The joints of the human body withstand daily stress, so they are vulnerable to a wide variety of damaging factors. Among joint diseases, arthrosis is common, and it affects both large and small joints. Arthrosis of the knee joint is a degenerative-dystrophic damage to the knee joint, in which its motor activity is impaired. If there is no proper treatment, the disease can lead to disability.
Since the disease gives rise to characteristic deformities in the joints, it is called deformed arthrosis of the knee joint, which correctly describes the special features of the pathology. The disease is chronic and is more often diagnosed in women, moreover, those who are overweight and venous pathology in the lower legs, but there may be other causes. Due to age -related changes, it also occurs in older people.
Arthrosis in young people can be triggered by injury. As a result of degenerative-dystrophic changes, cartilage softens, peels off and becomes covered with cracks of various depths. After that, it stops performing its function.
The reasons
Various causes lead to the appearance of deformed knee joint arthrosis. Traumatic factors are a common cause of incidents. Post -traumatic arthritis can develop as a result of dislocations or fractures in certain areas, as well as meniscus injuries. Typically, gonarthrosis of the knee joint appears in young people who are actively involved in sports, or in people whose work is associated with increased mobility, lifting and carrying heavy loads.
Few people know that such damage can also be the result of treatment, when the injury itself has healed, but during prolonged limb immobilization, circulatory disturbances in this area occur. Because of this, gonarthrosis appears.
Increased physical activity on the knee is one of the main factors in the onset of the disease. It most often affects athletes who have a constant active load on the knee. At a young age, arthrosis may not be noticeable, usually rapid changes beginning after cessation of physical activity.
There is also a risk of disease in people who, even in adulthood, do not reduce the load on the joints. In such athletes, the risk of fractures and dislocations increases, microtraumas appear. Therefore, already after forty years, doctors recommend that athletes reduce the load, turn to coaching. Running and squatting should be avoided, as these are the activities that put the most stress on the knee joint. Often, one limb is affected and left -sided gonarthrosis or right -sided gonarthrosis occurs.
An important factor for the development of arthrosis of the knee joint is the removal of the menisci. If for some reason the menisci have been removed, then in 90 percent of cases this leads to the appearance of arthrosis - the so -called knee loop occurs, in which the articular joint experiences more friction than usual.
The problem of being overweight is also relevant for people with arthrosis. Being overweight puts unnecessary pressure on the joints. As a result, it is not the cartilage itself that is damaged, but the meniscus. And with a combination of overweight and varicose veins on the lower legs, acute arthrosis threatens to appear.
Weak ligament apparatus in some patients is a congenital feature, and sometimes the ligaments are affected by other diseases. One way or another, weak ligaments trigger increased mobility in the joint, which causes the articular surface to abrade significantly. The consequences of a weak ligament may not be felt for a long time until the patient experiences symptoms of actual arthrosis.
Articular pathology also leads to disease progression. The most common cause of osteoarthritis is arthritis - inflammation of the articular joints. With arthritis, typical signs are observed - a deterioration in the composition of synovial fluid, pathological changes in cartilage, swelling, redness of soft tissues. Even after osteoarthritis is cured, the chronic process leads to the appearance of arthrosis.
Violations of metabolic processes often lead to pathology of the musculoskeletal system. Bones and joints lack nutrients and minerals that are essential for tissue strength. With its deficiency, the bone and cartilaginous surface are subject to a destructive process, therefore, even with a slight load, primary arthrosis appears.
symptoms
Osteoarthritis of the knee joint is indicated by complex features that are difficult to release. The symptoms are not only felt in the first stage of pathological development, but already in the second and third stages give different symptoms of arthrosis of the knee joint:
- sick- one of the main signs that does not appear immediately. An interesting fact is that with the development of arthrosis, the pain may not be felt even for several months or years, until the disease worsens. Usually, the first signs of pain are discomfort while doing physical exercise, walking or running, but it also shows itself when the meniscus is pinched. With the second stage of arthrosis, pain in the joints is felt more strongly, and with the third stage of development, a painful sensation appears even at rest. The attack worsens even after a short walk without a strong load on the joints, so patients try to save their knees;
- change the shape- manifestations become more pronounced in the third stage of development of arthrosis. The knee will maintain its normal shape, but will appear slightly swollen and swollen. When arthritis joins, the knee will turn red, become hot and painful to the touch;
- Crispywith arthrosis appearing in the second and third stages of disease development. The crunchy sound is different from the healthy clicking sound that can sometimes be heard when the knees are extended and bent. In arthrosis, the symptoms are characterized by a dry, harsh sound that comes on suddenly and is accompanied by pain;
- synovitis- accumulation of a certain amount of fluid in the joint cavity. It’s there and it’s normal. But the accumulation of excessive amounts leads to the development of cysts - the most pronounced Baker's cyst, which can be determined in the position of not bent legs;
- limited mobility in the knee- a typical sign of pathology, because patients first try to protect themselves from pain consciously, and in the final stages of arthrosis they are unable to straighten the limb at all. In the third stage of development, deformity of the knee joint osteoarthritis (DOA) completely leads to loss of movement. The patient adjusts to move with the legs bent, while using supportive means.
