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The disease is also known as arthroarthritis (from the Latin knee), osteoarthrosis (as the disease was formerly known), and osteoarthritis (a term that reflects the mechanism of development and modern understanding of the disease).Osteoarthritis deformans of the knee has a chronic course that takes years to develop.Most patients are over 50 years old.Females 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 the tissues are destroyed, degenerative dystrophic damage to the articular cartilage occurs, and subsequently inflammatory processes involve the underlying bone.Destruction of the articular surface can lead to loss of joint function, limit activities, and affect the patient's quality of life.
Causes and risk factors
The main causes of osteoarthritis:
- Hard physical labor.Continuous loads on the legs lead to the development of cartilage microdamage and inflammatory processes.Loaders, erectors, miners and quarry workers are at risk.Osteoarthritis deformans often affects professional athletes (weightlifters, cyclists, tennis players, football players, basketball players, hockey players, etc.).
- Injuried.Injuries, bruises, and fractures to ligaments, tendons, and menisci can lead to disruption of joint biomechanics.If not treated properly, it can lead to the development of post-traumatic arthropathy.
- Surgical procedures on the knee may lead to the development of pathology in the articular cartilage and surrounding tissues.
- Being overweight increases stress on the joints of the lower limbs.Up to 80-90% of all osteoarthritis progression is related to joint overload.
- old age.In people over the age of 50-60, the regeneration process slows down, collagen production decreases, and hormonal levels are affected.This leads to the development of pathology.
- Changes in female hormones.During menopause, estrogen production decreases, disrupting calcium absorption, leading to a weakening of the musculoskeletal system and brittle bones.Increased risk of osteoporosis.
- Thyroid problems.Thyroid hormones are involved in the metabolism of calcium and phosphorus in the body.Their deficiency or excess can lead to knee joint disease.
- Genetic predisposition.Collagen mutations can cause disorders in the connective tissue components, leading to worsening of the shock-absorbing function of articular cartilage.
- genetics.If a patient's family has a relative (mainly women) who has been diagnosed with knee joint disease, the likelihood of developing the disease is high.
- Inflammatory diseases.Infectious arthritis, bursitis, and synovitis caused by bacterial or viral infections are often complicated by the development of knee arthropathy.
- Vascular disease.Tissues do not receive proper nutrition and blood supply is compromised, resulting in articular cartilage ischemia and degenerative dystrophy.
- Malnutrition and metabolic disorders.Eating foods rich in purine (protein) can cause salt deposits in the knees, as in gouty arthritis.
- Certain diseases Gonorrhea, tuberculosis, syphilis, chlamydia, and influenza can cause severe damage to joints.
- Various chemicals, including certain drugs, cause poisoning in the body.
- Autoimmune diseases, such as rheumatoid arthritis, are associated with disruption of the body's immune defenses when antibodies are produced against one's own cells.
disease symptoms
The main symptoms of knee joint disease:
- Joint pain is sore in nature, sometimes at night, if aggravated, severe stabbing pain;
- Creaking and clicking sounds during movement are caused by disruption of the consistency of the joint surfaces, the presence of osteophytes and cartilage defects;
- Edema and swelling are associated with the development of inflammatory processes in the joints and surrounding soft tissues;
- Deformations of joint spaces and limb axes indicate disease progression;
- The thigh muscles are atrophied and weak, and the size of the quadriceps and biceps is reduced;
- Pain, the development of adhesions, and the appearance of osteophytes (bone spurs) lead to limited joint movement and stiffness.
The first sign of osteoarthritis that you should be aware of is pain that occurs during or after exercise.The pain will go away after rest and no medication is needed.Your knees will be stiff and painful in the morning, and it will take some time for the joints to develop after getting up after going to bed and before walking.
signs of deterioration
As the pathology progresses, the symptoms of arthrosis become more pronounced: the knee begins to hurt at rest, and at night, during flexion and extension of the joint, foreign sounds - crackles, crunches, clicks - appear.Lameness, stiffness of movement, and soft tissue swelling occur.
