Have you been diagnosed with osteoarthritis of the knee joint, are you experiencing severe pain and starting to limp?Looking for where to receive treatment?Contact a medical center, they will help you relieve the pain, discover the causes of the disease and provide you with the necessary treatment.We have more than 20 effective joint restoration methods in our arsenal.
The disease is also known as gonarthrosis (from the Latin genu - knee), osteoarthrosis (as the disease was previously called) and osteoarthritis (the term reflects the mechanism of development and modern understanding of the disease).Deforming osteoarthritis of the knee joint has a chronic course and develops over several years.Most patients are over 50 years old.Women predominate in 2/3 of the cases.
How does the disease develop?
Under the influence of external and internal factors, the blood supply and nutrition of tissues is disturbed, degenerative-dystrophic damage develops in the articular cartilage, with the subsequent participation of the underlying bone in the inflammatory process.Destruction of articular surfaces causes loss of joint function, limits movement, and interferes with the patient's quality of life.
Causes and risk factors.
The main reasons for the development of osteoarthritis:
- Hard physical work.Constant loads on the legs cause microtrauma of the cartilage and the development of the inflammatory process.Loaders, installers, miners and quarry workers are at risk.Deforming osteoarthritis often affects professional athletes (weightlifters, cyclists, tennis players, soccer players, basketball players, hockey players, etc.).
- Injuries.Damage to ligaments, tendons, menisci, hematomas and fractures cause an alteration in the biomechanics of the joint.If treated incorrectly, this leads to the development of post-traumatic osteoarthritis.
- Surgical operations on the knee can lead to the development of pathology of the articular cartilage and surrounding tissues.
- Excess weight increases stress on the joints of the lower extremities.Up to 80-90% of the progression of all osteoarthritis is associated with joint overload.
- Old age.In people over 50 to 60 years old, regenerative processes slow down, collagen production decreases and hormonal levels are affected.Which leads to the development of pathology.
- Hormonal changes in women.During menopause, estrogen production decreases, which impairs calcium absorption, weakens the musculoskeletal system and makes bones brittle.Increases the risk of developing osteoporosis.
- Problems with the thyroid gland.Thyroid hormones participate in the metabolic processes of calcium and phosphorus in the body.Its deficiency or excess can cause knee osteoarthritis.
- Genetic predisposition.Collagen mutation can cause alterations in connective tissue elements, leading to impairment of the shock absorption function of articular cartilage.
- Inheritance.There is a high probability of developing the disease if there are relatives diagnosed with gonarthrosis in the patient's family, mainly in the female line.
- Inflammatory diseases.Infectious arthritis, bursitis and synovitis caused by bacterial or viral infection are often complicated by the development of gonarthrosis.
- Vascular diseases.The tissues do not receive adequate nutrition, the blood supply is impaired, which leads to the development of ischemia and degenerative-dystrophic changes in the articular cartilage.
- Poor nutrition and metabolic disorders.The consumption of foods rich in purines (proteins) contributes to the deposition of salts in the knee, for example, in gouty arthritis.
- Specific diseases such as gonorrhea, tuberculosis, syphilis, chlamydia and influenza can cause serious damage to the joint.
- Intoxication of the body with various chemicals, including some medications.
- Autoimmune disorders are associated with a violation of the body's immune defenses when antibodies are produced against its own cells, for example, rheumatoid arthritis.
Symptoms of the disease
The main symptoms of gonarthrosis:
- Pain in the joint, painful in nature, sometimes at night, in case of exacerbation, intense shooting;
- Cracking and clicking during movement are caused by a violation of the congruence of the articular surfaces, the presence of osteophytes and cartilage defects;
- Swelling and swelling are associated with the development of an inflammatory process in the joint and surrounding soft tissues;
- Deformation of the joint space and axis of the limb indicates the progression of the disease;
- Atrophy and weakness of the thigh muscles, the volume of the quadriceps and biceps muscles decreases;
- Limitation of mobility and stiffness in the joint is caused by pain, the development of adhesions and the appearance of osteophytes (bony spines).
The first signs of osteoarthritis to look out for are pain that occurs during or after exercise.The pain disappears with rest and does not require medication.Morning stiffness in the knee, initial pain, before getting up and walking after sleeping, it takes a while for the joint to develop.
Signs of exacerbation
With the development of pathology, the symptoms of osteoarthritis become brighter: the knees begin to hurt at rest, and at night, during flexion and extension of the joint, strange sounds appear: creaking, creaking, clicking.Lameness develops, stiffness of movement and swelling of the soft tissues appears.
