Arthrosis of the knee joint, also called gonarthrosis, can significantly impair a person's quality of life. During the development of the disease, there is a gradual loss of hyaline cartilage in the joint. Gradually, the cartilage loses its density and height. Its razvlecheniya and thinning is noted, and over time it disappears completely. Accordingly, there is no soft protective pad in the bone, and this leads to an increased load on the end plate of the innervated articular surface of the bone. As a result of this load, painful sensations develop. The code for arthrosis of the knee joint according to ICD-10 is M17.
The knee joint is affected quite often, since it is the knee that has a significant load during walking, physical effort, and running. In this case, awkward movements can lead to injury to the soft tissues of the knee and cause arthrosis. That is why gonarthrosis is one of the main causes of disability. According to statistics, this disease affects about 20% of people on the planet to varying degrees.
Why arthrosis develops, how to prevent the development of this disease, which doctor treats arthrosis of the knee joint, and what kind of treatment methods the doctor can recommend after the diagnosis is made, will be discussed in this article.
Pathogenesis
The disease develops against the background of a mismatch between the load on the joint and its ability to withstand it. In this case, the properties of cartilage can be determined by genetics or change due to the influence of acquired factors - both exogenous and endogenous. The development and progression of gonarthrosis can occur with age, against the background of obesity, due to dysplasia of the femoral-patellar joint or changes in the axis of the lower extremity, disorders of the biomechanics of the joint, damage to the menisci and ligaments.
The basis of pathogenesis is the predominance of catabolic over anabolic processes, which is noted in the cartilaginous and subchondral bones, menisci and synovium. As a result, structural changes occur and the biological properties of the cartilage are lost. Further, the pathological process spreads to muscles and ligaments.
The basis of the articular cartilage is the connective tissue matrix and chondrocytes. The connective tissue matrix contains type II collagen and aggrecan molecules. The cushioning properties of the cartilage are provided precisely by the connective tissue matrix.
The inflammatory process in arthrosis is not as intense as in arthritis. However, in osteoarthritis, pro-inflammatory mediators are also present.
Classification
According to the origin of gonarthrosis, the following types are distinguished:
- Primary (idiopathic)- develops without the influence of any external causes.
- Secondary- certain factors lead to the development of the disease. Most often they are associated with injuries, fractures, surgical interventions on the joint, as well as inflammatory factors - acute and chronic arthritis.
The following degrees of knee arthrosis are also determined:
- Arthrosis of the 1st degree- is determined in the period from the appearance of the first signs of the disease to the development of bone deformities visible on X-rays or during examination. During this period, pain of varying intensity appears during movement.
- At grade 2- unpleasant sensations are observed even at the slightest exertion. When walking and squatting, the knee crunches, the mobility of the joint decreases. The picture shows the growth of bone tissue along the edges of the joint, as well as the narrowing of the joint space. On external examination, it can be noted that the knee is increased in size.
- At grade 3there is practically no cartilage tissue inside the joint. If the disease progresses, the bones can grow together, which provokes complete immobility of the leg. Sleep is disturbed, it becomes impossible to move without a stick or crutch.
The following types of this disease are also distinguished:
- Patellofemoral arthrosis of the knee- a condition in which degenerative changes are noted in the posterior part of the patella, that is, the patella. With this form of the disease, pain is primarily disturbed when descending a ladder or from a mountain. Patellofemoral arthrosis can develop in runners. The disease is often diagnosed in young people.
- Post-traumatic arthrosis of the knee joint- a consequence of the injury. The post-traumatic type of illness may not initially appear. But later, a person loses full-fledged motor activity of the joint.
Causes of arthrosis of the knee joint
Currently, work is underway to study the reasons leading to the development of such a pathology.
At the moment, the causes of gonarthrosis are associated with the influence of the following factors:
- Age - at a certain age, degenerative changes in tissues begin in a person, and the ability of cartilage tissue to regenerate decreases.
- Arthritis - Over time, arthritis can lead to the development of arthrosis.
- Postponed injuries and overloads - in addition to injuries, the development of the disease can provoke the need to often kneel, squat, lift weights.
