Osteoarthritis of the knee joints

Osteoarthritis of the knee joint (deforming osteoarthritis of the knee joint, DOA, gonarthrosis) refers to degenerative-dystrophic changes in the joint structures in which the cartilage layer between the bone elements first becomes thinner and then collapses. In the initial stages, the patient feels discomfort and a slight limitation of mobility, then the joint deforms and the destruction of the cartilage causes it to lose its function completely. Acute osteoarthritis is very painful and is accompanied by a significant decrease in the patient's physical activity. If treatment of gonarthrosis of the knee joint is not started in a timely manner, the patient may become disabled.

For reference:According to statistics, one in five adults worldwide suffers from osteoarthritis of the knee joint. Osteoarthritis of the knee can occur on one or both sides; in women, the pathology is diagnosed twice as often as in men. People over 45 years old often face the problem of joint deformation due to age-related changes in the body. If this diagnosis is made in young people, the cause is usually trauma.

Why does pathology develop?

The knee joint is one of the most complex in the human body. It bears the most load when walking and other movements. It is not surprising that with age its elements wear out and lose their function. First, the cartilage layer in the articular joint loses its elasticity and elasticity, then it dries up and cracks. The shock-absorbing properties of cartilage are reduced, and this is exactly what causes discomfort and pain during movements: the shocks and jolts of the joint structures against each other are no longer softened by anything, the bones are gradually exposed and rub against each other.

Deforming arthrosis of the knee joint in old age is an optional phenomenon and is not diagnosed in everyone. There are a number of provoking factors, the combination of which causes pathological changes in the joint.

The most common causes of pathology are the following:

• Excess weight – the joint must withstand additional loads;
• Osteoporosis is a pathology in which demineralization of bone tissue occurs;
• chronic diseases associated with metabolic disorders in the body;
• traumatic sports – gonarthrosis is often called a disease of football players due to frequent injuries to the knee joint;
• some types of professional activities associated with heavy physical activity - osteoarthritis and osteoarthritis - occur in loaders;
• Spinal injuries in which the distribution of loads on the joints of the lower extremities is disrupted;
• hereditary predisposition.

Articular cartilage does not wear out immediately. In the early stages, the manifestations of the disease are absent or insignificant, the patient does not consult a doctor and does not take measures to stop the pathological process. If dystrophic changes are nevertheless detected, the patient has time to start treatment and prevent irreversible changes. To do this, you must first determine what are the main symptoms of arthrosis of the knee joints.

How do you recognize the disease?

The symptoms of arthrosis of the knee joint become clear at the stage when the cartilage has already become thinner and begins to deteriorate. Grade 1 gonarthrosis may not become noticeable for years. However, later observant patients remember that they still felt atypical symptoms, simply did not attach great importance to them, since they were not constant and did not cause much discomfort.

You can suspect destruction and inflammation of the right or left knee joint based on the following specific signs:

• Morning stiffness in the joint;
• Restriction of mobility after staying in one position for a long time;
• Pain in the knee when climbing stairs – burning, hypersensitivity;
• pain in the knees at night;
• Pain after physical work or sport;
• periodic sudden weakening of the lower extremities. When right-sided gonarthrosis or left-sided gonarthrosis develops, only one affected leg gives way.

However, the main symptom of knee joint destruction remains pain. They can vary in intensity and may subside at times. However, as the pathology progresses, they occur more often, become more intense and disturb the patient even at rest in the absence of physical activity. Based on the severity of the symptoms, the doctor can diagnose what stage the disease is in.

