Arthrosis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease, which is accompanied by the gradual destruction of cartilage with the gradual involvement of periarticular structures in this process.Lack of timely treatment leads to limited movement and even disability of the patient.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over 65 who consult a doctor with complaints of knee pain.The elderly are at risk because with age the articular cartilage becomes thinner, microcracks appear in it and it gradually collapses.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes less, which is why the surfaces of the bones begin to touch and collapse;
- bony growths (osteophytes) appear;
- the joint capsule becomes denser, which causes joint stiffness;
- A spasm of the muscles surrounding the joint occurs.
Without treatment, the knee deforms and its movements are significantly limited.It can affect one or both joints
According to statistics, every fifth person in the world has gonarthrosis.The disease is mainly diagnosed in people over 40 years old, but the age factor is not the only reason for the development of the pathology.
Why does gonarthrosis appear?
In elderly patients, arthrosis of the knee joint occurs due to the natural wear and tear of the cartilage tissue.Other causes of the disease:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtraumas;
- previous surgical interventions;
- autoimmune diseases;
- chronic joint diseases;
- regular increased loads on the knee joint, for example, running or jumping, constant standing or kneeling;
- genetic predisposition.
At risk are women over 40, athletes, overweight patients and people in construction professions.
How to recognize arthrosis of the knee joint?
The disease develops slowly, over several years, and has a chronic course.Its changes are irreversible, so it is important to start treatment as soon as possible when symptoms appear.
The first signs of gonarthrosis:
- stiffness in the knee;
- discomfort when straightening or bending the knee joint, going up or down stairs;
- creaking or clicking noises when moving;
- slight pain in the knee, which appears only after standing for a long time and goes away with rest.
Over time, the worry intensifies.Strong stiffness, motor disturbances and severe pain appear, which do not leave the patient even at rest.It is difficult for a person to walk, sit or stand up.Without treatment, the knee joint deforms, leading to disability.
The severity of the changes, as well as the possibility of recovery, depends on the stage of the disease.
Degrees of gonarthrosis
There are 4 degrees of severity of the disease:
- Graduate.At the beginning of the disease, there are practically no symptoms.There are minor discomforts in the knee after training, which does not interfere with leading a normal lifestyle.Pathological changes can only be detected using x-rays.
- degree II.A crackling noise and periodic pain appear during physical activity, walking, climbing stairs, squatting or standing for a long time.X-ray images can reveal a narrowing of the joint space and the initial signs of osteophyte formation.
- degree III.The pain syndrome becomes permanent and does not leave the person in peace.The knee hurts especially badly in the morning and in the evening;during the day the pain is painful and tolerable.Since degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a cracking sound is heard when he moves.There is a "joint mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity, causing severe pain.The knee becomes deformed and can become inflamed and swollen.X-rays show signs of joint deformity, osteophytes, significant joint space narrowing and meniscus damage.
- degree IV.Without treatment, the disease becomes extremely severe.Cartilage, ligaments and menisci are completely destroyed, which makes joint movement impossible, articular surfaces are deformed and a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnosing
Diagnosing arthrosis of the knee joint is not difficult.An orthopedic traumatologist performs the examination and treatment.He examines the patient's knee, assesses motor activity, studies clinical manifestations and palps to identify areas of swelling and the presence of effusion.
To confirm the preliminary conclusion, he describes an instrumental examination:
- X-ray examination - allows you to identify the narrowing of the joint space, the presence of osteophytes;
- CT scanning of the joint is a more informative diagnostic method than X-rays;indicates the condition of the joint cavity;
- Ultrasound of the joint - allows you to determine the volume of fluid in the joint cavity, the presence of osteophytes, assess the condition of the surrounding soft tissues, the thickness of hyaluronic cartilage;
- MRI - suitable for studying not only bone and cartilage tissue, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method;during the procedure, the synovial fluid may be punctured.
In addition, a clinical and biochemical blood test, an immunological study and a test for rheumatoid factor may be required.
Treatment of arthrosis
An orthopedist should treat gonarthrosis, taking into account the clinical picture and the degree of joint damage.You cannot self-medicate.
The doctor can prescribe drugs from the following groups:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors, which restore cartilage and prevent its further destruction;
- analgesic blockades that effectively eliminate pain;
- glucocorticosteroids, which are indicated for severe diseases;
- antispasmodics to eliminate muscle spasms.
Drug therapy is complemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetotherapy, electro- and phonophoresis.In addition, physical therapy and massage are prescribed.
You should definitely control your weight and try to get rid of extra pounds, which cause additional stress on the knee joints.It is important to stick to a dietary diet;the diet should contain foods that nourish cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.This can be arthroscopy, osteotomy or endoprosthetics.
The most favorable prognosis is if arthrosis is detected in stage 1, then the changes can be slowed down and even stopped.Stiffness or pain in the knee is not normal;it is worth examining to understand the cause of the discomfort.