What is osteoarthritis of the knee joint (knee): causes, symptoms and treatment of the disease

Osteoarthritis of the knee joint (gonarthrosis) is a degenerative lesion of the joint, which ultimately leads to its deformation. In it, the cartilage tissue begins to break down. Gradually, the functionality of the knee is impaired and the patient loses his ability to move normally. This disease is very common.

Treatment for osteoarthritis of the knee is long-term, but cannot provide a complete cure for the problem. However, therapy is needed to maintain joint mobility and functionality for as long as possible, as well as to improve the patient's quality of life.

Types of diseases

It is possible to classify gonarthrosis of the knee joint due to the reasons for its development. It is primary and secondary. The first type of disease is the most common. It has another name - idiopathic osteoarthritis. The exact cause of this form of osteoarthritis of the knee is difficult to determine because there are too many influencing factors.

The secondary type of pathology is clearly related to one reason or another. For example, it often occurs after a knee injury due to heavy physical exertion of the knee joint. Such gonarthrosis is often genetically determined. Some diseases can also cause dystrophic changes in the knee joint: diabetes, rheumatoid arthritis, congenital deformity of the lower extremities.

Why pathology develops

The knee joint is one of the most complex joints in the human body. It is formed from the femur, tibia and patella. The articulation also includes triangular cartilage with curved edges - menisci. Well-coordinated knee work is provided by the musculoskeletal system. Almost all bone surfaces of the joint are covered with cartilage tissue, the thickness of which is about 0, 5 cm. It feeds on blood vessels, as well as in a diffuse way (obtaining nutrients from synovial fluid).

The cartilage in the knee allows the bone surfaces to slide and soften. If the nutrition of this tissue is disturbed, then dystrophic processes begin in it, it becomes thinner. If left untreated, the cartilage disappears completely and the knee joint stops moving. The reason for the development of osteoarthritis can be different. For example, the following factors can provoke the appearance of a secondary form of pathology:

• Excessive stress on the knee joint. In this case, changes may occur that the person is not even aware of. Therefore, the load should be moderate, especially in old age. The biggest damage comes from squatting and running on hard surfaces (asphalt).
• Knee injury. This may include damage to the meniscus, dislocation of the joint, fracture. This reason contributes to the development of the disease in young people. After fixation of the limb, blood circulation in it deteriorates. Damage or removal of the menisci in 90% of cases leads to osteoarthritis.
• Too much body weight. Being overweight can damage the menisci. Recovery of the knee joint is long and difficult. In obese people, bilateral osteoarthritis of the knee often occurs. An additional negative point is the presence of varicose veins. In this case, the patient develops the most severe form of gonarthrosis of the knee.
• Weakness of the ligament apparatus. Therefore, there is too high mobility of the joints. Despite the fact that a person can sit on the couch without problems, even without warming up, at this time the joint receives microtrauma. If the knee is sufficiently damaged, osteoarthritis begins to develop.
• Disorder of metabolic processes. In this case, the knee joint does not receive enough nutrients.
• Joint pathologies. The presented pathology can be provoked by arthritis of the knee joint (reactive, rheumatoid). It is characterized by the development of inflammation and accumulation of too much fluid in the joint cavity. The cartilage in the knee begins to deteriorate.
• Stressful situation. Mood swings, the constant presence of the nervous system in a state of tension can provoke osteoarthritis of the knee joint.
• Congenital diseases of the muscles, tendons and dysplasia.
• Chondrocalcinosis (premature deposition of calcium salts in the cartilage of the knee). The pathology is systemic.
• Osteomyelitis. This is an inflammation of the bone marrow in which purulent masses form. They adversely affect the surrounding tissues. Over time, the purulent masses protrude beyond the bone of the knee joint. Lack of treatment threatens the development of sepsis.
• Acromegaly. It is an endocrine disease in which the level of growth hormone - growth hormone - increases. Most often, a benign tumor in the front of the pituitary gland contributes to an increase in its amount. If such a disease develops during adolescence, the child develops a specific physique. Excessive growth rate of cartilage tissue leads to deformation of the knee joint.
• Diabetes.
• Hypothyroidism. This disease is also endocrine. This is due to a lack of thyroid hormones. A person's weight begins to increase, he moves a little and the cartilage of the knee joint wears out.
• Frostbite. In this case, ice crystals form in the soft tissues, killing the living cells.
• Synovitis (inflammation localized in the synovial sac of the joint).

All these causes are able to provoke gonarthrosis of the knee, while the person will not even notice when the disease began to develop.

What are the stages of osteoarthritis in its development?

