Arthrosis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease associated with the gradual destruction of the cartilages, with the gradual involvement of the periarticular structures in this process.The lack of timely treatment leads to the patient's limited mobility and even disability.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over the age of 65 who consult a doctor with complaints of knee pain.The elderly are at risk, because with advancing 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, therefore the surfaces of the bones touch and collapse;
- bone growths (osteophytes) appear;
- the joint capsule becomes denser, causing joint stiffness;
- A spasm of the muscles surrounding the joint occurs.
Without treatment, the knee becomes deformed and 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 most often 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?
In elderly patients, arthrosis of the knee joint occurs due to the natural wear and tear of cartilage tissue.Other causes of the disease:
- congenital diseases of the locomotor system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtraumas;
- previous surgical interventions;
- autoimmune diseases;
- chronic joint diseases;
- regular increased load on the knee joint, such as running or jumping, constant standing or kneeling;
- genetic predisposition.
Women over 40, athletes, overweight patients and construction workers are at risk.
How can knee arthrosis be recognized?
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 knees;
- discomfort when straightening or bending the knee joint, going up or down stairs;
- squeaking or clicking sounds when moving;
- mild pain in the knee that occurs only after prolonged standing and goes away with rest.
Over time, the discomfort increases.Severe stiffness, motor disorders, severe pain occur, which does not leave the patient even when he is at rest.It is difficult for the person to walk, sit down or stand up.Without treatment, the knee joint deforms, leading to disability.
The severity of the changes, as well as the probability of recovery, depends on the stage of the disease.
Grades of gonarthrosis
The disease has 4 degrees of severity:
- I degree.At the beginning of the disease, there are practically no symptoms.After training, minor discomfort appears in the knee, which does not interfere with a normal lifestyle.Abnormal changes can only be detected with the help of X-rays.
- Grade II.A cracking sound and intermittent pain occur during exercise, walking, climbing stairs, squatting or standing for long periods of time.X-rays can reveal narrowing of the joint space and early signs of osteophytes.
- Grade III.The pain syndrome becomes permanent and does not leave the person even at rest.The knee hurts especially in the morning and evening;during the day the pain is aching and tolerable.Since the degenerative processes begin at this stage, the person's gait changes, he begins to limp, and a screeching 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 joint cavity, causing severe pain.The knee becomes deformed, inflamed and swollen.X-rays show joint deformation, osteophytes, significant narrowing of the joint space and damage to the meniscus.
- Grade IV.Without treatment, the disease becomes extremely serious.Cartilage, ligaments and menisci are completely destroyed, which makes movement in the joint impossible, the joint surfaces are deformed, and a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnostics
Diagnosing arthrosis of the knee joint is not difficult.An orthopedic traumatologist performs examination and treatment.He examines the patient's knee, assesses motor activity, studies clinical manifestations, and identifies swollen areas and the presence of effusion by palpation.
To confirm the preliminary conclusion, he prescribes an instrumental test:
- X-ray examination - allows to identify the narrowing of the joint space, the presence of osteophytes;
- A CT scan of the joint is a more informative diagnostic method than X-rays;shows the state of the joint cavity;
- Ultrasound of the joint - allows the determination of the amount of fluid in the joint cavity, the presence of osteophytes, the assessment of the condition of the surrounding soft tissues, the thickness of hyaluron 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 can be punctured during the procedure.
In addition, clinical and biochemical blood tests, immunological tests and rheumatoid factor tests may be necessary.
Treatment of arthrosis
The orthopedist must treat gonarthrosis, taking into account the clinical picture and the degree of damage to the joint.You cannot self-medicate.
The doctor can prescribe medicines belonging to the following groups:
- anti-inflammatory non-steroidal drugs;
- chondroprotectors, which restore cartilage tissue and prevent its further destruction;
- analgesic blockades that effectively eliminate pain;
- glucocorticosteroids, which are recommended for severe diseases;
- antispasmodics to eliminate muscle spasms.
Drug therapy is complemented by physiotherapy 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 that cause additional stress on the knee joints.It is important to follow a diet plan;the diet should include foods that nourish the cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.This can be arthroscopy, osteotomy or endoprosthesis.
The most favorable prognosis is if arthrosis is detected in the 1st stage, then the changes can be slowed down or even stopped.Knee stiffness or pain is not normal;it is worth investigating to understand the cause of the discomfort.