Osteoarthritis or osteoarthrosis of the knee joint is a disease that occurs in the context of dystrophic changes with the subsequent growth of the connective tissue.There are many factors affecting the development of the disease, but all finally lead to a violation of metabolism in cartilage.In the medical literature, osteoarthritis of the knee joint is called gonarthrosis.
According to statistics, gonarthrosis occupies a main position in the frequency of occurrence among other osteoarthritis.The disease leads to serious discomfort, which can develop in pain during walking and rest.
Knowledge of early symptoms will help suspect the development of pathology and cure them in the early stages.
Reasons
According to the medical classification, there is gonarthrosis or primary and secondary osteoarthritis of the knee joint.
The osteoarthritis of the knee joint can occur in the context of various diseases or act as their complication.When, due to an unclear story or a clinical image, the exact cause cannot be established, gonarthrosis is called primary, but if the cause is known, such osteoarthritis is called secondary.
Arthrosis develops with age in almost all people, on average, this period begins after 45 to 50 years of life.
The course and pathogenesis of primary and secondary osteoarthritis are the same and do not depend on the cause of the occurrence.
The most common causes of osteoarthritis and osteoarthrosis of the knee joint are:
- Traumatic damage to the knee;
- articular deformation in the inside and exterior;
- shortening a lower limb;
- Abnormal hypermobility of the joint;
- Chondroblastic dysplasia;
- Calcinosis of cartilage;
- osteomyelitis of femur and tibia;
- rheumatoid arthritis or arthritis of any other etiology;
- Glucose metabolism;
- Metabolic diseases and hormonal diseases.
Injuries.After receiving the knee injury in the joint cavity, inflammation with a large alituration objective can develop.After the disappearance of pro-inflammatory agents, repair or osteoarthritis processes are activated.
Most often, the disease occurs in the bottom of a fracture with a rupture of ligaments and damage to the bag and the surface of the cartilage of the joint.
Congenital deformations.Valgus or varior deformation is very often and without appropriate correction can be complicated by sclerotic changes in the knee.This happens due to the fact that one of the knees falls more than the load it should not be.
Shortening one of the lower limbs.In addition to the deformations, in the pathogenesis of the development of the disease, a poor distribution of weight on the knees plays the role.
Knee hypermors.In this state, the wear of the cartilage tissue of the knee joint can occur with later degeneration and degeneration in osteoarthritis.Hypermition often leads to spontaneous dislocations and sprains of the joint capsule.
Dysplasia by hand.Due to the inappropriate development of the motor surface in the knee joint, pathological growth of the connective tissue occurs.
Calcinosis of the joint.Pathogenesis is based on the deposit of salts in the joint cavity and the formation of a specific precipitate, which causes calcification with subsequent osteoarthritis.
Osteomyelitis.Inflammatory bacterial disease in which the destruction of bones and joints occurs.First of all, ankylosis and only the sclerosis is formed.
Arthritis of all etiology.The most dangerous are rheumatoid arthritis, accompanied by autoimmune lesions of the heart and joints.
Diabetes, such as metabolic disorders, leads to a violation of the flow of nutrients in the articulation and germ of cartilage.
Obesity.With a large body weight, large loads are on their knees when they walk and in a standing position.Due to constant pressure, blood flow towards the knee joints decreases and atrophy with dystrophy develops.
Symptoms
Symptoms with osteoarthritis of the knee joint depend on the stage of the pathological process.Based on this, by analyzing the symptoms and the rate of their growth, you can assess the scale of changes in the cartilage fabric.
Symptoms of knee osteoarthritis:
- the presence of pathological sounds during movement;
- pain after loading or at rest;
- Reduction of functions;
- edema and joint increase;
- pathological dislocations, fractures and subluxation;
- Temporary bakement which can occur during the bending and extension of the joint.
The click and the crunch are not immediately noticed, and if they notice it, they do not pay attention.The pathological sounds encounter the idea that a pathological process with the deposit of salts or the formation of osteophytes occurs in the difference in cartilage.
Pain occurs due to the formation of calcines or osteophytes.At first, pain syndrome is not expressed later, it only appears in the morning and passes after lunch, with the progression of the disease, the pain can occur at rest.
A decrease in joint functions manifests itself in the rigidity of movements and a decrease in their amplitude.Depending on the scene, the constraint of the movements can last a certain time and go to rest.
Edema occurs due to inflammation and hypersecretion of synovial fluid.There are also options when the skin is ignited on the joints.Such symptoms may have scarlet fever or rheumatism.
