Osteoarthritis of the knee

15 September 2020

Knee arthrosis, 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 joints. Gradually, the cartilage loses its density and height. Notice razvlecheniya and its dilution, and over time it disappears completely. Accordingly, there is no soft protective cushion on the bone, and this leads to an increased load on the end plate of the irritated articular surface of the bone. As a result of this load, pain develops. The ICD-10 code for knee osteoarthritis is M17.

The knee joint is affected quite often, as it is the knee that has a significant load during walking, physical exertion and running. In this case, uncomfortable movements can lead to damage to the soft tissues of the knee and cause osteoarthritis. This is why gonarthrosis is one of the leading causes of disability. According to statistics, this disease affects about 20% of people on the planet to varying degrees.

Why osteoarthritis develops, how to prevent the development of this disease, which the doctor treats knee osteoarthritis 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 against the background of a mismatch between the load on the joint and its ability to withstand it. In this case, the properties of cartilage can be determined by genetics or variation due to the influence of acquired factors, both exogenous and endogenous. The development and progression of gonarthrosis can occur with age, against the background of overweight, due to femoral-patellar joint dysplasia or changes in the lower extremity axis, disorders of the biomechanics of the joint, damage to the meniscus and ligaments.

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

The basis of articular cartilage is the connective tissue matrix and chondrocytes. The connective tissue matrix contains type II collagen and aggregate molecules. Cartilage damping characteristics are provided precisely by the connective tissue matrix.

The inflammatory process in osteoarthritis 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 cause.
Secondary- several factors lead to the development of the disease. Most often they are associated with injuries, fractures, joint surgery, as well as inflammatory factors - acute and chronic arthritis.

The following degrees of knee osteoarthritis are also determined:

First degree osteoarthritis- defined in the period from the appearance of the first signs of the disease to the development of visible bone deformities on x-rays or during examination. During this period, pain of varying intensity appears during movement.
In grade 2- unpleasant sensations are noticed even at the slightest strain. When you walk and collect, the knee cracks, the mobility of the ankle decreases. The photo shows the growth of bone tissue along the edges of the article as well as the narrowing of the joint space. On external examination, it can be noticed that the knee has increased in size.
In grade 3there is virtually no cartilage tissue inside the joint. If the development of the disease progresses, the bones may grow together, which provokes complete immobility of the leg. Sleep is disturbed, it becomes impossible to move without a stick or crutch.

The following types of this disease are also distinguished:

Patellofemoral osteoarthritis of the knee joint- a condition in which degenerative changes are observed in the back of the patella, ie in the pelvis. With this form of the disease, the pain is mainly bothered when descending a ladder or from a mountain. Patellofemoral osteoarthritis can develop in runners. The disease is often diagnosed in young people.
Post-traumatic osteoarthritis of the knee- consequence of injury. The post-traumatic type of disease may not appear initially. But later, a person loses full joint motor activity.

Causes of Knee Osteoarthritis

Currently, work is underway to study the reasons leading to the development of such a pathology.

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

Age - at a certain age, degenerative changes in tissues begin in a person and the ability of cartilage tissue to regenerate decreases.
Arthritis - Over time, arthritis can lead to the development of osteoarthritis.
Injuries and delayed overload - in addition to injuries, the development of the disease may provoke the need to kneel, gather, lift weights.
Overweight and obesity - due to excess body weight, there is an added load on the ankles. In addition, substances that provoke its damage enter the bloodstream from pathological adipose tissue, and later in the joint.
Diseases leading to metabolic disorders - the risk of this pathology increases with atherosclerosis, diabetes mellitus.
Hormonal disorders - most often women get sick after 55 years.
Sports - people who practice certain sports are more likely to develop the disease. This is typical for runners as well as football, tennis, basketball players.

Symptoms of Knee Osteoarthritis knee symptoms

As a rule, the symptoms of osteoarthritis of the knee joints increase slowly, as the process of its development takes years. If too many joints are affected, symptoms of polyarthritis develop.

The onset of the disease depends on the severity, age and a number of 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.
Feeling of warmth in the joint.
Unpleasant sensations of stiffness in the wrist, which appear after a person has been in a static position for a long time.
Reducing the movement of the knee joint, making it difficult for a person to get out of a chair, go down stairs or get out of a car.
Chewing and cracking in the knee is most often seen with sudden movements of the joints.
It is believed that changes in weather affect the degree of pain and discomfort.

Analyzes and diagnoses

To determine if such a disease can be cured, the diagnosis must first be confirmed. In the diagnosis process, the doctor examines and interviews the patient. But the most informative study in this case is a knee radiograph.

