Arthrosis of the knee

15 September 2020

Arthrosis of the knee joint, also called gonarthrosis, can significantly affect 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. Razvlecheniya and its thinning are observed, and over time it disappears completely. Therefore, there is no soft protector on the bone, and this causes an increase in load on the end plate of the articular surface of the bone that is turned on. As a result of this load, pain develops. The code for knee joint arthrosis according to ICD-10 is M17.

Knee joints are often affected because the knee has significant loads while walking, physical exertion, and running. In this case, awkward movements can cause injury to the soft tissues of the knee and cause arthrosis. That is why gonarthrosis is one of the leading causes of disability. According to statistics, the disease affects about 20% of people on the planet to varying degrees.

Why arthrosis develops, how to prevent the development of the disease, which doctors treat arthrosis of the knee joint, and what treatment methods a doctor can recommend once a 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 hold it. In this case, the nature of cartilage can be determined by genetics or changes due to the influence of acquired factors, both exogenous and endogenous. The development and progression of gonarthrosis can occur with increasing age, with a background of obesity, caused by femoral-patellar joint dysplasia or changes in the lower extremity axis, joint biomechanical disorders, damage to the menisci and ligaments.

The basis of pathogenesis is the predominance of catabolic versus anabolic processes, which are noted in cartilage and subcondral, menisci and synovium. As a result, structural changes occur and the biological properties of cartilage disappear. Subsequently, the pathological process spreads to the muscles and ligaments.

The basis of articular cartilage is the matrix of connective tissue and chondrocytes. The connective tissue matrix contains collagen molecules and aggregates type II. The protective properties of cartilage are provided precisely by the connective tissue matrix.

The inflammatory process in arthrosis is not as intense as in arthritis. However, in osteoarthritis, pro-inflammatory mediators are also present.

Welding

According to the origin of gonarthrosis, the following types are distinguished:

Primary (idiopathic)- develops without the influence of external causes.
Secondary- certain factors lead to the development of the disease. Often it is associated with injuries, fractures, surgical interventions in the joints, and even inflammatory factors - acute and chronic arthritis.

The following stages of knee arthrosis are also determined:

1st degree arthritis- determined in the period from the appearance of the first signs of the disease to the development of visible bone defects on x-rays or during examination. During this period, pain of varying intensity appears during movement.
In class 2- unpleasant sensations can be seen even at low loads. While walking and squatting, knees bend, joint movement decreases. The picture shows the growth of bone tissue along the edges of the joint, as well as narrowing of the joint space. On external examination, it can be observed that the knee is enlarged.
At grade 3there is practically no cartilage tissue in the joint. If the disease persists, the bones can grow together, which provokes the movement of the legs completely. Sleep is disturbed, making it impossible to move without a cane or cane.

This type of disease is also differentiated:

Patellofemoral knee arthritis- a condition in which degenerative changes are observed in the posterior part of the patella, i. e. the patella. With this form of the disease, the pain is mainly interrupted when descending stairs or from the mountains. Patellofemoral arthritis can develop in runners. The disease is often diagnosed in young people.
Post-traumatic arthritis of the knee joint- due to injury. This type of post-traumatic illness may not appear at first. But then, one loses joint motor activity completely.

Causes of knee joint arthrosis

Currently, work is underway to study the causes leading to the development of such pathologies.

Currently, the cause of gonarthrosis is associated with the influence of the following factors:

Age - at a certain age, degenerative changes in tissue begin in a person, and the ability of cartilage tissue to regenerate decreases.
Arthritis - Over time, arthritis can lead to the development of arthrosis.
Injuries and delayed loads - in addition to injuries, the development of the disease can provoke the need to frequently kneel, squat, lift weights.
Obesity and overweight - due to being overweight, there is an increase in load on the joints of the feet. In addition, substances that cause damage to the joint enter the bloodstream from pathological adipose tissue, and then into the joint.
Heredity - in some cases, the development of the disease is determined by a defective gene responsible for the growth of cartilage tissue. As a result, these tissues have low resistance to damage. If a close relative suffers from arthrosis, this will increase the likelihood.
Diseases leading to metabolic disorders - the risk of this pathology increases with atherosclerosis, diabetes mellitus.
Hormonal disorders - more often women get sick after 55 years.
Sports - people who practice certain sports are more likely to suffer from this disease. This is especially for runners, as well as football, tennis, basketball players.

Symptoms of knee arthrosis

As a rule, the symptoms of arthrosis of the knee joint increase slowly, as the process of its development lasts for many years. If many joints are affected, symptoms of polyarthrosis develop.

The manifestation of this disease depends on its severity, age and several other factors.

