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 one in three inhabitants of the planet suffers from arthrosis, and this number is not decreasing. At risk are the elderly, especially those who are overweight. From the age of 65, osteoarthritis is diagnosed in 70-85% of cases of knee pain treatment.
A rheumatologist helps preserve the quality of life of a patient with joint pathology.
Causes of osteoarthritis
- Destruction of the joint due to natural wear and tear (ageing of the body).
- Hormonal disorders (menopause, endocrine diseases).
- Congenital defects of the musculoskeletal system.
- Injuries, surgical operations on the knee joint.
- Professional sports.
- Monotonous physical work with increased stress on the knee joints.
- Over weight.
- genetic predisposition.
- Autoimmune diseases.
disease symptoms
Deforming osteoarthritis of the knee joint (gonarthrosis) develops slowly and continues chronically. In the early stages, the disease does not cause pain - a person feels only discomfort, stiffness in the lower limb. Gradually, the motor restrictions increase. Without proper treatment, the knee becomes noticeably deformed. Motor functions are so disturbed that it is difficult for a person to walk, sit down and get up. Deforming osteoarthritis progresses to the patient's incapacity. To save the joint, it is necessary to consult a doctor when the first symptoms of pathology appear.
Depending on the severity, there are three degrees of osteoarthritis 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 arthrosis of the first degree, a person may feel discomfort in the knee after a long stay on his feet, intense walking, physical exertion. The X-ray image shows a narrowing of the joint space, osteophytes growing inside the joint are visible. If arthrosis is accidentally detected at the first stage, for example, during a medical examination, its development can be significantly slowed down and even stopped.
- 2nd grade. The pain in osteoarthritis of the knee becomes intense, it is difficult to ignore. Especially strongly the foot bothers early in the morning or in the evening. During the day at rest, persistent pain persists. Degenerative processes in the joint are reflected in the gait - a person begins to limp. During the movement, a crack is heard in the knee. Arthrosis of the second degree can be complicated by "articular mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity. The foreign body causes severe pain that interferes with movement of the limb. On examination, the knee is deformed. Perhaps the adhesion of inflammation, swelling. The radiograph shows a narrow joint space and osteophytes, thickening of the bone.
- 3rd grade. A severe form of the disease that develops in the absence of treatment. 3rd degree osteoarthritis is a cause of permanent disability. The pain in the knee is very strong, mobility is limited, the person cannot walk independently, each step is painful. The leg deforms and begins to creak strongly. On the x-ray, the doctor determines the degeneration of cartilage tissue, the destruction of ligaments, menisci, and the growth of connective tissue.
Diagnosis of osteoarthritis
To examine the patient, physical, laboratory and instrumental diagnostic methods are used:
- The blood test is general, biochemical, immunological.
- Synovial fluid analysis.
- Bone scan.
- Knee ultrasound.
- CT scan or MRI if indicated.
The examination plan is always individual and depends on the patient's condition.
Treatment of osteoarthritis 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 joint is already destroyed. The earlier treatment is started, the more effective it will be.
Medical treatment
The doctor prescribes drugs to relieve inflammation, swelling, reduce pain, activate metabolic processes and tissue regeneration. Medicines are selected individually.
The following funds are available:
- Non-steroidal anti-inflammatory drugs(NSAIDs) in the form of tablets, ointments, injections. It means well relieve pain, swelling, improve the patient's well-being.
- Glucocorticosteroidsin the form of injections directly into the knee joint. Injections are indicated in severe cases of the disease, when the limb is practically immobilized.
- pain blocks. Help cope with symptoms and palliate the course of the disease.
- Chondroprotectors. Medications contribute to the restoration of cartilage tissue and slow down the destruction of the joint.
Conservative treatment
shock wave therapy
The method is non-invasive, helps to remove salt deposits, improves connective tissue trophism. Physiotherapy improves blood circulation, favorably affects the elasticity of the ligaments. Shock wave therapy is carried out in courses 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
The method combines the effects of ultrasound and therapeutic ointments. Means for physiotherapy, as a rule, have a complex composition and are prepared in a pharmacy on a prescription. Ultrasound increases the penetrating power of the active substance.
Massage
The procedure is contraindicated at the stage of exacerbation of arthrosis. When the inflammation is removed, the pain syndrome is reduced, you can start a course of massage. The lymphatic drainage technique helps prevent the accumulation of synovial fluid. Massage also improves blood circulation in the knee, relieves muscle spasm. The procedure is most effective after performing special exercises for arthrosis of the knee joint.
Toilets
You can take a course at home as prescribed by a doctor or as part of a spa treatment. With arthrosis, radon, turpentine and hydrogen sulfide baths are indicated. The procedures have a beneficial effect not only on the knee, but also on the hip and ankle joints.
Hirudotherapy
Medicinal leeches are placed around the deformed joint. The saliva of these creatures contains active substances that contribute to the restoration of cartilage. Hirudotherapy is usually prescribed for first and second degree osteoarthritis to relieve swelling and reduce pain.
Physiotherapy
Gymnastics for arthrosis of the knee joint is an obligatory part of complex treatment. Special exercises help maintain muscle tone in the diseased limb and prevent congestion. Gymnastics begins to do in the morning without getting out of bed. Then, during the day, another 3-4 sets of exercises are performed for several minutes. It is useful to supplement therapeutic exercises for arthrosis of the knee joint with swimming.
Surgery
Surgical intervention is indicated for arthrosis of 2 and 3 degrees:
- Puncture. With the help of a syringe, the accumulated fluid is pumped out of the joint cavity. Reduces internal pressure, reduces swelling, inflammation, improves mobility. The procedure is performed on an outpatient basis, at the surgeon's appointment.
- arthroscopy. The method is used for the rehabilitation of the knee joint. Arthroscopy is performed through small punctures, so the operation is quite easily tolerated, the rehabilitation period is short.
- corrective osteotomy. The classic technique for the treatment of deforming arthrosis, which consists in correcting the deformed anatomical axis of the lower limb, followed by fixation of the bone wedge resection site with a titanium plate. After an osteotomy, the patient needs rehabilitation for several months.
- stent. The installation of an artificial joint is performed with an extreme degree of deforming osteoarthritis of the knee joint and allows the knee to return to its previous range of motion without pain. After total arthroplasty, the patient needs a long rehabilitation (about 2-3 months).
arthroscopy
Minimally invasive treatment method. A video camera and microsurgical instruments are introduced into the joint cavity. The doctor conducts a full examination of the joint, removes particles of osteophytes, destroyed cartilage, scar tissue. Arthroscopy helps temporarily relieve pain and restore joint mobility.