The effectiveness of knee treatment depends on the degree of development of diagnosed osteoarthritis in the patient:

• First degree osteoarthritis of the knee. The pain at this stage is not felt much. The patient may suffer discomfort for years until he is in a hurry to contact specialists or perform some type of treatment. One needs help during an exacerbation. The sudden onset of pain is not typical of osteoarthritis of the knee.
• Osteoarthritis of the knee joint of 2nd degree. The intensity of the discomfort increases. The pain occurs not only after physical exertion of the knee joint, but also at rest. To get rid of unpleasant sensations, you need to rest more. Swelling occurs in the knee joint, the patient hears a crunch. The X-ray shows a narrowing of the joint space, a slight deformation of the knee joint.
• Osteoarthritis of the knee joint of 3rd degree. In this case, the mobility of the knee is severely limited and sometimes the leg cannot be fully straightened. The pain in the joints becomes strong and constant, it appears in response to changing weather conditions. The discomfort is sick in nature and it is difficult to get rid of it even at rest. Often the patient's sleep is disturbed and to alleviate at least some of his condition, he uses NSAIDs. The person develops lameness and the deformation of the joint is very noticeable.

Treatment of osteoarthritis should begin as early as possible before bone destruction becomes critical. In case of irreversible changes only surgery will help the patient.

Symptoms of osteoarthritis of the knee

The development of osteoarthritis does not occur overnight. As it progresses, the symptoms become more intense. The following manifestations are characteristic of gonarthrosis:

• Crunching and clicking, which is heard with a certain movement. The patient may notice this symptom quite late. However, he says that the joint surfaces are damaged, grooves and bone growths have appeared on them.
• Swelling and enlargement of the knee.
• Painful sensations. In the first stage of osteoarthritis, they are invisible and can appear only after a serious static load on the knee joint. Dynamic exercise in turn improves the condition of the joint, its nutrition and subsequent prognosis. Because the top layer of cartilage is erased in osteoarthritis, the nerve endings are exposed. After some time (after rest) the fibers are covered with a small layer of fibrin and become less sensitive - the pain in the knee disappears. If the knee joint continues to collapse, then the discomfort does not leave the person even at rest. Swelling appears in the bursa, which further compresses the nerves. The inflammatory process begins.
• Limited mobility. This symptom allows you to distinguish osteoarthritis from other pathologies of the knee joint. Stiffness appears in the morning after sleep and disappears after half an hour. If this condition lasts longer, then this indicates the presence of an inflammatory process.
• Reduced range of motion. The patient is unable to straighten the limb to the end. As the patient is constantly in pain, he tries to reduce the range of motion and the connections adapt to this. That is, they are shortened and do not allow the knee joint to fully perform its function.
• Silence of joints. Occurs as a result of a strong change in the joint surfaces.
• Dislocations and subluxations. They appear in the last stage of osteoarthritis, when the joint is severely deformed.

Over time, a person experiences muscle atrophy, osteophyte proliferation, and weakening of the lateral ligaments. The consequences of osteoarthritis are severe as a person becomes disabled.

How to correctly determine osteoarthritis?

To begin the proper treatment of osteoarthritis, the patient must undergo a thorough examination. Diagnosis should be differentiated and include the following tests:

1. X-ray of the knee joint. In gonarthrosis it is performed in two projections. The specialist needs an X-ray of both the injured and the healthy knee. Radiography allows you to identify the following signs of osteoarthritis: narrowing of the joint space, osteophytes, subchondral sclerosis. Also, the presented examination of the knee joint reveals subluxation, sites of ossification of cartilage tissue.
2. Arthroscopy. This is a minimally invasive procedure that is used not only to diagnose osteoarthritis but also to treat it. It provides for the use of a special LED wire with a camera at the end. It is inserted through a small hole on the side of the knee. The whole picture of the internal condition of the joint is reflected on the monitor. However, the procedure has a drawback: the joint is depressurized and pathogenic microorganisms can get into it.

3. Ultrasound. This diagnostic method is absolutely safe. The procedure helps to examine the soft tissues of the knee, as well as cartilage, synovium, blood vessels.
4. CT. This is an X-ray method that allows you to see not only bone structures but also soft tissues. Thanks to computer technology, the specialist can build a three-dimensional model of the knee. However, in order to obtain accurate information, the patient must receive a significant dose of radiation.
5. Scintigraphy. This is an X-ray using a contrast agent.
6. NMR. In this case, magnetic rays are used to obtain information. The picture shows the soft tissues more clearly.