- Obesity and overweight - due to excessive body weight, there is an increased load on the joints of the legs. In addition, substances that provoke its damage enter the blood from the pathological adipose tissue, and later into the joint.
- Heredity - in some cases, the development of the disease is determined by a defective gene responsible for the growth of cartilage tissue. As a consequence, this tissue can have a low resistance to damage. If close relatives have had arthrosis, this increases its likelihood.
- Diseases leading to metabolic disorders - the risk of this pathology increases with atherosclerosis, diabetes mellitus.
- Hormonal disorders - women are more likely to get sick after 55 years.
- Sports - people who practice certain sports are more likely to develop this disease. This is typical for runners, as well as football, tennis, basketball players.
Knee arthrosis symptoms
As a rule, the symptoms of arthrosis of the knee joint increase slowly, as the process of its development lasts for years. If multiple joints are affected, symptoms of polyarthrosis develop.
The manifestation of the disease depends on its severity, age and a number of other factors.
However, the main symptoms of gonarthrosis are as follows:
- Pain in the knee joint, aggravated by activity. During rest, the knee hurts less.
- Swelling in the knee area.
- A feeling of warmth in the joint.
- Unpleasant sensations of stiffness in the joint, which appear after a person has been in a static position for a long time.
- Decreased range of motion of the knee joint, making it difficult for a person to get out of a chair, go down stairs or get out of a car.
- Crunching and crackling in the knee, most often seen with sudden joint movements.
- It is believed that changes in the weather affect the degree of pain and discomfort.
Analyzes and diagnostics
To determine if such a disease can be cured, the diagnosis must be confirmed initially. In the process of diagnosis, the doctor examines and interviews the patient. But the most informative study in this case is the knee x-ray.
Also, to clarify the diagnosis, it is advisable to undergo an ultrasound scan, during which arthritis can be excluded, and the height of the articular cartilage can be measured.
If necessary, appoint additional examinations.
Knee arthrosis treatment
For the treatment of this disease to be as effective as possible, it is initially necessary to confirm the diagnosis and select the correct scheme of complex therapy. Treatment of arthrosis of the knee joint at home is possible if the patient carefully adheres to all the recommendations of a specialist, practicing both medication and additional methods of treatment. Only in this case can home therapy be effective.
Drug treatment and other methods of therapy for this disease are used depending on the degree of damage. The simplest is the treatment of arthrosis of the knee joint of the 1st degree. In case of a first-degree disease, a complex therapy regimen is used, which allows you to get an effect in the shortest possible time. Therefore, if a person is diagnosed with arthrosis of the 1st degree, the disease should be treated immediately.
Regarding how to treat arthrosis of the knee joint of the 2nd degree, the doctor makes a decision based on the patient's condition. Since at this stage changes in the cartilage tissue begin, treatment must be carried out immediately.
Whether it is possible to cure grade 3 arthrosis of the knee depends on many factors. At grade 3, the cartilage becomes thinner, so treatment at this stage is lengthy and least effective.
Medicines
Medical treatment of knee arthrosis is aimed at providing an analgesic and anti-inflammatory effect. It is also important to reduce the severity of cartilage destruction.
The following medicines are used for this purpose:
- Non-steroidal anti-inflammatory drugs - both tablets and local remedies are used - ointments, gels. The most effective local and systemic application of such funds.
- Chondroprotectors for arthrosis of the knee joint - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfates and others are used. Such drugs for arthrosis of the knee joint are prescribed as part of a comprehensive treatment. The price of chondroprotectors depends on the drug and varies significantly.
- For severe disease, medical treatment includes steroids. Both injections for arthrosis of the knee joint can be administered intramuscularly, and external agents with steroids can be used.
- External agents with skin irritants. In the description of folk remedies, you can also find annoying compresses.
