Knee osteoarthritis

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

• excessive physical activity that does not meet age requirements, which leads to joint damage;
• sedentary lifestyle;
• suffered injuries in the area of the knee joints - dislocations of the knee, fractures, breaks and tears of the ligaments, damage to the meniscus body, severe falls on the knee, bruises;
• increased body mass index, which puts more stress on the joints, meniscus rupture;
• Inheritance;
• Arthritis or other joint diseases (inflammation can lead to the appearance of edema or the accumulation of a large amount of synovial fluid in the joints, which provokes the destruction of cartilage tissue);
• Metabolic disorders that lead to the excretion of calcium from the body;
• Diabetes mellitus of any kind, hormonal disorders 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, as a result of which the center of gravity shifts and the load on the joint increases;
• nervous overload and stressful situations.

Why osteoarthritis of the knee joint occurs

Most often, the people themselves become the culprits in developing such a persistent disease. When pain in the knee joint occurs, people often ignore the painful sensations and prefer to go to the doctor for medication that will simply mask the pain.

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

Symptoms and diagnosis of osteoarthritis of the knee joints

The disease can be distinguished by the following features:

• Pain syndrome. Painful sensations usually come on suddenly, but most often with physical exertion, including mild ones. The pain can be of various types. These will be weak lumbago at first (unfortunately, few people pay attention to them). Mild pain that is only intermittent can last months or even years before the disease progresses to a more severe stage.
• Pronounced knee misalignment. A similar symptom is typical of the later stages. And at the beginning of the development of osteoarthritis, 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 synovial fluid in the cavity of the Baker's cyst or in the joint itself.
• A sharp crunch of the joints, which is accompanied by pain.
• Decreased mobility of the joints. This is particularly pronounced in the final stages of osteoarthritis. In this case, the flexion and extension of the knee causes severe pain, and in the latter stages movement becomes almost impossible.

NOTE! In a patient with osteoarthritis, the gait changes: it is characterized by drooping legs and limping.

Pathogenesis of osteoarthritis of the knee joints

Specialists differentiate between primary and secondary osteoarthritis.

Primary osteoarthritis of the knee joints

The following processes are characteristic of primary osteoarthritis of the knee:

1. Articular cartilage is capable of constantly deteriorating and, at the same time, rapidly renewing itself. Under normal conditions, these two processes should balance each other out. With age, cartilage destruction occurs at the same rate, but its recovery slows down. The mass of a person plays an important role here. In fact, if the mass of a person is 70 kg, in 10 steps on one leg he transfers 700 kg, and the one who weighs 120 kg transfers up to 1200 kg, which is a significant load on the joints and cartilage thatthus wears out faster.
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 goal.
3. The likelihood of developing osteoarthritis of the knee increases in people whose parents had the disease.

Secondary osteoarthritis of the knee joint

It develops for the following reasons:

• Multiple injuries. In a person of any age, they cause excessive stress on the cartilage. When a bone covered in cartilage is broken, irregularities called "steps" occur. In this area, the joint wears out with every movement, which leads to osteoarthritis.
• Development of rheumatoid arthritis, Koenig's disease, the appearance of purulent inflammation in the joint area.
• Vascular dysfunction.

Classification and stages of development of osteoarthritis of the knee joints

Orthopedic surgeons divide osteoarthritis of the knee into stages, on which further treatment of the disease depends. Of course, the course of treatment also depends on other factors, such as the reasons for the development, location and type of osteoarthritis.

IMPORTANT! Qualitative treatment can only be prescribed by a doctor after a full examination of the clinical picture. A self-administered therapy can only worsen the health situation.