• Manifestations of pathology in stage 1:Pain is not yet a problem; the patient may notice rapid fatigue during sports or physical activity, a slight limitation of joint mobility after long periods of rest. The x-ray shows a slight narrowing of the space between the joint bones and an uneven cartilage surface with slight densification.
• For gonarthrosis of the 2nd degreeSymptoms appear brighter and more frequent. The patient usually already understands that something is wrong with his knees. The joints hurt and "twist" when the weather changes after physical exertion. Even gentle movements lead to pain in the knee. If a person gives his legs rest, the pain disappears. But under load it starts again. Even at this stageof pathology, there may be a characteristic crunch in the knee when bending and straightening the leg, as well as difficulty and pain when trying to bend the leg at the knee to more than 90 degrees. An x-ray will show a change in the shape of the joint socket and the presence ofFluid in the joint cavity.
• Gonarthrosis 3 degreescharacterized by severe pain that occurs regardless of whether the limb is under weight or at rest. The aching joint hurts especially at night and in changing weather conditions. The patient is no longer able to bend his leg at the knee, which is why his physical activity and performance decreases. The x-ray clearly shows degenerative changes in the joint tissue. The deformation can also be seen visually with the naked eye. The patient's legs are bent at the knees like the letter "o" or "x", which ultimately leads to the patient no longer being able to move independently and without support and even more unable to carry out normal professional and domestic tasks. The person becomes disabled.

Typically, patients in the second stage of the disease consult a doctor, primarily to find an effective medication for knee pain. In the first stage, it is quite difficult to detect gonarthrosis because the symptoms are mild and only minor changes are visible on x-rays. Pathological changes in the joint can only be detected through a thorough examination.

Diagnostic methods

Diagnosis begins with a visual examination and questioning of the patient. What indicates the possible development of gonarthrosis:

• Enlargement and change in shape of the knee joint;
• a distinct crunching sound when the kneecap is displaced;
• pain when palpating the joint;
• Restriction of joint mobility.

In the early stages, degenerative changes in cartilage tissue may not be visible, so CT and MRI are also recommended. With the help of modern diagnostic techniques, the doctor is able to determine exactly how badly the joint is affected, whether there is inflammation and fluid accumulation in the joint cavity, and also distinguish arthrosis of the knee joint from other pathologies.

classification

In modern orthopedics there are two main types of arthrosis of the knee joints:

• primary gonarthrosis;
• secondary gonarthrosis.

The primary form of the disease develops on its own due to age-related changes or metabolic disorders. Secondary is a consequence of another disease, injury or unsuccessful surgical intervention. Post-traumatic osteoarthritis of the knee joint can develop several months after a bruise, subluxation, or fracture. Depending on the course, osteoarthritis is classified as acute or chronic. It is easier to cure the acute form of the disease.

Official medicine for gonarthrosis

Complex treatment of arthrosis of the knee joint begins only after the final confirmation of the diagnosis. If the patient's condition is not critical, doctors first try to stop the progression of the pathology with the help of medications. Physiotherapy, massage and manual therapy are used as additional methods.

The main goals of complex therapy:

• relieve pain and discomfort;
• restore joint mobility;
• Stop the destruction of the cartilage layer and restore it if possible.

Important points are physiotherapy and compliance with a special diet. There are exercises and products that restore damaged joint tissue and help restore at least partial mobility. If you consult a doctor in a timely manner, these measures will be enough for the knee joint to be fully functional again.

However, if the disease has reached the third stage, the joint is severely damaged; even the most expensive medications do not help in its recovery. In order to at least partially preserve the function of the limb, surgery is required. This involves the removal of the remains of the affected joint structures and the implantation of an implant; the procedure is called endoprosthetics.

Drug treatment of gonarthrosis

To eliminate the unpleasant symptoms of the disease, restore and strengthen the joint, a complex of drugs of various groups and effects is used.

• Non-steroidal anti-inflammatory drugs– Joint treatment begins with them, they quickly relieve pain, swelling, fever and partially stop the inflammatory process. However, they cannot be taken for a long period of time, since the active ingredients in the composition have an extremely negative effect on the functions of the digestive tract and blood composition. Usually, treatment with NSAIDs lasts no more than 5-7 days. The drugs can be in the form of tablets for internal use or in the form of ointments and gels for external use.
• Chondroprotectors– these are drugs that improve the nutrition of cartilage tissue and restore its strength and elasticity. Chondroprotectors also partially relieve pain and swelling. But such drugs do not work immediately. The first effect will be noticeable a few weeks after starting therapy. It is recommended to take chondroprotectors for at least six months.
• Hormonal medications.They are also called corticosteroids. Hormone-containing medications are used when the pain is very severe and the inflammation progresses even after taking NSAIDs. They are administered as injections intramuscularly or directly into the joint cavity. Such drugs immediately relieve pain, reduce swelling and inflammation. However, they have a number of contraindications and even more side effects than non-steroidal anti-inflammatory drugs, which is why they are prescribed in extreme cases. Hormonal drugs can only be purchased in pharmacies with a doctor's prescription. Immediately after the patient's condition improves, corticosteroids are discontinued.

