Knee arthrosis

The following factors can contribute to the development of arthrosis of the knee joints:

• excessive physical activity that does not meet age requirements, leading to damage to the joints;
• sedentary lifestyle;
• suffered injuries in the area of the knee joints - dislocations of the knee, fractures, ruptures and tears of the ligaments, damage to the body of the meniscus, severe falls on the knee, bruises;
• increased body mass index, which causes increased stress on the joints, meniscus rupture;
• heredity;
• arthritis or other joint diseases (inflammation can lead to the appearance of edema or the accumulation of large amounts of synovial fluid in the joints, provoking the destruction of cartilage tissue);
• metabolic disruptions leading to the excretion of calcium from the body;
• diabetes mellitus of any type, hormonal disruptions and other pathologies of the endocrine system;
• chronic or past diseases of an inflammatory and infectious nature;
• violation of blood flow;
• lupus erythematosus, rheumatoid, gouty and psoriatic pathologies, ankylosing spondylitis;
• flat feet, due to which the center of gravity shifts and the load on the joint increases;
• nervous overload and stressful situations.

Why arthrosis of the knee joint occurs

Most often, people themselves become the culprits of the development of such an intractable disease. Often, when pain in the knee joint appears, people ignore the painful sensations, preferring to go to the doctor to use any drugs that simply mask the pain.

After a few years, you will still have to consult a specialist, since with such a diagnosis, self-medication will not give a result. However, the severity of arthrosis will be at least average. Here, ointments, intra-articular administration of hyaluronic acid and preventive physical education are no longer enough, as could be done in the early stages of the course of the disease. Most likely, it will be necessary to act radically, including sometimes with the use of surgical intervention.

Symptoms and diagnosis of arthrosis of the knee joints

The disease can be distinguished by the following features:

• Pain syndrome. Painful sensations usually occur suddenly, but most often with physical exertion, even a slight one. The pain can be of a different nature. At first, these will be weak lumbago (unfortunately, few people pay attention to them). Mild pain that occurs only periodically can last for months, or even years, until the disease develops into a more severe stage.
• Marked knee deformity. A similar symptom is typical for the later stages. And at the beginning of the development of arthrosis, the knee swells and swells a little.
• The appearance of dense formations in the back wall of the knee joints. The accumulation of a large amount of joint fluid in the cavity of the Baker's cyst or in the joint itself.
• A sharp crunch of joints, which is accompanied by pain.
• Decreased joint mobility. This is especially pronounced in the last stages of arthrosis. In this case, flexion and extension of the knee causes severe pain, and in the last stages, movement becomes almost impossible.

REFERENCE! In a patient with arthrosis, the gait changes: it is characterized by drooping of the legs and limping.

Pathogenesis of arthrosis of the knee joints

Specialists distinguish primary and secondary arthrosis.

Primary arthrosis of the knee joints

For primary gonarthrosis, the following processes are characteristic:

1. Articular cartilage is capable of constantly deteriorating and at the same time rapidly renewing. Under normal conditions, these two processes should balance each other. With the passage of age, the destruction of cartilage occurs at the same rate, but its recovery slows down. The mass of a person plays an important role here. Indeed, if the mass of one person is 70 kg, then in 10 steps on one leg he will transfer 700 kg, and the one who weighs 120 kg will transfer as much as 1200 kg, which will become a significant load on the joints and cartilage, which will wear out faster because of this.
2. It is important to remember: the joint feeds on useful elements only when moving. A sedentary lifestyle leads to a slowdown in metabolic processes, which is why the necessary nutrients do not reach their destination.
3. The likelihood of developing gonarthrosis increases in people whose parents suffered from this disease.

Secondary arthrosis of the knee joint

It develops for the following reasons:

• Multiple injuries. In a person at any age, they will cause excessive stress on the cartilage. When any bone covered with cartilage is broken, irregularities, the so-called "steps", appear. In this area, now, with any movement, the joint will wear off, leading to arthrosis.
• Development of rheumatoid arthritis, Koenig's disease, the appearance of purulent inflammation in the joint area.
• Vascular dysfunction.

Classification and stages of development of arthrosis of the knee joints

Orthopedists divide gonarthrosis into stages, on which further treatment of the disease depends. Of course, the course of treatment will also depend on other factors, for example, the reasons for the development, localization and nature of arthrosis.

IMPORTANT! Qualitative treatment can only be prescribed by a doctor after a complete study of the picture of the disease. Self-administered therapy can only exacerbate the health situation.