The following facts indicate the progression of the disease:
- O-shaped leg deformation occurs in the limb axis;
- Persistent pain, pain at night and during weather changes (meteorological sensitivity);
- As flexion contracture develops, joint mobility worsens;
- Weakness and atrophy of thigh muscles.
Types and forms of disease
have:
- primary.It develops as a separate disease.More commonly, this knee condition is associated with age-related changes and genetics.
- Secondary.Occurs in the context of certain diseases or injuries, such as post-traumatic osteoarthritis.
Depending on the cause, arthropathy can be divided into the following types:
- Ischemic, related to problems with blood supply to tissues and vascular disease;
- Post-infection is caused by infections, viruses, autoimmune processes;
- The idiopathic nature of pathological development remains unclear;
- Metabolism is associated with metabolic disorders - gout, hemochromatosis, chondrocalcinosis;
- Menopause, due to age-related physical changes;
- Post-traumatic, trauma history;
- Hormone Imbalance - The result of hormonal imbalance in the body.
Development stage
I. Primary Arthropathy - The initial stage is associated with deterioration in the quality and quantity of synovial fluid (joint fluid, which provides nutrients to the cartilage, has shock-absorbing properties and promotes sliding of the joint surfaces).Malnutrition causes the cartilage tissue to wear down and degenerate, and the first signs of inflammation appear.In the initial stages, movement is not impaired.Patients may experience mild pain, tingling when moving, and sometimes the joint may rupture.Symptoms occur during and after physical activity.Cosmetically, the knee looks healthy.
2. Grade 2 osteoarthritis - results in thinning of the cartilage to 1.5-2.0 mm (normal 2.5-3.0 mm), narrowing of the joint space is observed, and the appearance of small single bone growths (osteophytes).The inflammatory process is wave-like in nature, alternating between phases of remission and exacerbation.Grade 1-2 knee arthrosis is associated with swelling and weakness of the thigh muscles.The pain bothers me when I rest, when the weather changes, and when I feel tired after walking.Movements become stiffer, morning stiffness and joint creaking occur.It is during this stage that patients most often consult their doctors.
three.Third-degree knee arthrosis manifests as external deformation of the joint and bending of the limb axis.The cartilage tissue was severely damaged and thinned to 1-1.5 mm, and bone was exposed in some places.Bone growth can be easily felt under the skin, and range of motion is significantly reduced.When osteoarthritis reaches 2-3 degrees, the joint space narrows, the joint cannot bend and straighten, all activities are accompanied by pain and chewing sensation, and morning stiffness worsens.Characteristic joint contractures occur.I'm worried about severe knee pain, even at rest.Patients often suffer from insomnia due to the inability to assume a comfortable position that does not cause pain and from sensing changes in the weather.
Four.Grade 4 knee arthropathy is characterized by complete destruction of the articular surface with visible exposure of bone and cartilage represented by rare “islands”.The joint spaces are almost invisible.The lower limbs had obvious O-shaped deformity and obvious swelling.Liquidity is almost completely lost.At present, non-surgical treatment methods are not effective; it is indicated that endoprosthesis is used for joint replacement.
Orthopedic surgeon comments: In order to accurately determine the degree of joint disease in the knee joint, in addition to examining the patient, it is also extremely important to conduct instrumental examination (ultrasound, X-ray photography or MRI of the joint).Bilateral knee arthropathy is common, so it is recommended to examine both the left and right knee joints.This will help you choose the best treatment to prevent further progression of the disease.
diagnosis
To make a diagnosis, an X-ray or ultrasound of the knee joint is usually sufficient.In difficult cases, laboratory tests and magnetic resonance imaging (MRI) are required.If pathological fluid accumulates in the joint, aspiration and follow-up examination may be necessary.
Ultrasound diagnosis
Helps identify diseases in early stages.Allows you to measure the thickness of the cartilage layer, the undulation of the joint, the presence of synovial fluid, the size of osteophytes and ossification.
radiography
Assess the extent of damage and the condition of bone and cartilage tissue.It will reveal the presence of osteophytes, joint space narrowing, and joint deformity.In the initial stages of the disease, tests are not informative.
analyze
General blood and urine tests, blood chemistry tests reveal signs of inflammation, the presence of infection, and diseases of bone and cartilage tissue.They allow you to evaluate the general condition of the body, determine the cause of the disease, knee joint disease, and rule out conditions with similar symptoms.