The main classification divides osteoarthritis of the knee into four stages of development:

1. First phase. At this stage the disease is just developing. External symptoms are barely noticeable or completely absent, the shape of the joint is in a satisfactory condition. Symptoms are only mild discomfort or a feeling of heaviness in the knee after long walks and vigorous physical exertion. An X-ray examination is not very meaningful: an X-ray can only show a slight narrowing of the joint space. Unfortunately, at this stage, due to the insignificance of the symptoms, a person does not seek medical help.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. The pain intensity decreases at rest. Moving together becomes difficult. A crunch or creak of knees can be heard when walking. The narrowing of the joint space and osteophytes are noticeable on the X-ray. The patient begins to limp.
3. When the osteoarthritis has passed into the third stage, the pain syndrome can be felt constantly even without movement. The processes of deformation and degeneration go into an irreversible stage. The curvature of the joint becomes pronounced, the distance between the articular surfaces is noticeably reduced, numerous osteophytes are enlarged. Painful sensations now disturb the patient even in complete rest. A person is dependent on outside support (walking aids, walking sticks) and needs help from others. 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 noticeable or completely absent, the bones are severely deformed. Even weak movements become torture for the patient. At this stage of osteoarthritis of the knee, the patient is recognized as disabled. Without surgery, the disease can lead to disability.

Complications of osteoarthritis of the knee joints

With advanced osteoarthritis, dislocations and subluxations of the knee joint can occur. With a dislocation, the epiphysis of the femur extends completely outside of the joint, making movement in the joint impossible, and the axis of the leg is shifted significantly to one 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 joint dysfunction.

Neglect of the disease can lead to a complete loss of functionality of the lower extremity.

ATTENTION! The habit of taking it easy on a sore leg sometimes leads to deformation of the intervertebral discs and the appearance of hernias.

Consequences of neglected osteoarthritis of the knee

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

• Pain around the clock from which no pain medication can save;
• Loss of support of a limb (it is impossible to stand on a sore leg, or at least lean against it);
• Immobilization of the articular block;
• pronounced curvature of the bones around the knee;
• severe swelling around the affected area.

Methods of treating osteoarthritis of the knee joint

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

Hormones

These drugs are prescribed in case of severe exacerbation, which is accompanied by synovitis and severe pain. Usually, hormones are given by injection. The following drugs are most commonly used:

• Flosterone;
• Diprosfan;
• Hydrocortisone.

Treatment with hormones is usually brief, injections are only given during a period of severe exacerbation. Hormones are administered with 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 to be the most effective and safest: there are practically no contraindications, and side effects rarely occur.

The drugs aim to restore cartilage, improve metabolic processes, nourish cartilage tissue and protect it from further destruction. But even in the end stage of osteoarthritis, chondroprotectors are powerless.

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

Vasodilator drugs

These funds are necessary to get rid of small vessel spasms, increase blood flow and supply of nutrients to the affected joint area. Prescribed to take vasodilators along with chondroprotectors.

If joint fluid does not accumulate during osteoarthritis of the knee (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 because the composition of the acid is similar to the composition of the intra-articular fluid. If acid is injected into the joint, it forms a film that prevents strong friction of the cartilage during movements, influences the extracellular matrix, improves metabolic processes in the joint and also stimulates the production of its own hyaluronic acid in the joint - i. e. H. restores the function of the joint to normal and stops the pathological processes that destroy the cartilage. . . .

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

physical therapy

A course of physical therapy exercises will bring positive results only if, after a full study of the anamnesis, it was prescribed by a doctor and all exercises are carried out under the supervision of a specialist.

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

• Slowing down the development of stiffness;
• Preventing further destruction of cartilage tissue;
• Eliminate muscle spasms that lead to pain.

physical therapy

Various procedures can be prescribed as additional therapy: electrophoresis, acupuncture, laser therapy, UHF and diadynamic currents. A local massage will also give a good result.

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

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

Forecast. prophylaxis

At an advanced stage of the disease, the prognosis is disappointing. It is therefore recommended to ask a doctor for advice if only minor symptoms of osteoarthritis occur.

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. If necessary, follow a weight loss diet.
2. Reduce the load on the joints in sports, constantly monitor them.
3. Treat infectious diseases in a timely manner and prevent their transition to the chronic stage.
4. Rest, avoid stressful situations if possible.
5. Increase the protective functions of the body (take vitamins at regular intervals, temper them).
6. Avoid hypothermia in the body, especially in the lower extremities.