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 limitation of the patient's mobility and even disability.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over 65 years of age who consult a doctor with complaints of knee pain.Elderly people are at risk, because with age, the articular cartilage becomes thinner, microcracks form there and gradually collapse.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes less, so the surfaces of the bones begin to touch and collapse;
- bone growths (osteophytes) appear;
- the joint capsule becomes tighter, which causes joint stiffness;
- A spasm of the muscles surrounding the joint occurs.
Without treatment, the knee deforms and the movements in it 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 of age, but the age factor is not the only reason for the development of the pathology.
Why does gonarthrosis occur?
Arthrosis of the knee joint in elderly patients occurs due to the natural wear of 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;
- regularly increased loads on the knee joint, for example, running or jumping, constant standing or kneeling;
- genetic predisposition.
The risk group includes women over 40, athletes, overweight patients and people working in the construction field.
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 when symptoms appear, treatment should be started as soon as possible.
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 sounds when moving;
- slight pain in the knee occurs only after standing for a long time and disappears with rest.
As time goes by, anxiety gets stronger.Severe stiffness, motor disorders and severe pain that do not leave the patient even at rest appear.It is difficult for a person to walk, sit or stand up.If left untreated, the knee joint deforms and causes disability.
The severity of the changes, as well as the probability of recovery, depends on the stage of the disease.
Degrees of gonarthrosis
The disease has 4 degrees of severity:
- I degree.At the beginning of the disease, there are practically no symptoms.After training, there is a slight discomfort in the knee, which does not interfere with a normal lifestyle.Pathological changes can only be detected using X-rays.
- II degree.During physical activity, walking, climbing stairs, squatting or standing for a long time, a creaking sound and periodic pain appear.X-ray images can reveal narrowing of the joint space and early signs of osteophyte formation.
- III degree.The pain syndrome is permanent and does not leave the person even at rest.The knee hurts a lot, especially in the mornings and evenings;during the day the pain is painful and unbearable.Since degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a creaking sound is heard when he moves.There is a "joint mouse" - this is a condition in which particles of destroyed bone or cartilage enter the synovial cavity and cause severe pain.The knee becomes deformed and can become inflamed and swollen.X-rays show signs of joint deformity, osteophytes, significant narrowing of the joint space, and meniscus damage.
- IV degree.Without treatment, the disease becomes extremely serious.Cartilage, ligaments and menisci are completely destroyed, which makes movement in the joint impossible, articular surfaces are deformed and a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnostics
The diagnosis of arthrosis of the knee joint is not difficult.Examination and treatment is carried out by an orthopedic traumatologist.He examines the patient's knee, assesses motor activity, studies clinical manifestations, and palpates to determine areas of swelling and the presence of effusion.
To confirm the initial result, he prescribes an instrumental examination:
- X-ray examination - allows to determine the narrowing of the joint space, the presence of osteophytes;
- CT scan of the joint is a more informative diagnostic method than X-rays;indicates the state of the joint cavity;
- Ultrasound of the joint - allows to determine the volume of fluid in the joint cavity, the presence of osteophytes, the condition of the surrounding soft tissues, the thickness of the 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;the synovial fluid may be punctured during the procedure.
In addition, a clinical and biochemical blood test, an immunological study and a test for rheumatoid factor may be required.
Treatment of arthrosis
The orthopedist should treat gonarthrosis taking into account the clinical picture and the degree of joint damage.You cannot treat yourself.
The doctor can prescribe drugs from the following groups:
- non-steroidal anti-inflammatory drugs;
- chondroprotectors that restore cartilage and prevent further destruction;
- analgesic blockades that effectively relieve pain;
- glucocorticosteroids indicated for severe disease;
- antispasmodics to relieve 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 manage your weight and try to get rid of extra pounds that put extra stress on your knee joints.It is important to follow a dietary diet;the diet should contain foods that nourish the cartilage tissue.
In advanced cases, when the cartilage is seriously damaged, surgery is required.This can be arthroscopy, osteotomy or endoprosthetic.
The most favorable prognosis is that if arthrosis is detected at the 1st stage, the changes can be slowed down and even stopped.Stiffness or pain in the knee is not normal;it is worth to undergo an examination to understand the cause of anxiety.