However, the main symptoms of gonarthrosis are as follows:

Pain in the knee joint, exacerbated by activity. During rest, the knee hurts less.
Swelling in the knee area.
A feeling of warmth in the joints.
An unpleasant sensation of stiffness in the joints, which appears after a person has been in a static position for a long time.
Decreased knee joint movement, making it difficult for a person to get out of a chair, down stairs or out of a car.
Fractures and cracks in the knee, most often seen with sudden joint movements.
It is believed that climate change affects the level of pain and discomfort.

Analysis and diagnostics

To determine whether such a disease can be cured, the diagnosis must be confirmed beforehand. In the process of diagnosis, the doctor examines and interviews the patient. But the most informative study in this case is the X-ray of the knee.

Also, to clarify the diagnosis, it is recommended to undergo an ultrasound scan, where you can exclude arthritis, as well as measure the height of the articular cartilage.

If necessary, appoint an additional examination.

Treatment of knee arthrosis

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 right complex therapy scheme. Treatment of osteoarthritis of the knee joint at home is possible if the patient carefully adheres to all the recommendations of the specialist, adopts additional medications and treatment methods. Only in this case home therapy can 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 arthrosis. In the event of a first-degree disease, a complex therapy scheme is used, which allows you to get the effect in the shortest possible time. Therefore, if a person is diagnosed with 1st degree arthrosis, the disease should be treated immediately.

On how to treat grade 2 knee joint arthrosis, the doctor decides based on the patient's condition. Since at this stage the cartilage tissue changes begin, treatment must be done immediately.

Whether it is possible to cure grade 3 knee arthrosis depends on many factors. By grade 3, cartilage becomes thinner, so treatment at this stage is long and most ineffective.

Medicine

Medical treatment of knee arthrosis aims to have analgesic and anti-inflammatory effects. It is also important to reduce the severity of cartilage destruction.

The following drugs are used for this purpose:

Nonsteroidal anti-inflammatory drugs - both tablets and local medicines are used - ointments, gels. The most effective application of local and systematic funds.
Chondroprotectors for knee arthrosis - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfate and others are used. Such a remedy for arthrosis of the knee joint is prescribed as part of a complex treatment. The price of chondroprotectors depends on the drug and varies significantly.
For severe illness, medical treatment includes steroids. Injections for arthrosis of the knee joint can be given intramuscularly, and even external agents with steroids can be used.
External agents with skin irritants. In the description of folk remedies, you can also get annoying compresses.
During treatment, the doctor may prescribe an injection into the knee. Different medications can be used for injections into the knee joint for arthrosis. In particular, corticosteroids are injected to relieve severe inflammation. Injection reviews show that it is in this form of steroids that steroids act most quickly and effectively. Knee obstruction can be done not only with glucocorticosteroids, but also with anesthetics. Reviews from restrictions indicate that this method is effective in relieving severe pain. Also, injections in the knee can be done during treatment with chondroprotectors. It improves metabolic processes, activates collagen production. But to get the effect, it is necessary to do at least five injections. Also, hyaluronic acid is injected intra-articularly, which improves the quality of intra-articular fluid and provides effective protection to cartilage tissue. Vitamins can also be given intra-articularly.
Plasmolifting method - essentially consists of the introduction of platelet-rich blood plasma into a sore knee.
Medical bile for arthrosis of the knee joint - used for compresses. It should be noted that medical bile can be an effective drug only if its use is prescribed by a doctor according to a specific scheme. Therefore, the option of "we treat at home" without seeing a doctor is unacceptable in this case.

Procedures and Operations

If arthrosis and polyarthrosis, non-drug treatment methods are also used, their use is no less effective.

Physiotherapy. Various techniques are used, including shock wave therapy methods, myostimulation, phonophoresis, ozone therapy, kinesitherapy and others. Physiotherapy can reduce pain, relieve inflammation. Any physiotherapy prescribed by a doctor should be done exactly at the complex advised by the doctor.

Laser therapy- produces a decongestant, analgesic, anti-inflammatory effect.

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

Knee pads for knee arthrosis- wearing such a tool reduces the severity of pain. In addition, the knee brace protects it from instability. But to get the desired effect, it is necessary to choose the right knee bandage or knee brace. There are many general tips on how to choose a knee bandage for knee arthrosis. In addition, many different models of knee pads are offered - with movement constraints, amplifiers, and the like. But still, those who want to buy knee pads for arthrosis, are advised not to rely on user reviews, but on doctor's recommendations. The price of orthopedic knee pads depends on various features - materials, quality. The knee bandage is particularly relevant if the patient has post-traumatic arthrosis. But patellofemoral arthrosis, as well as other types of disease, can be treated with this method.

Therapeutic gymnastics for knee arthrosisis an effective method that allows you to improve the condition and prevent surgery, provided the person regularly and continuously performs exercise therapy for knee joint arthrosis. Physiotherapy exercises help strengthen the leg muscles, and stop the development of pathological processes. However, a set of exercises for knee joint arthrosis must be performed in a specific sequence, and such gymnastics is selected individually. Therefore, what is best for the class is not a gymnastics video, but a set of exercises developed by a doctor. In this case, not only filling is important, but complete exercise therapy.