The following facts indicate the progression of the disease:
- the appearance of deformations of the axis of the limbs in the form of O-shaped legs;
- constant nature of pain, pain at night and when the weather changes (meteosensitivity);
- further deterioration of joint mobility, with the development of flexion contracture;
- weakness and atrophy of the thigh muscles.
Types and forms of the disease.
There is:
- Primary.It develops as an independent disease.Most often, this knee gonarthrosis is associated with hereditary and age-related changes.
- Secondary.It occurs in the context of certain diseases or injuries, for example, post-traumatic osteoarthritis.
Depending on the causes, the following types of osteoarthritis are distinguished:
- Ischemic, associated with problems with blood supply to tissues and vascular disorders;
- Post-infectious disease is caused by infections, viruses, autoimmune processes;
- The idiopathic nature of the development of the pathology remains unclear;
- Metabolism is associated with metabolic disorders: gout, hemochromatosis, chondrocalcinosis;
- Involutional, as a result of age-related changes in the body;
- Posttraumatic, trauma history;
- Dishormonal: consequence of hormonal imbalances in the body.
Development stages
I. First degree osteoarthritis: the initial stage is associated with a deterioration in the quality and quantity of synovial fluid (joint fluid, provides nutrition to cartilage, has shock absorption properties and promotes sliding of articular surfaces).Malnutrition causes the wear and degradation of cartilage tissue, and the appearance of the first signs of inflammation.In the initial stage, movements are not affected.Patients experience slight pain, tingling, and sometimes the joints may creak when moving.Symptoms occur during and after physical activity.Externally, the knee appears quite healthy.
II.Second degree osteoarthritis: causes thinning of the cartilage to 1.5-2.0 mm (normal 2.5-3.0 mm), a narrowing of the joint space is observed, and small single bone growths (osteophytes) appear.The inflammatory process is wave-like in nature and alternates phases of remission and exacerbation.Gonarthrosis of grade 1-2 is accompanied by swelling and weakness of the thigh muscles.The pain bothers me at rest, when the weather changes and after walking I feel tired.Movements become more rigid, morning stiffness and creaking in the joint appear.It is at this stage that patients usually consult a doctor.
III.Third degree gonarthrosis is manifested by external deformation of the joint, curvature of the axis of the limb.The cartilage tissue is severely damaged, thinned to 1-1.5 mm and in some places exposed bone is visible.Bone growths can be easily felt under the skin and range of motion is significantly reduced.In 2-3 degrees of osteoarthritis, the joint space narrows, the joints cannot bend or flex, all movements are accompanied by pain and crunching, and morning stiffness intensifies.A characteristic joint contracture develops.I am concerned about sharp pain in my knee, even at rest.Patients often suffer from insomnia because they cannot adopt a comfortable position that does not cause pain and feel changes in the weather.
IV.Grade 4 gonarthrosis is characterized by complete destruction of the articular surfaces, exposed bone is visible, and cartilage is represented by rare "islands".The joint space is almost invisible.A pronounced O-shaped deformity of the lower extremities and swelling are noted.Mobility is almost completely lost.Treatment with non-surgical methods at this stage is ineffective;Joint replacement with an endoprosthesis is indicated.
An orthopedic doctor comments: To accurately determine the degree of osteoarthritis of the knee joint, in addition to examining the patient, it is extremely important to conduct an instrumental examination (ultrasound, X-ray or MRI of the joint).Bilateral gonarthrosis is very common, so it is recommended to examine the left and right knee joints.This will help you choose the optimal treatment and therefore prevent further progression of the disease.
Diagnosis
An x-ray or ultrasound of the knee joint is usually sufficient to make a diagnosis.In difficult cases, laboratory tests and magnetic resonance imaging (MRI) are prescribed.If pathological fluid accumulates in the joint, a puncture and subsequent examination may be necessary.
Ultrasound diagnosis
Helps identify the disease at an early stage.It allows measuring the thickness of the cartilage layer, the relief of the joint, the presence of joint fluid, the size of osteophytes and ossifications.
Radiography
Perform to assess the degree of damage, the state of bone and cartilaginous tissue.It will show the presence of osteophytes, narrowing of the joint space and joint deformation.In the initial stages of the disease, the examination is not informative.
Analysis
General blood and urine tests and blood biochemistry show signs of inflammation, the presence of infection, and disorders in bone and cartilage tissue.They allow you to evaluate the general condition of the body, determine the causes of the disease, gonarthrosis and exclude pathologies with similar symptoms.
MRI
Magnetic resonance imaging A highly accurate diagnostic method that helps visualize the smallest changes.It will help to make a diagnosis both at an early stage and in complex cases before surgical treatment.
What doctor treats you?
The following specialists treat knee osteoarthritis:
- Orthopedic doctor - diagnoses the disease, performs intra-articular injections, plasma therapy, provides high-tech assistance and surgical treatment.