Also, to clarify the diagnosis, it is advisable to undergo an ultrasound scan, during which you can rule out arthritis, as well as measure the height of the articular cartilage.

If necessary, schedule additional exams.

Treatment of knee osteoarthritis

In order for the treatment of this disease to be as effective as possible, it is first necessary to confirm the diagnosis and choose the correct regimen of complex therapy. Treatment of osteoarthritis of the knee joints at home is possible if the patient carefully follows all the recommendations of a specialist, practicing medications and additional methods of treatment. Only then can home therapy be effective.

Drug treatment and other methods of therapy for this disease are used depending on the degree of damage. The simplest is the treatment of grade 1 knee joint osteoarthritis. In case of a first degree disease, a complex therapy scheme is used, which allows you to get an effect in the shortest possible time. Therefore, if a person is diagnosed with grade 1 osteoarthritis, the disease should be treated immediately.

Regarding the treatment of osteoarthritis of the knee joints of the 2nd degree, the doctor makes a decision based on the patient's condition. Since changes in cartilage tissue begin at this stage, treatment should be performed immediately.

Whether it is possible to cure grade 3 knee osteoarthritis depends on many factors. In grade 3, the cartilage becomes thinner, so treatment at this stage is longer and less effective.

Medications

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

The following medicines are used for this purpose:

Non-steroidal anti-inflammatory drugs - used both tablets and local remedies - oils, gels. The most effective local and systematic implementation of such funds.
Chondroprotectors are used for knee osteoarthritis - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfate and others. Such drugs for osteoarthritis of the knee joints are described as part of a complex treatment. The price of chondroprotectors depends on the drug and varies considerably.
For serious illnesses, medical treatment includes steroids. Injections for osteoarthritis of the knee joints can be administered intramuscularly, and external steroid agents can be used.
External agents with skin irritants. In the description of folk remedies, you can also find annoying bandages.
During treatment, your doctor may prescribe knee injections. Various drugs can be used for injections into the knee joint for osteoarthritis. In particular, corticosteroids are injected to relieve severe inflammation. Injection reviews show that it is in this form that steroids act faster and more effectively. Knee blockade can be performed not only with glucocorticosteroids, but also with anesthetics. Blockade reviews show that this method effectively relieves even severe pain. Also, a knee injection can be performed during treatment with chondroprotectors. Improves metabolic processes, activates collagen production. But to get the effect, it is necessary to perform at least five injections. Also, hyaluronic acid is injected inside the joint, which improves the quality of the fluid inside the joint and provides effective protection of cartilage tissue. Vitamins can also be administered jointly.
Plasmolifting method - its essence consists in the introduction of platelet-rich blood plasma into the injured knee.
Medical gallbladder for osteoarthritis of the knee joints - used for bandages. It should be noted that medical bile can be an effective medicine only if its use is prescribed by a doctor according to a certain scheme. Therefore, the option "we treat at home" without consulting a doctor is unacceptable in this case.

Procedures and Operations

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

Physiotherapy. Various techniques are used, including shock wave therapy, myostimulation, phonophoresis, ozone therapy, kinesitherapy, and more. Physiotherapy can reduce pain, relieve inflammation. Any physiotherapy prescribed by a doctor should be performed exactly in the complex that the doctor has advised.

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

Ozone Therapy- relieves pain, produces an anti-inflammatory effect, which makes it possible to reduce the amount of hormonal agents used.

Knee pads for osteoarthritis of the knee- wearing such equipment reduces the severity of the pain. Plus, the knee brace protects it from instability. But in order to get the desired effect, it is necessary to choose the right knee pads or a knee brace. There are many general tips on how to choose knee pads for knee osteoarthritis. In addition, many different models of such knee pads are offered - with movement restrictions, amplifiers, and the like. But still, those who want to buy knee pads for osteoarthritis, it is advisable to rely not on user reviews but on doctor's recommendations. The price of an orthopedic knee block depends on different characteristics - material, quality. Knee pads are especially important if the patient develops post-traumatic osteoarthritis. But patellofemoral osteoarthritis, as well as other types of disease, can be treated with this method.

Therapeutic gymnastics for osteoarthritis of the kneeis an effective method that allows you to improve the condition and prevent surgery, provided that a person performs regularly and persistently exercise therapy for osteoarthritis of the knee joints. Physiotherapy exercises help to strengthen the leg muscles and stop the development of the pathological process. However, a series of exercises for osteoarthritis of the knee joints must be performed in a certain sequence and such gymnastics is chosen individually. Therefore, it is better that the basis for the classes was not a gymnastics video, but a series of exercises developed by a doctor. In this case, it is not just the charging that is important, but a complete exercise therapy.