Degree of development
Osteoarthritis of the knee joint goes through three stages in its development.
With stage 1 arthrosis, the pain is insignificant and occurs only with active physical exertion on the knee joint. Already in the first stage, fluid can accumulate in the cavity, which in the second and third is already a cyst. With progression, pain occurs during movement, but quickly passes. Externally, the deformity of the knee joint is not visible, so the diagnosis of arthrosis of the knee joint can be difficult.
With second -degree disease, damage to cartilage tissue is more pronounced. If you take an x-ray, then the level of bone growth is already noticeable on it. With any movement, a sharp sudden pain appears in the knee, but, returning to a comfortable position, the knee is no longer sore. In the second stage of DOA, you can hear a special snort of arthrosis. With progression, problems with knee extension and flexion worsen. The deformation becomes noticeable externally.
Third -degree osteoarthritis of the knee joint is characterized by significant thinning of cartilage tissue. Gradually, the cartilage wears out until the bone is exposed in some areas. X -ray images show a large number of osteophytes - bone growths, salts that have appeared in the joint cavity. Externally, changes are clearly visible, and the patient is concerned about persistent pain. It is not difficult to make a diagnosis - enough visual examination and X -ray control is carried out.
With the development of this degree, arthrosis can lead to complete loss of function. In any stage of pathological development, osteoarthritis of the knee joint can combine.
Treatment
Overcoming arthrosis of the knee joint is not easy, especially if the disease is advanced or inflammation has merged and arthritis has developed.
conservative
The most active group of drugs against arthrosis are nonsteroidal anti-inflammatory drugs. This is mainly an inhibitor of cyclooxygenase-2, it can relieve inflammation, swelling perfectly and contribute to rapid recovery.
These drugs have significant limitations, so they should not be used without a doctor's recommendation. For example, they can exacerbate stomach ulcers, heart disease, pathology of the urinary organs. Nonsteroidal anti-inflammatory drugs are also prohibited during pregnancy.
The second group of agents are chondroprotectors that enhance the characteristics of cartilage tissue. They are used for arthrosis to restore the correct structure of cartilage, because in the process of solution it loses a very important component - chondroitin and glucosamine. Thus, almost all chondroprotectors contain both of these substances, but some preparations are single components.
With the help of these drugs it is possible to help patients in the first and second stages of disease development, but not in the third, when irreversible changes have occurred.
During conservative therapy, the doctor will also give recommendations on nutrition. If the patient or patients are overweight, it is important to follow a diet to normalize weight. How to strengthen a stable weight - the doctor will also tell. It is also not recommended to eat a lot of salt, but it is better to fill the diet with calcium, vitamins and minerals. Jelly, jelly will come in handy.
Operation
The most common type of surgery for arthrosis is arthroscopy, but other interventions are performed. Treatment of arthrosis of the knee joint is usually carried out in the second and third stages, when conservative therapy is no longer helpful.
If minimally invasive intervention is required, for example, when fluid accumulates in the knee joint, it is possible to do it with a puncture. A puncture is made in the cavity of the knee joint and excess fluid is pumped out. This method can diagnose the disease and at the same time apply for treatment. Fluids are taken in the early stages in minimal amounts, but this has significantly improved patient well -being. Then, after examining the biomaterial, another part is removed, and corticosteroids are injected into the joint cavity.
Arthroscopy is the most common. Through small incisions in the skin, several instruments are introduced that allow the examination of the joint and the necessary manipulation in it. With the help of arthroscopy, it is possible to remove tissue particles that have been separated from the cartilage, but there is always a risk that secondary gonarthrosis will appear.
With severe damage, there is a need to perform a periarticular osteotomy. This is a larger scale effect on the joint, as a result of which it is filed slightly and set at the desired angle. After surgery, recovery is longer, but the effects last longer.
Significant destruction of the articular elements leads to complete immobilization of the limb. The joint does not perform its function, which means that it needs to be replaced and surgery needs to be performed. Endoprosthetics of the knee joint is an expensive operation, but it only makes it possible to return the patient to movement in the limb. Various knee prostheses are installed - plastic, ceramic or metal. This is a durable structure that allows you to forget about problems for decades.
Physiotherapy
Physiotherapy methods can only be used when the acute period has passed and the patient is in a state of recovery.
Methods actively used include:
- ozone therapy- exposure to the affected joints with ozone, and the substance can be injected or used as an external treatment. This type of assistance to patients is very effective, so it is often used in the treatment of various pathologies, including arthrosis. Treatment makes it possible to activate blood circulation in problem areas, to achieve anti-inflammatory and analgesic effects. At the same time, treatment with glucocorticoids was carried out;
- kinesiotherapy- treatment is carried out with the help of special training sets. Loads are formed taking into account individual data, and when performing exercises, special simulators are used that strengthen the joints. The difference between kinesiotherapy and physiotherapy exercises is the active effect not only on osteoarthritis of the knee, but also on the whole body as a whole.
Apply not only ozone therapy and kinesiotherapy, but also physical therapy. Good results were given by the author's method of training to eliminate knee arthrosis. During training and afterwards, you may need to wear a special knee brace - an orthosis, to strengthen the right or left knee joint.