Dis loss and subluxation occur for the reason that the process applies to knee bones and ligaments.
Clos is a condition in which movement in any axis is completely limited.Such a symptom indicates the neglect of the process and the need for complex treatment.
Degree of osteoarthritis
Classify osteoarthritis according to the following signs:
- radiological symptoms;
- clinical manifestations;
- Laboratory data.
The most common and practical classification is radiological, it is simple and understandable even for people without medical education.
Based on X -rays, four degrees of osteoarthritis in the knee joint are distinguished:
- The reduction of the joint gap is low and there are no osteophytes;
- The interspoint gap is not trampled on, but there are signs of small calcines or osteophytes;
- The interspoint gap has a narrowed expression, there are osteophytes, the joint deformation begins;
- Lack of joint gap, bone deformation, ankylosis and dystrophy.
Regarding the clinical image, the following steps are distinguished:
- The light degree symptoms are insignificant, occur in the morning and spend 30 to 60 minutes after waking up;
- The average degree is a pronounced symptom, the feeling of discomfort comes before lunch, the swelling is insignificant, it progresses quickly without treatment;
- A severe degree - characterized by constant painful pain, discomfort at rest, morning stiffness does not pass before dinner, ankylosis, burgis and sinusitis of the knee joint develop.
Laboratory tests are taken into account, the indicators of soybeans and leukocytes are assessed.It is also necessary to check the presence of a rheumatoid factor.
Diagnostic methods
The diagnosis of osteoarthritis of the knee joint is not complicated, but requires certain doctor's skills.
Two types of diagnostic measures are distinguished:
- Laboratory diagnosis;
- Instrumental diagnostics.
For the right diagnosis, each of the methods must be taken into account and analyze the image as a whole.
Laboratory
If osteoarthritis is suspected, the attending physician prescribes the following tests:
- Test of blood and general urine;
- Biochemical blood test;
- determination of antibodies against the rheumatoid factor;
- Determination of antibodies against their own cells.
Laboratory data does not make information on the disease development stage.
Instrumental
The instrumental diagnosis of osteoarthritis includes the following methods:
- x -ray in two standard projections;
- mini-invasive arthroscopy;
- UZD examination;
- CT;
- MRI;
- Scintigraphy (according to the indications).
The radiation diagnostics aim to determine changes in the joint and to assess the condition of the cartilage.
Treatment
The treatment of osteoarthritis of the knee joint is a long process.The duration of treatment is due to the fact that repairing the cartilage fabric occurs very slowly, and in some cases it is quite impossible to restore the joint.
Modern methods of treatment of osteoarthritis in the knee joint include complete measures which aim to eliminate inflammation, to normalize lifestyle and to improve the metabolism of the cartilage fabric.
There are such methods of therapy:
- drug therapy;
- Therapy and massage of the exercise;
- traditional medicine;
- Surgical interventions.
The doctor prescribes treatment according to the duration of the disease, the stage of his development and his clinical manifestations.
Drugs
The drug aims to relieve pain and inflammatory reaction.To this end, the following drugs are prescribed:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors;
- glucocorticoids;
- Cytostatic.
The osteoarthritis tablets in the knee joint have many side effects, in treatment, it is necessary to monitor the state of the gastrointestinal and kidneys.
Often, drugs for osteoarthritis are prescribed for a long time, so that the least toxic drugs should be selected.
Exercises
The treatment of osteoarthritis using exercise therapy aims to strengthen the muscles and ligaments of the knee.With the loads dosed in the cartilage of the sick joint, the metabolism improves and the regenerative processes are accelerated.
The exercises must be selected individually taking into account the stage of the patient's disease and the physical capacities.
Massage
Massage of the knee joint allows you to improve blood circulation and relieve discomfort.An appropriate massage can prevent the appearance of ankyloses and false joints.
Popular
Treatment of osteoarthritis of the knee joint at home should not be the main method of fighting pathology, or can only act as an addition to the drug.
Home treatment includes:
- decrease in body weight;
- Normalization of labor hygiene and respect for the day's diet;
- The fight against inflammation.
The anti-inflammatory effect is possessed by such herbs:
- Dyeing thyme and thousand feet;
- Bardanes leaves;
- White cabbage leaves;
- Infusions and dandelion and chamomile decorations.
Operation
The operation is prescribed with the ineffectiveness of conservative therapy or at the patient's request.One of the main indications for surgical intervention is the 4th stage of the disease by radiological characteristics.
During the operation, surgeons can completely replace the joint with endoproshese or change one of its parts.