Arthrosis of the knee joint is a degenerative-dystrophic pathology that leads to deformation and destruction of articular cartilage. Gradually, the limb loses mobility. According to statistics, almost every third of the population of the planet suffers from arthrosis, and this number is not declining. At risk are the elderly, especially those who are overweight. After 65 years, arthrosis is diagnosed in 70-85% of treatment cases for knee pain.
A rheumatologist helps maintain the quality of life of patients with joint pathology.
Causes of arthrosis
- Joint destruction due to natural wear and tear (body aging).
- Hormonal disorders (menopause, endocrine diseases).
- Congenital malformations of the musculoskeletal system.
- Injury, surgery on the knee joint.
- Professional sports.
- Boring physical labor with increased pressure on the knee joint.
- Overweight.
- genetic predisposition.
- Autoimmune diseases.
Symptoms of the disease
Deformed knee joint arthrosis (gonarthrosis) develops slowly and persistently in a chronic form. In the early stages, the disease does not cause pain: a person only feels discomfort, stiffness in the lower limbs. Gradually, the motor restriction increases. Without adequate treatment, the knee appears deformed. Motor function is disrupted so that it is difficult for a person to walk, sit, get up. Arthrosis deformation progresses to the patient’s disability. To save the joints, it is necessary to consult a doctor when the first symptoms of pathology appear.
According to severity, there are three degrees of arthrosis of the knee joint:
- 1 degree. The clinical manifestations of the disease are mild. Most patients do not pay attention to the symptoms and continue to lead a normal life. With stage 1 arthrosis, a person may feel discomfort in the knee after a long stay on his feet, intensive walking, doing physical exercise. X-ray images show narrowing of the joint space, osteophytes growing inside the joint are visible. If arthrosis is inadvertently detected in the first stage, for example, during a medical examination, its progression can be significantly slowed and even stopped.
- 2 degrees. The pain in osteoarthritis of the knee becomes intense, difficult to ignore. Especially once the legs bother early in the morning or evening. During the day at rest, the excruciating pain persists. The degenerative process in the joints is reflected in the gait: a person begins to drown. During the movement, a throbbing is heard in the knee. Level 2 arthrosis can be complicated by "articular rats" - this is a condition in which destroyed bone or cartilage particles enter the synovial cavity. Foreign bodies cause severe pain that interferes with limb movement. On examination, the knee was deformed. Probably the involvement of inflammation, swelling. X-rays show narrow joint spaces and osteophytes, bone thickening.
- 3 degrees. A severe form of the disease that develops in the absence of treatment. Level 3 arthrosis is the leading cause of permanent disability. The pain in the knee is very strong, mobility is limited, the person can not walk freely, every step is painful. Legs deformed and began to crackle loudly. On radiographs, the doctor determines cartilage tissue degeneration, ligament destruction, menisci, and connective tissue growth.
Diagnosis of arthrosis
To examine patients, physical, laboratory, instrumental diagnostic methods are used:
- Blood analysis is general, biochemical, immunological.
- Synovial fluid analysis.
- Radiography.
- Ultrasound of the knee.
- CT or MRI if indicated.
The examination plan is always individual and depends on the patient’s condition.
Treatment of arthrosis of the knee joint
Therapy includes a set of procedures, medications, recommendations for lifestyle changes. It is important not to try to treat arthritis on your own. Often, patients in the early stages of the disease use anesthetic ointments and go to the doctor when the joints are already destroyed. The earlier treatment is started, the more effective it is.
Medical treatment
Doctors prescribe drugs to relieve inflammation, swelling, to reduce pain, activate metabolic processes and tissue regeneration. Medications are selected individually.
The following funds are available:
- Non-steroidal anti-inflammatory drugs(NSAIDs) in the form of tablets, ointments, injections. Means well relieve pain, swelling, improve patient well -being.
- Glucocorticosteroidsin the form of direct injections into the knee joint. Injections are indicated in cases of severe disease, when the limb is practically immobile.
- Pain restriction. Helps to relieve symptoms and reduce the course of the disease.
- Chondroprotectors. Medications contribute to the recovery of cartilage tissue and slow down the destruction of joints.
Conservative treatment
shock wave therapy
This method is non -invasive, helps remove salt deposits, increases the trophism of connective tissue. Physiotherapy improves blood circulation, has a beneficial effect on ligament elasticity. Shock wave therapy is carried out in a course of 4-10 procedures.
Plasmolifting (PRP therapy)
The patient’s own platelet -rich plasma is injected into the joint. The plasmolifting course accelerates tissue regeneration.
Phonophoresis
This method combines the effects of ultrasound and therapeutic ointments. Means for physiotherapy, as a rule, have a complex composition and are available in pharmacies by prescription. Ultrasound increases the penetrating power of the active substance.
massage
This procedure is contraindicated in the stage of exacerbation of arthrosis. When the inflammation is removed, the pain syndrome is reduced, you can start a course of massage. Lymphatic drainage techniques help prevent the accumulation of synovial fluid. Massage also improves blood circulation in the knee, relieving muscle spasms. This procedure is most effective after performing special exercises for arthrosis of the knee joint.
Take a shower
You can run the course at home as prescribed by a doctor or as part of a spa treatment. With arthrosis, radon, turpentine, hydrogen sulfide baths are indicated. The procedure has a good effect not only on the knee, but also on the hip and ankle joints.
Hirudotherapy
Medicated leeches are placed around the deformed joint. The saliva of this creature contains active ingredients that contribute to the recovery of cartilage. Hirudotherapy is usually prescribed for stage 1 and 2 arthrosis to relieve swelling and reduce pain.
Physiotherapy
Gymnastics for arthrosis of the knee joint is a mandatory part of the complex treatment. Special exercises help maintain muscle tone in diseased limbs, avoiding congestion. Gymnastics is started in the morning without getting out of bed. Then, during the day, another 3-4 sets of exercises are done for a few minutes. It is useful to supplement therapeutic exercises for arthrosis of the knee joint by swimming.
Surgery
Surgical intervention is indicated for 2nd and 3rd degree arthrosis:
- Puncture. With the help of a syringe, the accumulated fluid is pumped out of the joint cavity. Reduces internal stress, reduces swelling, inflammation, improves mobility. The procedure is performed on an outpatient basis, at the appointment of a surgeon.
- Arthroscopy. This method is used for the rehabilitation of the knee joint. Arthroscopy is performed through a small puncture, so the operation is easily accepted, the recovery period is short.
- Corrective osteotomy. The classic technique for the treatment of deformed arthrosis, which consists of correcting the deformed anatomical axis of the lower limb, is followed by fixing the bone wedge resection site with a titanium plate. After an osteotomy, the patient needs rehabilitation for several months.
- Endoprosthetics. Artificial joint installation is performed with an extreme degree of deformed arthrosis at the knee joint and allows the knee to return to its previous range of motion without pain. After total arthroplasty, the patient requires a long recovery (approximately 2-3 months).
Arthroscopy
Minimally invasive treatment methods. Video cameras and microsurgical instruments are inserted into the joint cavity. The doctor conducts a thorough examination of the joints, extracting osteophyte particles, destroyed cartilage, scar tissue. Arthroscopy helps relieve temporary pain and restore joint mobility.