Have you been diagnosed with arthrosis of the knee joint, are experiencing severe pain, and are you starting to limp?Looking for where to get treatment?Contact a medical center, they will help relieve pain, find out the causes of the disease and provide the necessary treatment.We have more than 20 effective methods of joint restoration in our arsenal.
The disease is also known as gonarthrosis (from the Latin genu - knee), osteoarthrosis (as the disease was called before) and osteoarthritis (the term reflects the mechanism of development and the modern understanding of the disease).Deforming osteoarthritis of the knee joint has a chronic course and develops over several years.The majority of patients are over 50 years of age.Women predominate in 2/3 of cases.
How does the disease develop?
Under the influence of external and internal factors, the blood supply and nutrition of tissues is disrupted, degenerative-dystrophic damage to the articular cartilage develops, with subsequent involvement of the underlying bone in the inflammatory process.Destruction of the articular surfaces leads to loss of joint function, limits movement and interferes with the patient’s quality of life.
Causes and risk factors
The main reasons for the development of osteoarthritis:
- Hard physical labor.Constant loads on the legs lead to microtraumas of the cartilage and the development of the inflammatory process.At risk are loaders, installers, miners, and quarry workers.Often deforming osteoarthritis affects professional athletes (weight lifters, cyclists, tennis players, football players, basketball players, hockey players, etc.).
- Injuries.Damage to ligaments, tendons, menisci, bruises and fractures lead to disruption of the biomechanics of the joint.If treated incorrectly, this leads to the development of post-traumatic arthrosis.
- Surgical operations on the knee can lead to the development of pathology of the articular cartilage and surrounding tissues.
- Excess weight increases stress on the joints of the lower extremities.Up to 80-90% of the progression of all osteoarthritis is associated with joint overload.
- Old age.In people over 50-60 years old, regenerative processes slow down, collagen production decreases, and hormonal levels suffer.Which leads to the development of pathology.
- Hormonal changes in women.During menopause, the production of estrogen decreases, which disrupts the absorption of calcium, leads to weakening of the musculoskeletal system, and makes bones fragile.The risk of developing osteoporosis increases.
- Problems with the thyroid gland.Thyroid hormones are involved in the metabolic processes of calcium and phosphorus in the body.Their deficiency or excess can provoke knee arthrosis.
- Genetic predisposition.Collagen mutation can cause disturbances in connective tissue elements, which leads to a deterioration in the shock-absorbing function of articular cartilage.
- Heredity.There is a high probability of developing the disease if the patient’s family has relatives diagnosed with gonarthrosis, mainly in the female line.
- Inflammatory diseases.Infectious arthritis, bursitis, synovitis caused by bacterial or viral infection are often complicated by the development of gonarthrosis.
- Vascular diseases.The tissues do not receive proper nutrition, the blood supply is impaired, which leads to the development of ischemia and degenerative-dystrophic changes in the articular cartilage.
- Poor nutrition and metabolic disorders.Eating foods high in purines (proteins) contributes to the deposition of salts in the knee, for example, gouty arthritis.
- Specific diseases gonorrhea, tuberculosis, syphilis, chlamydia, and influenza can cause serious damage to the joint.
- Intoxication of the body with various chemicals, including some medications.
- Autoimmune disorders are associated with a violation of the body's immune defense when antibodies are produced against its own cells, for example rheumatoid arthritis.
Symptoms of the disease
The main symptoms of gonarthrosis:
- Pain in the joint, aching in nature, sometimes at night, in case of exacerbation, severe stabbing;
- Crunching and clicking during movement are caused by a violation of the congruence of the articular surfaces, the presence of osteophytes and cartilage defects;
- Puffiness and swelling are associated with the development of an inflammatory process in the joint and surrounding soft tissues;
- Deformation of the joint space and the axis of the limb indicates the progression of the disease;
- Atrophy and weakness of the thigh muscles, the volume of the quadriceps and biceps muscles decreases;
- Limitation of mobility and stiffness in the joint is caused by pain, the development of adhesions, and the appearance of osteophytes (bone spines).
The first signs of osteoarthritis that you should pay attention to are pain that occurs during or after exercise.The pain goes away with rest and does not require medication.Morning stiffness in the knee, starting pain, before getting up and walking after sleep, it takes some time to develop the joint.
Signs of exacerbation
With the development of pathology, the symptoms of arthrosis become brighter: the knees begin to hurt at rest and at night, during flexion and extension of the joint, extraneous sounds appear - crackling, crunching, clicking.Lameness, stiffness of movement develops, and soft tissue swelling appears.
The following facts indicate the progression of the disease:
- the appearance of deformation of the limb axis in the form of O-shaped legs;
- constant nature of pain, pain at night and when the weather changes (meteosensitivity);
- further deterioration of joint mobility, with the development of flexion contracture;
- weakness and atrophy of the thigh muscles.