- During treatment, the doctor may prescribe injections into the knee. Different drugs can be used for injections in the knee joint for arthrosis. In particular, corticosteroids are injected to relieve severe inflammation. Reviews of injections indicate that it is in this form that steroids act most quickly and effectively. Knee blockade can be performed not only with glucocorticosteroids, but also with anesthetics. Reviews of the blockade indicate that this method effectively relieves even severe pain. Also, an injection in the knee can be performed during treatment with chondroprotectors. It improves metabolic processes, activates collagen production. But in order to get the effect, it is necessary to carry out at least five injections. Also, hyaluronic acid is injected intra-articularly, which improves the quality of the intra-articular fluid and provides effective protection of the cartilage tissue. Vitamins can also be administered intra-articularly.
- Plasmolifting method - its essence consists in the introduction of platelet-rich blood plasma into the sore knee.
- Medical bile for arthrosis of the knee joint - used for compresses. It should be noted that medical bile can be an effective remedy only if its use is prescribed by a doctor according to a certain scheme. Therefore, the option "we treat at home" without consulting a doctor is unacceptable in this case.
Procedures and Operations
For arthrosis and polyarthrosis, non-drug methods of treatment are also used, the use of which is no less effective.
Physiotherapy. Various techniques are used, including the method of shock wave therapy, myostimulation, phonophoresis, ozone therapy, kinesitherapy and others. Physiotherapy can reduce pain, relieve inflammation. Any physiotherapy prescribed by a doctor should be carried out exactly in the complex that the doctor advised.
Laser therapy- produces decongestant, analgesic, anti-inflammatory effects.
Ozone therapy- it relieves pain, produces an anti-inflammatory effect, which makes it possible to reduce the amount of hormonal agents used.
Knee pads for arthrosis of the knee- wearing such devices reduces the severity of pain. In addition, the knee brace protects it from instability. But in order to get the desired effect, it is necessary to choose the right knee pads or a knee brace. There are many general tips on how to choose knee pads for knee arthrosis. In addition, many different models of such knee pads are offered - with movement restraints, amplifiers, and the like. But still, those who want to buy knee pads for arthrosis, it is advisable to rely not on user reviews, but on the doctor's recommendations. The price of an orthopedic knee pad depends on different characteristics - material, quality. Knee pads are especially relevant if the patient develops post-traumatic arthrosis. But patellofemoral arthrosis, as well as other types of the disease, can be treated with this method.
Therapeutic gymnastics for arthrosis of the kneeis an effective method that allows you to improve the condition and prevent surgery, provided that the person regularly and persistently performs exercise therapy for arthrosis of the knee joint. Physiotherapy exercises helps to strengthen the muscles of the legs, and to stop the development of the pathological process. However, a set of exercises for arthrosis of the knee joint must be performed in a certain sequence, and such gymnastics is selected individually. Therefore, it is best that the basis for classes was not a video of gymnastics, but a set of exercises developed by a doctor. In this case, it is not just charging that is important, but a full-fledged exercise therapy.
With a similar pathology, different types of exercise therapy can be practiced.
Special gymnastics.Such exercises are recommended both during treatment and for people over 40 years of age for prevention. Knee exercises should be done every day. These exercises are also suitable for older adults, as they can be done at a calm pace.
Massage and manual therapy- suitable for patients with limited mobility, can be combined with exercise therapy. In the absence of an opportunity to visit a massage therapist, self-massage can be performed according to the scheme that the specialist will demonstrate.
As additional methods to improve the patient's condition and active rehabilitation, yoga, acupuncture, stretching of the joints, special exercises on simulators (exercise bike and others) can be practiced.
If conservative methods prove to be ineffective, surgical treatment is practiced.
The following techniques can be used:
- Puncture- getting rid of excess fluid in the joint can reduce the symptoms of inflammation and restore mobility.
- Arthroscopy- can be performed using endoscopy. Using this technique, the joint surfaces are cleaned from fragments of destroyed cartilage tissue.
- Periarticular osteotomy- during such an intervention, one of the bones that forms the knee joint is sawn and fixed again at a different angle. As a result, the severity of pain decreases and the mobility of the knee increases. The intervention is effective in the first and second degree of the disease.
- Endoprosthetics- replacement of the knee joint with a special biocompatible construction. This is a very complex intervention, which is carried out with the third degree of the disease.