The treatment is complemented by intra-articular injections of hyaluronic acid. This substance stimulates the production of synovial fluid, saturates cells with moisture, restores their elasticity and strength, and prevents abrasion. The cost of the procedure is quite high, but the effectiveness is worth the price.

On a note:Of all the drugs listed above, only chondroprotectors affect the cause of the disease. They stimulate the regeneration of destroyed cartilage tissue and prevent damage to surviving cartilage cells. However, these drugs are expensive, and in order to achieve a noticeable and lasting effect, they must be taken regularly for several months, sometimes even years, in a row. The cost of full treatment is often prohibitive for many patients, especially retirees.

Unconventional treatment methods

Patients who have experienced first-hand what knee osteoarthritis is and what unpleasant symptoms it brings always have several available remedies in stock in case the pharmacy and medication are not available. People suffering from gonarthrosis and knee pain prepare tinctures, rubs and ointments based on medicinal plants in advance - almost all recipes require time and fresh raw materials, which are available only in the spring-summer season.

Dandelion treatment

There are several ways to strengthen the joint, restore its mobility and relieve excruciating pain with the help of this medicinal plant. The easiest way is to eat five dandelion heads a day during the flowering period. This should be done on an empty stomach, after rinsing the flowers with boiling water. A tincture for rubbing the joints is also made from dandelion.

The cooking recipe is as follows:

1. Collect exactly 50 open dandelion heads.
2. Pour into a dark glass bottle with a tight stopper.
3. Pour in 300ml of good vodka or triple cologne.
4. Leave to infuse away from sunlight for a month, shaking the container from time to time.
5. Transfer to the first aid kit without pumping, rub it on the sore knee before going to bed, then wrap the joint warmly and go to bed under a blanket.

There is another interesting recipe for arthrosis of the joints with dandelion. First you need to collect and dry the leaves of the plant. Then pour boiling water and let it steam for half an hour. The resulting mixture must be chewed slowly and thoroughly until exactly three thousand steps are required.

Recipes with burdock

The simplest recipe:

1. Pick two or three young leaves from the plant and rinse them with cold water.
2. Lightly crush the leaves to release the juice.
3. Apply to the affected joint and secure with a bandage.

Keep this "compress" overnight, remove it in the morning and throw away the leaves. Repeat the process daily for three weeks.

To enhance the effect, traditional healers recommend lubricating the knee with cinquefoil oil before applying burdock oil. It is very easy to prepare. Two tablespoons of chopped cinquefoil are poured into 250 ml of purified vegetable oil without fragrances. The oil should be well preheated, but not boiling. Leave the mixture for two weeks, then the oil can be used to treat joints.

Turpentine, eggs and other joint remedies

You can use the yolk of a chicken egg to prepare an effective rub for sore joints. It is prepared like this:

1. Lightly beat an egg yolk in a bowl.
2. Add a small spoonful of turpentine and stir.
3. Then add a large spoonful of vinegar and beat again.

The mixture is stored in the refrigerator and used before bedtime. After rubbing, the knee is wrapped in a warm cloth overnight. In the morning you need to remove the bandage, rinse off the remaining product with warm water and then apply any anti-arthrosis ointment.

Remember that all homemade preparations are effective only immediately after preparation and are not stored for a long time (with the exception of tinctures with alcohol, they can be stored in a dark and cool place for up to six months). Don't expect instant results. Folk remedies work on a cumulative system; Permanent relief only occurs after three to four weeks of regular use of home remedies for knee osteoarthritis. In later stages they are no longer effective and only help to temporarily relieve pain and swelling.

Summary:Osteoarthritis of the knee joint, also known as gonarthrosis, is one of the most common diseases of the musculoskeletal system in older people. In young people it occurs after injuries or excessive physical exertion. With a competent and comprehensive approach, the disease can be completely cured only at stage 1-2. In the third stage, endoprosthetics usually have to be resorted to in order to at least partially restore the functions of the extremity and prevent complications.