- Physiotherapist - responsible for instrumental physiotherapy treatment.
- Rheumatologist - will help if the disease is associated with autoimmune disorders.
- Sports doctor: this will be necessary in case of a history of sports illness.
- A nutritionist is needed if the patient is overweight.
At the recovery stage, the treating doctor can involve other specialists:
- Masseur - massages the lower extremities, restores muscle tone, thereby stimulating blood circulation and helping to restore joint mobility.
- Physiotherapist doctor: selects special exercises and controls their implementation.
- Rehabilitation specialist: helps with the patient's social adaptation;The specialist is in special demand after serious reconstructive knee surgery.
What treatment is prescribed?
The sooner the disease is detected and treatment of osteoarthritis symptoms begins, the greater the chances of recovery.Otherwise, the disease can lead to irreversible consequences and significantly worsen the quality of life.
Therefore, the treatment of osteoarthritis of the knee joint of 1 to 2 degrees has a good chance of completely restoring the function of the knee joint.Unfortunately, patients do not always seek medical help in the initial stages.
How to quickly relieve pain and how to treat it?
First of all, it is necessary to eliminate pain and inflammation.Prescribed:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers.Medications allow you to quickly relieve inflammation in osteoarthritis and help reduce pain and swelling.
- Corticosteroids are used when NSAIDs and analgesics do not help, for example, in the treatment of grade 3-4 osteoarthritis of the knee joint.The patient is given a pharmacological block: drugs are injected directly into the joint cavity.This helps relieve pain and achieve relief within minutes after the injection.
- Special ointments and analgesic patches.
An orthopedic doctor comments: Treatment of osteoarthritis of the knee joint of 2-3 degrees is always complex and, as a rule, includes more than 15 (!) points of recommendations in the prescription sheet.It's not just about medications and injections.This is a whole series of rehabilitation measures aimed at correcting the biomechanics of the joint and the patient's lifestyle.Only this approach will help preserve the joint and stop the progression of the disease.
Preparations that strengthen bone and cartilage tissue:
- Chondroprotectors based on chondroitin and glucosamine are the nutritional basis of chondrocytes.
- Hyaluronic acid preparations serve as analogues of synovial fluid.
- Medicines that improve microcirculation and blood supply to articular cartilage.
- Calcium and vitamin D supplements strengthen the bones that make up the knee joint.
- Intra-articular injections of hyaluronic acid preparations, an artificial analogue of synovial fluid, help lubricate the joint surfaces.
- Pharmacological blocks help to quickly relieve swelling, pain and inflammation.As a rule, the effect is noticeable the next day.
Treatment of knee osteoarthritis also includes physical therapy:
- Electrophoresis.Using an electrical current, the medication penetrates the affected area.Electrophoresis is used to treat knee pain due to gonarthrosis.
- Phonophoresis.The drug enters the area of inflammation under the influence of sound waves.An additional advantage of the method in the treatment of gonarthrosis deformans is the thermal effect.
- Shock wave therapy.The procedure improves blood circulation, stimulates tissue nutrition and is used to destroy osteophytes and scar tissue.
- Traction therapy (joint traction) - helps to unload the joint space, stretch it by several millimeters and thus reduce the mutual pressure of the articular surfaces.
- Electromyostimulation: stimulates blood flow and muscle function using electrical current and restores muscle tone.
- Mechanotherapy helps develop joint movements and combat contractures using special robotic simulators.
- Laser therapy creates deep tissue heating and reduces the inflammatory response.
- Magnetotherapy.The therapeutic effect is based on the properties of the magnetic field to reduce pain, inflammation and swelling of tissues.
Orthobiology methods aim to stimulate regeneration and replace defects in cartilage tissue:
- Plasmolifting is a plasma-based drug, made from the patient's own blood, which triggers regeneration processes and contains growth factors.
- PRP Therapy: Plasma obtained from the patient's blood is used as a drug.Platelet-rich plasma stimulates the regeneration of chondrocytes and relieves the inflammatory process.
- SVF therapy is based on the use of stromal vascular fraction cells obtained from the patient's own adipose tissue.
- SVF therapy + PRP therapy: the simultaneous use of concentrated plasma and progenitor cells allows you to achieve the best results.
- Stem cell treatment.The method is based on the use of bone marrow cells and is currently under development.
Each case is individual and requires the development of an independent rehabilitation program for the treatment of osteoarthritis of the knee joint.
Don't know where to treat osteoarthritis?Do you want to get professional help and undergo treatment without surgery?Register at a health center.We offer to undergo an examination and start restoring your health on the day you contact us.Take advantage of modern knee osteoarthritis treatment at competitive prices.