Osteoarthritis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease that is accompanied by gradual destruction of cartilage with the gradual participation of periarticular structures in this process.Lack of timely treatment leads to limited mobility and even disability of the patient.
Description of the disease.
Gonarthrosis is diagnosed in 70-85% of patients over 65 years of age who consult a doctor for knee pain.Older people are at risk because with age the articular cartilage becomes thinner, microcracks appear and it gradually collapses.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes less, so the surfaces of the bones begin to touch and collapse;
- bone growths (osteophytes) appear;
- the joint capsule becomes denser, causing joint stiffness;
- A spasm of the muscles surrounding the joint occurs.
Without treatment, the knee becomes deformed and movements in it are significantly limited.It can affect one or both joints.
According to statistics, one in five people in the world suffers from gonarthrosis.Basically, the disease is diagnosed in people over 40 years of age, but the age factor is not the only cause of the development of the pathology.
Why does gonarthrosis occur?
In elderly patients, osteoarthritis of the knee joint occurs due to natural wear and tear of cartilage tissue.Other causes of the disease:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtrauma;
- previous surgical interventions;
- autoimmune diseases;
- chronic joint diseases;
- regular increased loads on the knee joint, for example, running or jumping, constant standing or kneeling;
- genetic predisposition.
At risk are women over 40 years of age, athletes, overweight patients and people who work in construction professions.
How to recognize osteoarthritis of the knee joint?
The disease develops slowly, over several years, and has a chronic course.Its changes are irreversible, so it is important to start treatment as soon as possible when symptoms appear.
The first signs of gonarthrosis:
- knee stiffness;
- discomfort when straightening or bending the knee joint, going up or down stairs;
- creaking or clicking noises when moving;
- slight pain in the knee, which appears only after standing for a long time and disappears with rest.
Over time, the discomfort intensifies.Severe stiffness, motor disturbances and intense pain appear that do not leave the patient even at rest.A person finds it difficult to walk, sit or stand.Without treatment, the knee joint becomes deformed and causes disability.
The severity of the changes, as well as the likelihood of recovery, depend on the stage of the disease.
Degrees of gonarthrosis
There are 4 degrees of severity of the disease:
- I graduate.At the beginning of the disease, there are practically no symptoms.Minor discomfort occurs in the knee after exercise, which does not interfere with leading a normal lifestyle.Pathological changes can only be detected by X-ray.
- second grade.A periodic crunch and pain appears during physical activity, walking, climbing stairs, squatting or standing for a long time.X-ray images may reveal joint space narrowing and early signs of osteophyte formation.
- III degree.The pain syndrome becomes permanent and does not leave the person even at rest.The knee hurts especially in the morning and at night;during the day the pain is painful and tolerable.Since degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a creak is heard when moving.There is a "joint mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity and causes severe pain.The knee becomes deformed and can become inflamed and swollen.X-rays show signs of joint deformation, osteophytes, significant narrowing of the joint space, and damage to the meniscus.
- IV degree.Without treatment, the disease becomes extremely serious.Cartilage, ligaments and menisci are completely destroyed, making movement in the joint impossible, the joint surfaces are deformed and a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnosis
Diagnosing osteoarthritis of the knee joint is not difficult.An orthopedist-traumatologist performs the examination and treatment.Examines the patient's knee, evaluates motor activity, studies clinical manifestations, and palpates to identify areas of swelling and the presence of effusion.
To confirm the preliminary conclusion, an instrumental examination is prescribed:
- X-ray examination - allows you to identify the narrowing of the joint space and the presence of osteophytes;
- CT scan of the joint is a more informative diagnostic method than x-rays;shows the state of the joint cavity;
- Ultrasound of the joint - allows you to determine the volume of fluid in the joint cavity, the presence of osteophytes, evaluate the condition of the surrounding soft tissues and the thickness of hyaluronic cartilage;
- MRI - suitable for studying not only bone and cartilage tissue, but also ligaments, menisci, synovial membrane and other structures;
- Arthroscopy is an invasive diagnostic method;During the procedure, the synovial fluid may be punctured.
Additionally, a clinical and biochemical blood test, an immunological study and a rheumatoid factor test may be necessary.
Osteoarthritis treatment
An orthopedist should treat gonarthrosis taking into account the clinical picture and the degree of damage to the joint.You can't self-medicate.
The doctor can prescribe drugs from the following groups:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, which restore cartilage and prevent its further destruction;
- analgesic blocks that effectively eliminate pain;
- glucocorticosteroids, which are indicated for serious diseases;
- antispasmodics to eliminate muscle spasms.
Pharmacotherapy is complemented by physiotherapy procedures: shock wave therapy, laser therapy, magnetotherapy, electro and phonophoresis.Additionally, physiotherapy and massage are prescribed.
You definitely need to monitor your weight and try to get rid of extra pounds, which cause additional stress on your knee joints.It is important to follow a dietary diet;The diet must contain foods that nourish cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.It can be arthroscopy, osteotomy or endoprosthesis.
The most favorable prognosis is that if osteoarthritis is detected in stage 1, the changes may slow down and even stop.Stiffness or pain in the knee is not normal;It is worth having an examination to understand the cause of the discomfort.