced.

Special gymnastics.These exercises are recommended during treatment and for people over 40 years of age for prevention. Knee exercises should be done every day. These exercises are also suitable for the elderly, as they can be done at a leisurely pace.

Massage and manual therapy- suitable for patients with limited mobility, can be combined with exercise therapy. In the absence of an opportunity to visit a massage therapist, the self-massage can be performed according to the scheme that the specialist will demonstrate.

As additional methods to improve the patient's condition and active rehabilitation, yoga, acupuncture, joint stretching, special exercises on simulators (exercise bike and others) can be practiced.

If conservative methods prove to be ineffective, surgical treatment is practiced.

The following techniques can be used:

• Puncture- eliminating excess fluid in the joint can reduce the symptoms of inflammation and restore mobility.
• Arthroscopy- can be performed through endoscopy. Using this technique, joint surfaces are cleared of fragments of destroyed cartilage tissue.
• Periarticular osteotomy- during this intervention, one of the bones that forms the knee joint is sawn and fixed again at a different angle. As a result, the intensity of the pain decreases and the mobility of the knee increases. The intervention is effective in the first and second degree of the disease.
• Endoprosthesis- replacement of the knee joint with a special biocompatible construction. This is a very complex intervention, which is carried out with the third degree of the disease.

Treatment of arthrosis of the knee joint with folk remedies

Numerous reviews on the treatment of folk remedies for this disease confirm that such methods can be used as auxiliaries, facilitating the patient's condition. However, these methods should not replace the main treatment. Folk remedies are used for scrubbing, compresses, baths, ingestion. Any thematic forum contains a lot of advice on this subject.

• Rub with garlic. Several cloves of garlic should be peeled and chopped. Mix the resulting porridge with 200 ml of vegetable oil and insist in a dark place for a week. Apply to the knee overnight with a film and a warm cloth on top.
• Mustard grind. To prepare the remedy, take 50 g of camphor and mustard powder, 500 ml of vodka, the protein of an egg. All are mixed and stored in a jar in a dark place for a week. Then, the product should be rubbed on the knee three times a day.
• Elecampane Grind. Pour 50 g of elecampane root with 125 ml of vodka and insist for two weeks. Rub twice a day.
• Burdock compresses. Burdock is a popular remedy for treating osteoarthritis. Several burdock leaves should be folded with the fluffy side and greased with vegetable oil. Attach them to the knee and cover with cellophane and a warm cloth on top. In addition, burdock leaves can be smeared with vodka. The compress is applied at night. Likewise, treatment with horseradish leaves is carried out.
• Cabbage leaf. It is also applied to the sore spot at night. It is pre-lubricated with honey, cologne or vodka.
• Honey compress. It is necessary to mix equal parts of honey, ammonia (10%), glycerin and medical bile, add a few drops of iodine. Keep the pre-mixed product in a dark place for 10 days. Heat before applying the compress.
• Decoction of onion. It is done internally. To prepare the broth, it is necessary to take two large onions, cut them and pour 1 liter of water. Cook until the onions are tender. Take a 100 ml decoction three times a day.
• Celery juice. Grind the celery stalks in the blender, squeeze out the juice. Drink 100 ml of juice three times a day.
• Gelatin. For arthrosis, it is recommended to consume foods that contain gelatin. It is recommended to include jam, jelly and other gelatin dishes on the menu.
• Bath with pine needles. Pour boiling water over 1 kg of pine needles and leave for several hours. Add to a hot bath, in which you can also dissolve 0. 5 kg of salt. Take a 20 to 30 minute shower.

Prevention

To prevent the development of osteoarthritis of the knee joint, the following preventive measures must be observed:

• Eat well and include a variety of foods in your diet that contain vitamins and minerals.
• Avoid excessive loads on the knee joint, protect it from injury.
• Give up bad habits.
• Control your weight and prevent obesity.
• Treat all illnesses in a timely manner, do preventive exams.
• Practice sports, preferring light physical activities.
• Wear high quality shoes that are as comfortable as possible.
• Ensure correct posture.

Diet for osteoarthritis of the knee joints

• Effectiveness: healing effect
• Terms: permanently

During treatment and rehabilitation, diet is very important. First, the diet must be healthy and light - it is important to prevent excess weight, which can aggravate the condition and cause acute osteoarthritis. But the acute course of the disease requires not only treatment, but also weight loss.

It is also important to include foods that contain important components for cartilage tissue in the diet:

• Birds, rabbit.
• Sea fish.
• Soy products.
• Eggs.
• Vegetables, zucchinis, carrots, pumpkin.
• Nuts.
• Fruits, berries.
• Vegetable oils.
• Dishes with gelatin.

At the same time, you need to limit your consumption of such products:

• Beans, sorrel, spinach, tomatoes.
• Flour dishes.
• Animal fat.
• Spices, vinegar.
• Alcohol.
• Red Meat

You need to eat often, in small portions. You should also drink about 2 liters of fluid a day.

Consequences and complications

If treatment is not carried out immediately, osteoarthritis can lead to the following complications:

• Inflammatory process of periarticular tissues.
• Limitation of joint mobility.
• Change the shape of the joints.
• Degeneration of the hip joint.

These complications can lead to the development of deficiencies and irreversible changes.

Forecasting

It is important to treat the disease in a timely manner. The most favorable prognosis will be if you start treatment in 1 or 2 stages of the disease.