The main classification divides gonarthrosis into four stages of development:

1. Initial stage. At this stage, the disease is just emerging. External symptoms are hardly noticeable or completely absent, the shape of the joint is in a satisfactory condition. Symptoms include only mild discomfort or heaviness in the knee after long walks, as well as strong physical exertion. An x-ray examination will be of little information: an x-ray may show only a slight narrowing of the joint space. Unfortunately, at this stage, a person does not seek medical help due to the insignificance of the symptoms.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. The severity of pain decreases at rest. Joint movement becomes difficult. A crunch or creak of knees is heard while walking. On the X-ray, the narrowing of the joint space becomes noticeable, as well as osteophytes. The patient begins to limp.
3. When arthrosis has passed into the third stage, the pain syndrome will be felt constantly, even in the absence of movement. The processes of deformation and degeneration pass into an irreversible stage. The distortion of the joint becomes pronounced, the distance between the articular surfaces is noticeably reduced, numerous osteophytes are increased in size. Painful sensations now disturb the patient even in a state of complete rest. A person becomes dependent on outside support (walkers, canes) and requires help from other people. Conservative treatment at this stage is less effective.
4. The fourth stage is characterized by constant debilitating pain. Osteophytic growths increase in number and size, the cartilage is completely destroyed, the joint space is barely traced or completely absent, the bones are severely deformed. Even weak movements become torture for the patient. At this stage of gonarthrosis, the patient is recognized as disabled. In the absence of surgery, the disease can lead to disability.

Complications of arthrosis of the knee joints

Advanced arthrosis can lead to dislocations and subluxations of the knee joint. With dislocation, the epiphysis of the femur extends completely outside the joint, due to which movement in the joint becomes impossible, and the axis of the leg is substantially shifted to the side. Fortunately, such a negative variant of the development of the disease is rather rare.

Subluxations are more common. They are characterized by a partial displacement of the joints relative to each other and a slight deviation of the tibia axis. In this case, subluxations are accompanied by severe pain and dysfunction of the joints.

The neglect of the disease can lead to a complete loss of functionality of the lower limb.

ATTENTION! The habit of sparing a sore leg sometimes causes deformation of the intervertebral discs and the appearance of hernias.

Consequences of neglected gonarthrosis

The advanced stage of gonarthrosis is almost always characterized by the following unfavorable symptoms:

• round-the-clock pain, from which no pain reliever can save;
• loss of support for a limb (it is impossible to stand on a sore leg or at least to lean on);
• immobilization of the articular block;
• pronounced curvature of the bones around the knee;
• severe swelling around the affected area.

Methods for the treatment of arthrosis of the knee joint

The prescribed treatment depends on the degree of development of the disease. There are several therapy options.

Hormones

These drugs are prescribed for severe exacerbation, accompanied by synovitis and severe pain. Usually hormones are given by injection. The following drugs are most commonly used:

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The course of treatment with hormones is usually short; injections are performed only during a period of severe exacerbation. Hormones are administered at an average frequency of once every 10 days.

Chondroprotectors

Chondroprotectors are prescribed at the initial stage of the development of the disease. This therapy is currently considered the most effective and safest: there are practically no contraindications, and side effects appear in the rarest cases.

The drugs are aimed at restoring cartilage, improving metabolic processes, nourishing cartilaginous tissue and protecting it from further destruction. But in the last stages of arthrosis, chondroprotectors are also powerless.

This group of medicines is produced in the form of injections, ointments, gels, tablets.

Vasodilator drugs

These funds are necessary to eliminate the spasm of small vessels, increase blood circulation and the supply of nutrients to the area of the affected joint. Prescribed to take vasodilators together with chondroprotectors.

If articular fluid does not accumulate during gonarthrosis (there is no synovitis), it is recommended to use warming ointments.

Hyaluronic acid

In another way, this tool is called an intra-articular fluid prosthesis, since the composition of the acid is similar in composition to the intra-articular fluid. When acid is injected into the joint, it forms a film that prevents strong friction of the cartilage during movement, affects the extracellular matrix, improving metabolic processes in the joint, and also triggers the production of its own hyaluronic acid in the joint - i. e. returns the functioning of the joint to normal, stopping the pathological processes that destroy cartilage. . . .

Acid treatment is prescribed only when exacerbation - synovitis is eliminated.

Physiotherapy

A course of physiotherapy exercises will bring positive results only if it was prescribed by a doctor after a complete study of the medical history, and all exercises are carried out under the supervision of a specialist.

Self-medication often leads to a worsening of the joint situation. Exercise therapy is appointed for the following purposes:

• slowing down the development of stiffness;
• prevention of further destruction of cartilage tissue;
• elimination of muscle spasm, leading to pain.

Physiotherapy

As an additional therapy, various procedures can be prescribed: electrophoresis, acupuncture, laser therapy, UHF, as well as diadynamic currents. Local massage will also give a good result.

Physiotherapy is aimed at reducing the severity of pain, eliminating inflammation, normalizing metabolic processes inside the affected joint and restoring its normal function.

IMPORTANT! It is important for the patient to monitor their diet and avoid strenuous physical exertion.

Forecast. Prophylaxis

With an advanced stage of the disease, the forecasts are disappointing. Therefore, it is recommended that if even minor symptoms of arthrosis occur, consult a doctor for advice.

People at risk (the elderly, athletes, as well as overweight people) must follow the doctor's recommendations and adhere to the following rules:

1. Eat right and control your weight. Follow a weight loss diet as needed.
2. Reduce the load on the joints while playing sports, constantly monitor it.
3. Timely treat infectious diseases, preventing their transition to the chronic stage.
4. Get adequate rest, avoid stressful situations if possible.
5. Increase the protective functions of the body (periodically take vitamins, temper).
6. Avoid hypothermia of the body, especially the lower extremities.