MRI
Magnetic Resonance Imaging A highly accurate diagnostic method that helps visualize the tiniest changes.It will aid in diagnosis at an early stage before surgical treatment and in complex cases.
Which doctor saw you?
The following specialists treat knee joint disease:
- Orthopedic Surgeons – Diagnose disease, provide intra-articular injections, plasma treatments, provide high-tech assistance and surgical treatments.
- Physiotherapist - Responsible for instrumental physical therapy.
- Rheumatologist - will be able to help if the disease is related to an autoimmune disease.
- Sports Physician - Required if there is a history of sports.
- If the patient is overweight, a nutritionist is needed.
During the recovery phase, the treating physician may involve other specialists:
- Masseur - Massage the lower limbs to restore muscle tone, thereby stimulating blood circulation and helping to restore joint mobility.
- Physiotherapy doctor - selects special exercises and controls their implementation.
- Rehabilitation specialists – help patients adjust to society; specialists are especially popular after serious knee reconstruction surgery.
What treatment is prescribed?
The sooner the disease is detected and treatment of osteoarthritis symptoms begins, the better the chance of recovery.Otherwise, the disease may lead to irreversible consequences and significantly worsen quality of life.
Therefore, treating 1-2 degrees of knee arthritis has a good chance of fully restoring knee joint function.Unfortunately, patients do not always seek medical help in the initial stages.
How to get pain relief quickly and how to treat it?
First, eliminate pain and inflammation.Regulation:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers.These medications can help you get rid of joint inflammation quickly and help reduce pain and swelling.
- Corticosteroids are used when NSAIDs and analgesics are ineffective, such as in the treatment of grade 3-4 knee arthritis.The patient is given a drug block - a drug injected directly into the joint space.This helps relieve pain and achieve relief within minutes of the injection.
- Special ointments and pain relief patches.
Orthopedic surgeon comments: The treatment of 2-3 degree knee joints is always complex and often contains more than 15 (!) points of advice in the prescription list.It's not just medicine and injections.This is a series of rehabilitation measures aimed at correcting joint biomechanics and the patient's lifestyle.Only this approach can help protect the joints and halt the progression of the disease.
Preparations for strengthening bone and cartilage tissue:
- Chondroprotectants based on chondroitin and glucosamine are the nutritional basis of chondrocytes.
- Hyaluronic acid preparations are used 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 a hyaluronic acid preparation (an artificial analog of synovial fluid) help lubricate the joint surfaces.
- Medicinal blockade helps quickly relieve swelling, pain, and inflammation.Generally speaking, the effect will be obvious the next day.
Treatment for knee osteoarthritis also includes physical therapy:
- Electrophoresis.Using an electrical current, the drug penetrates into the affected area.Electrophoresis is used to treat knee pain caused by knee joint disease.
- Sonic therapy.The drug enters the area of inflammation under the influence of sound waves.Another advantage of this method for treating osteoarthritis of the knee is the thermal effect.
- Shock wave therapy.This 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, stretching it by several millimeters, thus reducing the mutual pressure on the joint surfaces.
- Electrical Myostimulation - Uses electrical current to stimulate blood flow and muscle function, restoring muscle tone.
- Mechanical therapy helps develop joint movement and combat contractures using a special robotic simulator.
- Laser therapy produces deep tissue heating and reduces the inflammatory response.
- Magnet therapy.The therapeutic effect is based on the properties of the magnetic field, which reduces pain, inflammation and tissue swelling.
Bone biology methods aim to stimulate the regeneration of cartilage tissue and replace defects:
- Plasmolifting is a plasma-based drug made from the patient’s own blood that triggers the regenerative process and contains growth factors.
- PRP Therapy - Plasma obtained from the patient's blood is used as medicine.Platelet-rich plasma stimulates chondrocyte regeneration and reduces inflammatory processes.
- SVF therapy is based on the use of stromal vascular component 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 therapy.The method is based on the use of bone marrow cells and is currently under development.
Each case is individual and requires an individual rehabilitation plan to treat knee arthritis.
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