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

Special gymnastics.Such exercises are recommended both during treatment and for people over 40 for prevention. Knee exercises should be done daily. These exercises are also suitable for older adults, 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 masseur, 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 in simulators (exercise bike and others) can be practiced.

If conservative methods prove ineffective, surgical treatment is practiced.

The following techniques can be used:

Puncture- removing excess fluid from the joints can reduce the symptoms of inflammation and restore movement.
Arthroscopy- can be performed using endoscopy. Using this technique, the joint surfaces are cleaned of fragments of destroyed cartilage tissue.
Periarticular Osteotomy- during such an intervention, one of the bones that forms the knee joint is sawn and fixed back at another angle. As a result, the severity of the pain decreases and the mobility of the knee increases. The intervention is effective in the first and second degree of the disease.
Endoprosthetics- replacement of the knee joint with a special biocompatible construction. This is a very complex intervention, which is performed with the third degree of the disease.

Treatment of osteoarthritis of the knee joints with folk remedies

Numerous reviews of the treatment of folk remedies for this disease confirm that such methods can be used as an adjunct, making the patient's condition easier. However, such methods should not replace the main treatment. Folk remedies are used for rubbing, compresses, baths, swallowing. Each thematic forum contains many tips on this topic.

Rubbing with garlic. Some cloves of garlic should be peeled and chopped. Mix the resulting grill with 200 ml of vegetable oil and insist in a dark place for a week. Put on the knee overnight with a film and a warm cloth on top.
Grinding Mustard. To prepare the medicine, take 50 g of camphor and mustard powder, 500 ml of vodka, the protein of one egg. All mixed and stored in a jar in a dark place for a week. Next, the product should be rubbed into the knee three times a day.
Elecampane Grind. Pour 50 g of elecampane root with 125 ml of vodka and leave for two weeks. Rub twice a day.
Burdock compresses. Burdock is a popular folk remedy for treating osteoarthritis. Some burdock leaves should be folded down with the soft part and smeared with vegetable oil. Attach them to the knee and cover with cellophane and a warm cloth on top. Also, burdock leaves can be smeared with vodka. Compression is applied at night. Similarly, treatment with horseradish leaves is performed.
Cabbage leaf. It is also applied to the sore spot overnight. -It is 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 mixed product in a dark place for 10 days. Warm up before applying the compress.
onion stew. Taken from the inside. To prepare the soup, you need to take two large onions, chop them and pour 1 liter of water. Cook until onions are softened. Take a decoction of 100 ml three times a day.
Celery juice. Grind the celery stalk in a blender, squeeze the juice. Drink 100 ml of juice three times a day.
Gelatin. For osteoarthritis, it is recommended to consume foods that contain gelatin. Jelly, jelly and other gelatin dishes are recommended to be included in the menu.
Bath with pine needles. Pour boiling water over 1 kg of pine needles and leave for several hours. Add to a warm bath, in which you can also dissolve 0, 5 kg of salt. Take a bath for 20-30 minutes.

Prevention

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

Eat well and include a variety of foods that contain vitamins and minerals in your diet.
Avoid excessive loads on the knee joint, protect it from injury.
Let go of bad habits.
Monitor weight, prevent obesity.
Treat all diseases in time, go to preventive examinations.
Look for sports, preferring gentle physical activity.
Wear high quality shoes as comfortable as possible.
Ensure correct behavior.

Diet for osteoarthritis of the knee joints

Effectiveness: healing effect
Conditions: forever

Diet is very important during treatment and rehabilitation. First of all, food should be healthy and light - it is important to prevent excess weight gain, which can worsen the condition and provoke acute osteoarthritis. But the acute course of the disease requires not only treatment but also weight loss.

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

Poultry, rabbit.
Sea fish.
Soy products.
Eggs.
Greens, zucchini, carrots, squash.
Arra.
Fruits, berries.
Vegetable oils.
Dishes with gelatin.

At the same time, you should limit the consumption of such products:

Beans, sorrel, spinach, tomatoes.
Dishes with flour.
Animal fat.
Spices, vinegar.
Red Meat

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

Consequences and complications

If treatment is not done immediately, osteoarthritis can lead to the development of such complications:

Inflammatory process of periarticular tissues.
Restriction of joint mobility.
Change the shape of the nodes.
Degeneration of the hip article.

Such complications can lead to the development of disability and irreversible changes.

Prediction

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.