Osteoarthritis of the knee

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

• excessive physical activity that does not meet the age requirements, leading to joint damage;
• sedentary lifestyle;
• suffered injuries to the knee joints - dislocations of the knee, fractures, ruptures and tears of ligaments, damage to the body of the meniscus, severe falls of the knee, bruises;
• increased body mass index, which causes increased stress on the joints, rupture of the meniscus;
• heredity;
• 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, causing destruction of cartilage tissue);
• metabolic disturbances leading to excretion of calcium from the body;
• diabetes mellitus of any type, hormonal disturbances 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, due to 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, people themselves become the culprits for the development of such an incurable disease. Often when the pain in the knee joint appears, people ignore the painful sensations, preferring to go to the doctor to use drugs that simply mask the pain.

After a few years, you will still have to consult a specialist, because with such a diagnosis, self-medication will not give any results. However, the severity of osteoarthritis will be at least moderate. Here, ointments, intra-articular administration of hyaluronic acid and preventive physical education are no longer enough, as could be done in the early stages of the course of the disease. Most likely, it will be necessary to act drastically, sometimes including with the resort of 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 arise suddenly, but most often with even slight physical exertion. The pain can be of a different nature. At first it will be weak lumbago (unfortunately not many people pay attention to this). Mild pain that only occurs periodically can last for months or even years until the disease progresses to a more severe stage.
• Marked deformity of the knee. A similar symptom is typical for 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 joint fluid in the Baker's cyst cavity or in the joint itself.
• A sharp cracking of the joints, which is accompanied by pain.
• Decreased joint mobility. This is especially pronounced in the later stages of osteoarthritis. In this case, the flexion and extension of the knee causes severe pain, and in the later stages movement becomes almost impossible.

REFERENCE! In a patient with osteoarthritis, the gait changes: it is characterized by sagging legs and lameness.

Pathogenesis of osteoarthritis of the knee joints

Specialists distinguish between primary and secondary osteoarthritis.

Primary osteoarthritis of the knee joints

For primary knee osteoarthritis, the following processes are characteristic:

1. The articular cartilage is able to constantly deteriorate and at the same time to renew itself quickly. Under normal conditions, these two processes should balance out. With the passage of age, the destruction of cartilage occurs at the same rate, but its recovery slows down. The mass of a person plays an important role here. Indeed, if the mass of a person is 70 kg, then in 10 steps on one leg he will transfer 700 kg, and the one who weighs 120 kg will transfer up to 1200 kg, which will become a significant load on the joints andcartilage, which will wear down faster because of it.
2. It is important to remember that the joint feeds on useful elements only in movement. A sedentary lifestyle leads to a slowing of metabolic processes, which is why the necessary nutrients do not reach their destination.
3. The likelihood of developing knee osteoarthritis increases in people whose parents have suffered from this disease.

Secondary knee osteoarthritis

It develops for the following reasons:

• Multiple injuries. In a person at any age, they will put undue stress on the cartilage. When a bone covered with cartilage is broken, irregularities called "steps" appear. In this area now, with any movement, the joint will wear down, leading 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

Orthopedists divide knee osteoarthritis into stages, on which the further treatment of the disease depends. Of course, the course of treatment will also depend on other factors, for example the reasons for the development, location and nature of osteoarthritis.

IMPORTANT! Qualitative treatment can be prescribed by a doctor only after a full study of the picture of the disease. Self-administered therapy can only worsen the health situation.

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

1. Initial stage. At this stage, the disease is only emerging. External symptoms are barely noticeable or completely absent, the shape of the joint is in a satisfactory condition. Symptoms include only mild discomfort or heaviness in the knee after long walks, as well as intense physical exertion. An x-ray examination will be of little information: an x-ray may show only a slight narrowing of the joint space. Unfortunately, at this stage, a person does not seek medical help due to the insignificance of the symptoms.
2. The second stage is characterized by a noticeable pain syndrome, especially when walking and climbing stairs, as well as at night. The intensity of the pain decreases at rest. Joint movement becomes difficult. Cracking or crunching of the knees is heard while walking. On radiography, the narrowing of the joint space becomes noticeable, as well as the osteophytes. The patient begins to limp.
3. When osteoarthritis has passed to the third stage, the pain syndrome will be felt all the time, even in the absence of movement. The processes of deformation and degeneration pass to an irreversible stage. The deformation of the joint becomes pronounced, the distance between the joint surfaces is noticeably reduced, many osteophytes are enlarged. Painful sensations now disturb the patient even in a state of complete rest. A person becomes dependent on outside support (walkers, canes) and needs the help of other people. 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 traced or completely absent, the bones are severely deformed. Even weak movements become torture for the patient. At this stage of knee osteoarthritis, the patient is recognized as disabled. In the absence of surgery, the disease can lead to disability.