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

Special gymnastics.Such training is recommended during treatment and for people over the age of 40 for prevention. Knee exercises should be done daily. This exercise is also suitable for older adults, as it can be done calmly.

Massage and manual therapy- suitable for patients with limited mobility, can be combined with exercise therapy. If there is no opportunity to visit a masseur, self-massage can be done according to the scheme that will be shown by a specialist.

As an additional method to improve the patient's condition and active recovery, yoga, acupuncture, joint stretching, special exercises on the simulator (exercise bike etc. ) can be done.

If conservative methods are proven to be ineffective, surgical treatment will be performed.

The following techniques can be used:

Puncture- removing excess fluid in the joints can reduce symptoms of inflammation and restore mobility.
Arthroscopy- can be done using endoscopy. Using this technique, the joint surface is cleaned of fragments of destroyed cartilage tissue.
Periarticular osteotomy- during such an intervention, one of the bones that make up the knee joint is sawed and reassembled at different angles. As a result, the severity of the pain decreases and knee mobility increases. This intervention is effective in the first and second stages of the disease.
Endoprosthetics- replacement of the knee joint with a special biocompatible construction. This is a very complex intervention, performed with the third stage of the disease.

Treatment of arthrosis of the knee joint with folk remedies

Numerous reviews on the treatment of folk remedies for this disease confirm that such methods can be used as an auxiliary method, making the patient's condition easier. However, such methods cannot replace primary treatment. Folk remedies are used for rubbing, compressing, bathing, swallowing. Any thematic forum contains a lot of advice on this subject.

Rub with garlic. Some garlic cloves should be peeled and chopped. Mix the resulting gruel with 200 ml of vegetable oil and insist in a dark place for a week. Apply to knees overnight with film and warm cloth on top.
Mustard Blender. To prepare the remedy, take 50 g of camphor and mustard powder, 500 ml of vodka, protein per egg. All mixed and stored in jars in a dark place for a week. Next, the product must be applied to 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 the treatment of arthrosis. A few pieces of burdock should be folded down with a flexible, oily part with vegetable oil. Attach to the knee and cover with cellophane and a warm cloth over it. Also, burdock leaves can be rubbed with vodka. Compresses are used at night. The same goes for treatment with carrot leaves.
Cabbage leaves. It is also used on sore spots at night. It is pre-lubricated with honey, cologne or vodka.
Compress honey. You need to mix the same amount of honey, ammonia (10%), glycerin and bile, add a few drops of iodine. Store the pre-mixed product in a dark place for 10 days. Heat before applying the compress.
Boil onions. It is taken internally. To prepare the broth, you need to take two large onions, cut and pour 1 liter of water. Cook until onions are tender. Take 100 ml decoction three times a day.
Celery Juice. Grind celery stalks in a blender, squeeze the juice. Drink 100 ml of juice three times a day.
Gelatin. With arthrosis, it is recommended to consume foods that contain gelatin. Jelly, jelly and other dishes with gelatin are recommended to be included in the menu.
Bathe with a pine needle. Pour boiling water over 1 kg of pine needles and leave for several hours. Add to a warm water bath, where you can also dissolve 0. 5 kg of salt. Bathe for 20-30 minutes.

Prevention

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

Eat right and include a variety of foods that contain vitamins and minerals in your diet.
Avoid excessive load on the knee joint, protect it from injury.
Quit bad habits.
Monitor weight, prevent obesity.
Treat all diseases in a timely manner, undergoing preventive screening.
Follow sports, prefer gentle physical activity.
Wear high quality footwear that is as comfortable as possible.
Make sure the body posture is correct.

Diet for osteoarthritis of the knee joint

Effectiveness: healing effects
Conditions: permanent

During treatment and recovery, diet is quite important. First of all, food should be healthy and light - it is important to prevent overweight, which can worsen the condition and provoke acute arthrosis. But this disease not only requires treatment, but also weight loss.

It is also important to include diet foods that contain essential components for cartilage tissue:

Poultry, rabbit.
Sea fish.
Soy products.
Eggs.
Green, zucchini, carrots, pumpkin.
Peanuts.
Fruits, berries.
Vegetable oil.
Serve with gelatin.

At the same time, you need to limit the use of the product:

Beans, sorrel, spinach, tomatoes.
Flour.
Animal fat.
Spices, vinegar.
Alcohol.
Red Meat

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

Consequences and complications

If treatment is not done in a timely manner, arthrosis can lead to the development of such complications:

Inflammatory processes in periarticular tissue.
Joint mobility limitations.
Change the shape of the joint.
Hip joint deterioration.

Complications like these can lead to the development of defects and irreversible changes.

Forecast

It is important to treat the disease in a timely manner. The best prognosis is if you start treatment at 1 or 2 stages of the disease.