Arthrosis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease, which is accompanied by the gradual destruction of cartilage with the gradual involvement 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 the age of 65 who consult a doctor with complaints of knee pain.The elderly are at risk because with age the articular cartilage becomes thinner, micro-cracks appear in it and gradually collapse.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes less, which is why the bone surface begins to touch and collapse;
- bone growths (osteophytes) appear;
- the joint capsule becomes denser, which causes joint stiffness;
- Muscle spasms surrounding the joints occur.
Without treatment, the knee becomes deformed, and movement in it is very limited.May affect one or both joints
According to statistics, every fifth person in the world has gonarthrosis.Most of these diseases are diagnosed in people over the age of 40, but the age factor is not the only reason for the development of pathology.
Why does gonarthrosis occur?
In elderly patients, arthrosis of the knee joint occurs due to natural wear and tear of cartilage tissue.Other causes of disease:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtraumas;
- previous surgical intervention;
- autoimmune diseases;
- chronic joint disease;
- constant increased load on the knee joint, for example, running or jumping, standing or kneeling continuously;
- genetic predisposition.
At risk are women over 40, athletes, overweight patients, and people in the construction profession.
How to recognize arthrosis of the knee joint?
The disease develops slowly, over several years, and has a chronic course.The changes are irreversible, so it is important to start treatment as early as possible when symptoms appear.
The first signs of gonarthrosis:
- stiffness in the knees;
- discomfort when straightening or bending the knee joint, going up or down stairs;
- pulsating or clicking sound when moving;
- slight pain in the knee, which occurs only after standing for a long time and disappears with rest.
Over time, the discomfort increased.Severe stiffness, motor disturbances, and severe pain appear, which do not leave the patient even at rest.Difficulty for a person to walk, sit, or stand.Without treatment, the knee joint becomes deformed, leading to disability.
The severity of the changes, as well as the possibility of recovery, depends on the stage of the disease.
Stage of gonarthrosis
There are 4 degrees of severity of the disease:
- I have a degree.At the beginning of the disease, there are almost no symptoms.There is little discomfort in the knee after exercise, which does not interfere with leading a normal lifestyle.Pathological changes can only be detected using x-rays.
- II degree.Crackling noises and periodic pain appear during physical activity, walking, climbing stairs, squatting, or standing on your feet for a long time.X-ray images can reveal narrowing of the joint space and early signs of osteophyte formation.
- III degree.The pain syndrome becomes permanent and does not leave the person even at rest.Knee pain especially in the morning and in the evening;during the day the pain is painful and tolerable.Since the degenerative process begins at this stage, a person's gait changes, he begins to limp, and a crackling sound is heard when moving.There are "joint rats" - this is a condition where particles of destroyed bone or cartilage enter the synovial cavity, causing severe pain.The knee becomes deformed and may become inflamed and swollen.X-rays show signs of joint deformation, osteophytes, significant narrowing of the joint space, and damage to the meniscus.
- degree IV.Without treatment, the disease becomes very severe.Cartilage, ligaments and menisci are completely destroyed, which makes movement in the joint impossible, the articular surface is deformed, and a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnostics
Diagnosing arthrosis of the knee joint is not difficult.Orthopedic-traumatologists carry out examinations and treatments.He examines the patient's knee, assesses motor activity, studies clinical manifestations, and palpates to identify areas of swelling and the presence of effusion.
To confirm the initial conclusion, he prescribed an instrumental examination:
- X-ray examination - allows you to identify the narrowing of the joint space, the presence of osteophytes;
- A CT scan of the joint is a more informative diagnostic method than an x-ray;it shows the state of the joint cavity;
- Joint ultrasound - allows you to determine the amount of fluid in the joint cavity, the presence of osteophytes, assess the condition of the surrounding soft tissue, the thickness of hyaluronic cartilage;
- MRI - suitable for studying not only bone and cartilage tissue, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method;during the procedure, synovial fluid may be injected.
In addition, clinical and biochemical blood tests, immunological studies, and tests for rheumatoid factors may be required.
Treatment of arthrosis
Orthopedists should treat gonarthrosis, taking into account the clinical picture and the level of damage to the joint.You cannot self-medicate.
Doctors can prescribe drugs from the following groups:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, which restore cartilage and prevent further destruction;
- analgesic block that effectively eliminates pain;
- glucocorticosteroids, which are indicated for severe diseases;
- antispasmodic to relieve muscle spasms.
Drug therapy is complemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetotherapy, electro and phonophoresis.In addition, physical therapy and massage are prescribed.
You definitely need to control your weight and try to get rid of extra pounds, which cause extra stress on your knee joints.It is important to adhere to a nutritional diet;the diet should contain foods that nourish cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.This may be arthroscopy, osteotomy or endoprosthetics.
The best prognosis is if arthrosis is detected at stage 1, then the changes can be slowed down and even stopped.Stiffness or pain in the knee is not normal;it should be checked to understand the cause of the discomfort.