Types and forms of the disease
There are:
- Primary.It develops as an independent disease.More often, such knee gonarthrosis is associated with age-related changes and heredity.
- Secondary.Occurs against the background of certain diseases or injuries, for example post-traumatic osteoarthritis.
Depending on the causes, the following types of arthrosis are distinguished:
- Ischemic, associated with problems with blood supply to tissues and vascular disorders;
- Post-infectious is caused by infections, viruses, autoimmune processes;
- The idiopathic nature of the development of the pathology remains unclear;
- Metabolic is associated with metabolic disorders - gout, hemochromatosis, chondrocalcinosis;
- Involutional, as a result of age-related changes in the body;
- Post-traumatic, history of trauma;
- Dishormonal - a consequence of hormonal imbalances in the body.
Stages of development
I. Arthrosis of the 1st degree - the initial stage is associated with a deterioration in the quality and quantity of synovial fluid (articular fluid, provides nutrition to cartilage, has shock-absorbing properties, promotes the sliding of articular surfaces).Malnutrition leads to wear and degradation of cartilage tissue, and the appearance of the first signs of inflammation.At the initial stage, movements are not impaired.Patients experience slight pain, tingling, and sometimes the joints may crack when moving.Symptoms occur during and after physical activity.Externally, the knee looks quite healthy.
II.Osteoarthritis of the 2nd degree - leads to thinning of the cartilage to 1.5-2.0 mm (normal 2.5-3.0 mm), a narrowing of the joint space is observed, and small single bone growths (osteophytes) appear.The inflammatory process is wave-like in nature, alternating between phases of remission and exacerbation.Grade 1-2 gonarthrosis is accompanied by swelling and weakness of the thigh muscles.The pain bothers me at rest, when the weather changes, and after walking I feel tired.Movements become more rigid, morning stiffness and crunching in the joint appear.It is at this stage that patients most often consult a doctor.
III.Gonarthrosis of the 3rd degree is manifested by external deformation of the joint, curvature of the axis of the limb.The cartilage tissue is severely damaged, thinned to 1-1.5 mm, and exposed bone is visible in some places.Bone growths can be easily felt under the skin, and the range of motion is significantly reduced.At 2-3 degrees of osteoarthritis, the joint space narrows, the joints cannot bend and unbend, all movements are accompanied by pain and crunching, and morning stiffness intensifies.A characteristic joint contracture develops.I am worried about sharp pain in the knee, even at rest.Patients often suffer from insomnia due to the fact that they cannot take a comfortable position that does not cause pain, and they feel weather changes.
IV.Grade 4 gonarthrosis is characterized by complete destruction of the articular surfaces, exposed bone is visible, and the cartilage is represented by rare “islands.”The joint space is almost invisible.A pronounced O-shaped deformity of the lower extremities and swelling are noticeable.Mobility is almost completely lost.Treatment with non-surgical methods at this stage is ineffective; joint replacement with an endoprosthesis is indicated.
An orthopedic doctor comments: In order to accurately determine the degree of arthrosis of the knee joint, in addition to examining the patient, it is extremely important to conduct an instrumental examination (ultrasound, radiography or MRI of the joint).Bilateral gonarthrosis is very common, so it is recommended to examine both the left and right knee joints.This will help you choose the optimal treatment, and therefore prevent further progression of the disease.
Diagnostics
To make a diagnosis, it is usually sufficient to perform an x-ray or ultrasound of the knee joint.In difficult cases, laboratory examination and magnetic resonance imaging (MRI) are prescribed.If pathological fluid accumulates in the joint, it may require puncture and subsequent examination.
Ultrasound diagnostics
Helps identify the disease at an early stage.Allows you to measure the thickness of the cartilage layer, the relief of the joint, the presence of joint fluid, the size of osteophytes and ossifications.
Radiography
Carry out to assess the degree of damage, the condition of bone and cartilage tissue.It will show the presence of osteophytes, narrowing of the joint space, and joint deformation.In the initial stages of the disease, examination is not informative.
Analyzes
General blood and urine tests, blood biochemistry show signs of inflammation, the presence of infection, and disorders in bone and cartilage tissue.They allow you to assess the general condition of the body, determine the causes of the disease, gonarthrosis, and exclude pathologies with similar symptoms.
MRI
Magnetic resonance imaging A highly accurate diagnostic method that helps visualize the most minor changes.It will help in making a diagnosis both at an early stage and in complex cases before surgical treatment.
Which doctor treats you?
The following specialists treat gonarthrosis of the knee:
- Orthopedic doctor - diagnoses the disease, intra-articular injections, plasma therapy, provides high-tech assistance, and surgical treatment.