7. Thermography. The procedure is based on recording heat radiation from the surface of the patient's body. So you can identify tumors, foci of inflammation. For the purposes of the differential diagnosis, an examination is assigned.
8. General blood test. It helps to determine the severity of inflammation, to determine its nature.
9. Urine examination. Thanks to it it is possible to determine the systemic nature of the pathology.
10. Blood chemistry.

Thanks to these diagnostic measures, specialists can accurately diagnose osteoarthritis of the knee and prescribe really effective treatment.

Treatment of osteoarthritis of the knee

The treatment of osteoarthritis must be universal and long-term. As it will not be possible to completely stop the destruction of the joint, therapy will have to be carried out constantly to improve the patient's quality of life.

Drugs in the treatment of osteoarthritis

The doctor may prescribe the following medicines:

• Non-hormonal anti-inflammatory drugs. They are used in the form of tablets and ointments. However, in the case of a severe pain syndrome that cannot be eliminated by standard methods, an injection is used. Helps to quickly soothe pain, relieve swelling and reduce the intensity of inflammation. These remedies can only eliminate the symptom, but they cannot cure osteoarthritis. Only a doctor should prescribe these drugs. The course of treatment lasts no more than 14 days and relief comes after 2-3 days.
• Chondroprotectors for osteoarthritis of the knee joint. Each such drug contains beneficial substances that can regenerate cartilage. However, it will only be effective if it is implemented on time. If the cartilage is completely erased, then the use of chondroprotectors will be useless. Treatment with such drugs will be long-term (at least 6 months). Pills and topical medications are most commonly used, although injections are possible.
• Vasodilators. They help relieve spasm and pain syndrome, restore normal blood circulation and improve the nutrition of the knee joint.
• Glucocorticosteroids. They are most often used in the most difficult cases, when other drugs do not give a positive effect. Intra-articular injections in the knee are used for osteoarthritis. They can only be used once a year.
• Enzymes. They provide regeneration of the cartilage structure in the initial stages of development of osteoarthritis of the knee. They are also prescribed for injection into the joint.
• Hyaluronic acid. It provides smooth movement of the knee joint as it is able to replace synovial fluid.
• Topical preparations - ointments, creams, gels. They also relieve symptoms.
• Healing compresses. In this case, a drug is used that can penetrate the skin, help remove muscle cramps and has a resorbing effect. The compress can be made with the help of medical bile.

Drug therapy in the treatment of osteoarthritis is indispensable. However, medications should be used strictly in the dose prescribed by your doctor. It is impossible to increase or decrease the speed on your own, to change the daily norm without the knowledge of a specialist.

Features of physiotherapy and exercise therapy

You can also treat osteoarthritis of the knee with the help of physiotherapy procedures:

• Massage. Helps to restore normal blood circulation in the tissues, eliminate muscle spasm.
• Drug electrophoresis allows you to eliminate inflammation in the joint and also produces an analgesic effect.
• Magnetic therapy. With the help of specific radiation, the tissues surrounding the affected right or left joint are stimulated. Metabolic processes in cells are improved.
• UHF. The waves promote the production of synovial fluid, which lubricates the knee.
• Phonophoresis with corticosteroids.
• Electrotherapy helps to eliminate not only pain but also swelling.

• Mud treatment.
• Hirudotherapy.
• Shock wave therapy.
• Heat treatment. This includes paraffin therapy. Thanks to this procedure, the local blood circulation is improved.
• SMV therapy. This physiotherapy stimulates blood circulation, relieves swelling and helps improve the nutrition of cartilage tissue.

Physical therapy is extremely useful. It is necessary to restore the elasticity of muscle tissue and ligaments, to improve the mobility of the knee joint. The following exercises will be useful:

1. Lying on your stomach, you should alternately lift your legs up. In this case, they should not bend at the knee. The lifting height is approximately 20 cm.
2. Lying on your left side, you should bend your left leg and raise it to 30 degrees. You need to hold the limb in this position for up to 30 seconds. The same exercise should be done with the right leg.
3. Sitting in a chair, the legs should be straight and raised in turn as high as possible.

The set of exercises is chosen individually by the attending physician. Gymnastics is best done after a small massage with medicated ointments. Physiotherapy is an effective additional method for the treatment of osteoarthritis, which enhances the effect of drugs.

Is surgery necessary?