Complications of osteoarthritis of the knee joints

Advanced osteoarthritis can lead to dislocations and subluxations of the knee joint. With dislocation, the epiphysis of the femur extends completely outside the joint, making movement in the joint impossible, and the axis of the leg is noticeably shifted to the side. Fortunately, such a negative variant of the development of the disease is rather rare.

Subluxations are more frequent. They are characterized by a partial displacement of the joints relative to each other and a slight deviation of the axis of the tibia. In this case, the subluxations are accompanied by severe pain and dysfunction of the joints.

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

WARNING! The habit of sparing a sore leg sometimes causes deformation of the intervertebral discs and the appearance of hernias.

Consequences of neglected knee osteoarthritis

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

• round the clock pain, which no pain reliever can save;
• loss of limb support (it is impossible to stand on a sore leg or at least lean on);
• immobilization of the joint block;
• pronounced curvature of the bones around the knee;
• severe swelling around the affected area.

Methods of treatment of osteoarthritis of the knee joint

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

Hormones

These drugs are prescribed for a severe exacerbation, accompanied by synovitis and severe pain. Usually, hormones are given by injection. The following drugs are most commonly used:

• Flosterone;
• Diprosfan;
• Hydrocortisone.

The duration of hormonal treatment is usually short; injections are carried out only during a period of severe exacerbation. Hormones are given at 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 the most effective and safe: there are practically no contraindications, and side effects appear in the rarest cases.

Medicines are aimed at restoring cartilage, improving metabolic processes, nourishing cartilage tissue and protecting it from further destruction. But in the later stages of osteoarthritis, chondroprotectors are also powerless.

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

Vasodilator drugs

These funds are needed to eliminate spasms of small vessels, increase blood circulation and supply of nutrients to the affected joint area. Prescribed to take vasodilators with chondroprotectors.

If joint fluid does not accumulate during knee osteoarthritis (there is no synovitis), it is recommended to use warming ointments.

Hyaluronic acid

In another way, this tool is called intra-articular fluid prosthesis, because the composition of the acid is similar in composition to the intra-articular fluid. When acid is injected into the joint, it forms a film that prevents strong friction of the cartilage during movement, affects the extracellular matrix, improves metabolic processes in the joint, and also triggers the production of its own hyaluronic acid. in the joint - that is, brings back the functioning of the joint to normal, stopping the pathological processes that destroy the cartilage. . . .

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

Physiotherapy

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

Self-medication often leads to a worsening of the joint situation. Exercise therapy is designated for the following purposes:

• slow down the development of stiffness;
• prevention of further destruction of cartilage tissue;
• elimination of muscle spasms, resulting in pain.

Physiotherapy

As an additional therapy, various procedures can be prescribed: electrophoresis, acupuncture, laser therapy, UHF, as well as diadynamic currents. Local massage will also give a good result.

Physiotherapy is aimed at reducing the intensity of pain, eliminating inflammation, normalizing metabolic processes inside the affected joint and restoring its normal function.

IMPORTANT! It is important that the patient watches his diet and avoids strenuous physical exertion.

Forecast. Prophylaxis

With an advanced stage of the disease, the forecasts are disappointing. Therefore, it is recommended that if symptoms of osteoarthritis, even minor, occur, consult a doctor for advice.

People at risk (elderly people, athletes, as well as overweight people) must follow the doctor's recommendations and adhere to the following rules:

1. Eat well and control your weight. Diet as needed.
2. Reduce the load on the joints while playing sports, constantly monitor it.
3. Timely treat infectious diseases, preventing their transition to the chronic stage.
4. Get enough rest, avoid stressful situations if possible.
5. Increase the protective functions of the body (periodically take vitamins, temper).
6. Avoid hypothermia of the body, especially the lower extremities.