Treatment of arthrosis of the knee joint with folk remedies
Numerous reviews of the treatment of folk remedies for this disease confirm that such methods can be used as auxiliary ones, making the patient's condition easier. However, such methods should not replace the main treatment. Folk remedies are used for rubbing, compresses, baths, ingestion. Any thematic forum contains a lot of advice on this matter.
- Rubbing with garlic. Several cloves of garlic should be peeled and chopped. Mix the resulting gruel with 200 ml of vegetable oil and insist in a dark place for a week. Apply to the knee overnight with a film and a warm cloth on top.
- Mustard Grind. To prepare the remedy, take 50 g of camphor and mustard powder, 500 ml of vodka, the protein of one egg. All are mixed and stored in a jar in a dark place for a week. Next, the product must be rubbed into the knee three times a day.
- Elecampane Grind. Pour 50 g of elecampane root with 125 ml of vodka and insist for two weeks. Rub in twice a day.
- Burdock compresses. Burdock is a popular folk remedy for the treatment of arthrosis. Several sheets of burdock should be folded down with the fleecy side and greased with vegetable oil. Attach them to the knee and cover with cellophane and a warm cloth on top. Also, burdock leaves can be greased with vodka. The compress is applied at night. Similarly, treatment with horseradish leaves is carried out.
- Cabbage leaf. It is also applied to the sore spot at night. It is pre-lubricated with honey, cologne or vodka.
- Honey compress. It is necessary to mix equal parts of honey, ammonia (10%), glycerin and medical bile, add a few drops of iodine. Leave the premixed product in a dark place for 10 days. Warm up before applying the compress.
- Onion decoction. It is taken internally. To prepare the broth, you need to take two large onions, cut them and pour 1 liter of water. Cook until the onions are tender. Take a decoction of 100 ml three times a day.
- Celery Juice. Grind the celery stalks in a blender, squeeze the juice. Drink 100 ml of juice three times a day.
- Gelatin. For arthrosis, it is recommended to consume foods that contain gelatin. Jelly, jelly and other dishes with gelatin are recommended to be included in the menu.
- Bath with pine needles. Pour boiling water over 1 kg of pine needles and leave for several hours. Add to a warm bath, in which you can also dissolve 0. 5 kg of salt. Take a bath for 20-30 minutes.
Prevention
In order to prevent the development of arthrosis of the knee joint, the following preventive measures must be observed:
- Eat right and introduce a variety of foods containing vitamins and minerals into the diet.
- Avoid excessive loads on the knee joint, protect it from injury.
- Quit bad habits.
- Monitor weight, prevent obesity.
- Timely treat all diseases, undergo preventive examinations.
- Go in for sports, preferring gentle physical activity.
- Wear high quality footwear that is as comfortable as possible.
- Ensure correct posture.
Diet for arthrosis of the knee joints
- Effectiveness: healing effect
- Terms: permanently
Diet is very important during treatment and rehabilitation. First of all, food should be healthy and light - it is important to prevent excess weight gain, which can aggravate the condition and provoke acute arthrosis. But the acute course of the disease requires not only treatment, but also weight loss.
It is also important to include in the diet foods that contain components important for cartilage tissue:
- Poultry, rabbit.
- Sea fish.
- Soy products.
- Eggs.
- Greens, zucchini, carrots, pumpkin.
- Nuts.
- Fruits, berries.
- Vegetable oils.
- Dishes with gelatin.
At the same time, you need to limit the consumption of such products:
- Beans, sorrel, spinach, tomatoes.
- Flour dishes.
- Animal fat.
- Spices, vinegar.
- Alcohol.
- Red Meat
You need to eat often, in small portions. You should also drink about 2 liters of fluid a day.
Consequences and complications
If treatment is not carried out in a timely manner, arthrosis can lead to the development of such complications:
- Inflammatory process of periarticular tissues.
- Limitation of joint mobility.
- Changing the shape of the joints.
- Degeneration of the hip joint.
Such complications can lead to the development of disability and irreversible changes.
Forecast
It is important to treat the disease in a timely manner. The most favorable prognosis will be if you start treatment at 1 or 2 stages of the disease.