In the most difficult cases, when the joint is severely damaged by osteoarthritis, the patient is prescribed surgery. There are several types of interventions:

1. Articular traction. It involves stretching a joint damaged by osteoarthritis to increase the gap between the cartilages. This will make it possible to prevent further tissue destruction and its gradual recovery.
2. Endoprosthesis is a complete replacement of the joint destroyed by osteoarthritis. It is performed as a last resort. The replacement can be complete or partial. The prosthesis will have to be replaced after 10-15 years.
3. Osteotomy. Such treatment of osteoarthritis allows for mechanical correction of the deviations of severely deformed bones. In this case, the solid elements break in a strictly defined place. The bones are then positioned correctly and fused.
4. Arthroscopy. With its help, the surface of the cartilage destroyed by arthrosis is restored. In addition, foreign bodies and bone fragments can be removed from the joint with the help of an arthroscope. Such an operation is used for hypermobility of the joint. Arthroscopy is considered a mildly traumatic procedure, so rehabilitation after it does not take long.

It is better not to bring him to surgery. Treatment should begin in the first stage of osteoarthritis. Orthopedic devices will help to consolidate the result: cane, orthosis to reduce the load, knee braces with infrared radiation.

The use of folk remedies

It is impossible to completely cure osteoarthritis, as the degenerative process will gradually progress. However, you can eliminate the symptoms and stop the destruction of the knee joint in osteoarthritis. Folk remedies can be used during exacerbations, as well as during relative calm. But first you need to consult a specialist. The following recipes will be useful in osteoarthritis:

1. Chopped horseradish root should be boiled in a small amount of water over low heat. The slurry should then be filtered and placed around the knee affected by osteoarthritis. The compress must be fixed with a bandage. You need to do the procedure every day for a month. The compress improves blood circulation and tissue repair.
2. Rubbing any vegetable oil into the area of the knee joint for osteoarthritis will help relieve the pain. However, it needs to be warmed up a bit.
3. The mummy provides a good effect. It is necessary to mix 3-4 g of raw materials with 100 g of honey and mix everything thoroughly. You should rub the medicine into the sore spot in the evening before going to bed. Then wrap the affected area with a warm scarf. Acceptance of the mummy inside is also welcomed. You can use it at 0, 2 g per day.
4. Fresh dandelion flowers can be washed thoroughly and consumed 5-6 pieces a day. Also dry raw materials in the amount of 1 tbsp. you need to pour a glass of boiling water, insist and drink 1/3 cup three times a day.
5. Rubbing aloe leaves. It is necessary to twist 10 leaves of the plant and squeeze through cheesecloth. The juice is mixed with half a glass of honey and 150 ml of red wine. The resulting product is poured into a dark glass container and applied daily for a month.

Cabbage and burdock leaves will help relieve inflammation in osteoarthritis. Folk remedies can not be considered a panacea, but increase the effectiveness of other therapies.

Dietary rules for osteoarthritis

Treatment of osteoarthritis does not require a particularly strict diet, but you still need to adhere to certain dietary rules:

• Reduce salt intake. Its total amount per day should not exceed 2 g. It is better to salt the dish immediately before use, rather than during cooking.
• The amount of spices used during the treatment of osteoarthritis should also be reduced. The same goes for fermented foods, pickles. Marinades and canned foods are better to exclude from the diet.
• Animal fats are not recommended.
• The menu should not contain pastries, pastries and bread made from wheat flour.

• In osteoarthritis, alcohol and nicotine are strictly forbidden.
• Dishes containing gelatin are useful: aspic, jelly, beef bone broth.
• For osteoarthritis it is important to consume milk proteins (products should not be greasy), fish, seafood.
• The diet should contain vegetable oils, vegetables and fruits, freshly squeezed juices.
• One should consume enough fluids per day.

The correct diet for osteoarthritis should be developed by a specialist. You cannot go to extremes, even if the patient is overweight. Dramatic and improper weight loss will only worsen your health. In this case, treatment will be significantly delayed.

Prevention of osteoarthritis

To avoid the possibility of developing osteoarthritis, as well as not to lose the ability to walk, you should follow the following expert advice:

• We must not forget about movement. Better to go to the pool, ride a bike, go hiking in the fresh air. You can also go dancing.
• It is advisable to avoid any lesions and hypothermia of the knee joint, as this provokes post-traumatic osteoarthritis.
• It is better to use knee pads or other orthopedic devices for prolonged exercise.
• It is recommended to wear comfortable shoes.

• It is important to eat properly - osteoarthritis will not stand a chance if all the necessary nutrients are delivered regularly to the joint.
• If you are overweight, you need to get rid of it.
• It is better to avoid stress, as well as to properly organize the regime of work and rest.
• It is necessary to strengthen the body's defenses.
• Any inflammatory or infectious pathologies that can provoke the development of osteoarthritis must be eliminated in time.

Proper prevention can significantly slow down the destruction of joints, which under normal conditions is a natural aging process in the body.

Osteoarthritis of the knee joint is an incurable disease, but its progression can be slowed down and even stopped by improving the quality of life.