- Physiotherapist - responsible for instrumental physiotherapeutic treatment.
- Rheumatologist - will help if the disease is associated with autoimmune disorders.
- Sports doctor - will be required in case of a sports history of illness.
- A nutritionist is needed if the patient is overweight.
At the recovery stage, the attending physician may involve other specialists:
- Masseur - massages the lower extremities, restores muscle tone, thereby stimulating blood circulation and helping to restore joint mobility.
- Physiotherapy doctor - selects special exercises and controls their implementation.
- Rehabilitation specialist - helps with the patient’s social adaptation; the specialist is especially in demand after severe reconstructive surgery on the knee.
What treatment is prescribed?
The earlier the disease is detected and treatment for the symptoms of osteoarthritis is started, the greater the chance of recovery.Otherwise, the disease can lead to irreversible consequences and significantly worsen the quality of life.
Thus, treatment of arthrosis of the knee joint of 1-2 degrees has a good chance of completely restoring the function of the knee joint.Unfortunately, patients do not always seek medical help in the initial stages.
How to quickly relieve pain and how to treat it?
First of all, it is necessary to eliminate pain and inflammation.Prescribed:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and painkillers.The drugs allow you to quickly remove inflammation in arthrosis and help reduce pain and swelling.
- Corticosteroids are used when NSAIDs and analgesics do not help, for example, in the treatment of grade 3-4 arthrosis of the knee joint.The patient is given a drug blockade - drugs are injected directly into the joint cavity.this helps relieve pain and achieve relief within a few minutes after the injection.
- Special ointments and pain-relieving patches.
An orthopedic doctor comments: Treatment of arthrosis of the knee joint of 2-3 degrees is always complex, as a rule, it includes more than 15 (!) points of recommendations in the prescription sheet.It's not just medications and injections.This is a whole series of rehabilitation measures aimed at correcting the biomechanics of the joint and the patient’s lifestyle.Only this approach will help preserve the joint and stop the progression of the disease.
Preparations that strengthen bone and cartilage tissue:
- Chondroprotectors based on chondroitin and glucosamine are the nutritional basis of chondrocytes.
- Hyaluronic acid preparations serve as analogues of synovial fluid.
- Drugs that improve microcirculation and blood supply to articular cartilage.
- Calcium and vitamin D supplements strengthen the bones that form the knee joint.
- Intra-articular injections of hyaluronic acid preparations, an artificial analogue of synovial fluid, help lubricate the articular surfaces.
- Drug blockades help quickly relieve swelling, pain and inflammation.As a rule, the effect is noticeable the next day.
Treatment of osteoarthritis of the knee joint also includes physiotherapy:
- Electrophoresis.Using an electric current, the medicine penetrates the affected area.Electrophoresis is used to treat knee pain due to gonarthrosis.
- Phonophoresis.The medicine enters the area of inflammation under the influence of sound waves.An additional advantage of the method in the treatment of deforming gonarthrosis is the thermal effect.
- Shock wave therapy.The procedure improves blood circulation, stimulates tissue nutrition, and is used to destroy osteophytes and scar tissue.
- Traction therapy (joint traction) - helps to unload the joint space, stretch it by several millimeters, thereby reducing the mutual pressure of the articular surfaces.
- Electromyostimulation - stimulates blood flow and muscle function using electric current, restores muscle tone.
- Mechanotherapy helps to develop movements in the joint and fight contracture using special robotic simulators.
- Laser therapy creates deep tissue heating and reduces the inflammatory response.
- Magnetotherapy.The therapeutic effect is based on the properties of the magnetic field to reduce pain, inflammation, and tissue swelling.
Orthobiology methods are aimed at stimulating regeneration and replacing defects in cartilage tissue:
- Plasmolifting is a plasma-based drug, made from the patient’s own blood, which triggers regeneration processes and contains growth factors.
- PRP therapy - plasma obtained from the patient’s blood is used as a drug.Platelet-rich plasma stimulates the regeneration of chondrocytes and alleviates the inflammatory process.
- SVF therapy is based on the use of stromal vascular fraction cells obtained from the patient’s own adipose tissue.
- SVF therapy + PRP therapy - the simultaneous use of concentrated plasma and progenitor cells allows you to achieve the best results.
- Stem cell treatment.The method is based on the use of bone marrow cells and is currently under development.
Each case is individual and requires the development of a separate rehabilitation program for the treatment of arthrosis of the knee joint.
Don't know where to treat arthrosis?Do you want to get professional help and undergo treatment without surgery?Sign up for a health center.We offer to undergo an examination and begin restoring your health on the day you contact us.Take advantage of modern treatment for knee arthrosis at competitive prices.