Arthrosis of the knee joint is a degenerative-dystrophic pathology that leads to deformation and destruction of the articular cartilage. Gradually, the limb loses mobility. According to statistics, almost every third inhabitant of the planet suffers from arthrosis, and this number is not decreasing. At risk are the elderly, especially those who are overweight. After 65 years, arthrosis is diagnosed in 70-85% of cases of treatment for knee pain.
A rheumatologist helps to preserve the quality of life of a patient with joint pathology.
Causes of arthrosis
- Destruction of the joint due to natural wear and tear (aging of the body).
- Hormonal disorders (menopause, endocrine diseases).
- Congenital defects of the musculoskeletal system.
- Injuries, surgical operations on the knee joint.
- Professional sports.
- Monotonous physical labor with increased stress on the knee joints.
- genetic predisposition.
- Autoimmune diseases.
Symptoms of the disease
Deforming arthrosis of the knee joint (gonarthrosis) develops slowly and proceeds in a chronic form. In the early stages, the disease does not cause pain: a person feels only discomfort, stiffness in the lower limb. Gradually, motor restrictions increase. Without adequate treatment, the knee is noticeably deformed. Motor functions are disturbed so much that it is difficult for a person to walk, sit down, get up. Deforming arthrosis progresses to disability of the patient. To save the joint, it is necessary to consult a doctor when the first symptoms of pathology appear.
According to the severity, there are three degrees of arthrosis of the knee joint:
- 1 degree. Clinical manifestations of the disease are mild. Most patients do not pay attention to the symptoms and continue to lead a normal life. With arthrosis of the 1st degree, a person may feel discomfort in the knee after a long stay on his feet, intensive walking, physical exertion. The x-ray image shows a narrowing of the joint space, osteophytes growing inside the joint are visible. If arthrosis is accidentally detected in the first stage, for example, during a medical examination, its development can be significantly slowed down and even stopped.
- 2 degree. Pain in osteoarthritis of the knee becomes intense, it is difficult to ignore. Especially strongly the leg disturbs early in the morning or in the evening. During the day at rest, aching pain persists. Degenerative processes in the joint are reflected in the gait: a person begins to limp. During movement, a crunch is heard in the knee. Arthrosis of the 2nd degree can be complicated by the "articular mouse" - this is a condition in which a particle of bone or destroyed cartilage enters the synovial cavity. The foreign body causes severe pain that interferes with the movement of the limb. On examination, the knee is deformed. Perhaps the accession of inflammation, swelling. The x-ray shows a narrowed joint space and osteophytes, thickening of the bone.
- 3 degree. A severe form of the disease that develops in the absence of treatment. Arthrosis of the 3rd degree is the cause of permanent disability. The pain in the knee is very strong, mobility is limited, the person cannot walk independently, every step is painful. The leg is deformed and begins to crackle strongly. On the radiograph, the doctor determines the degeneration of cartilaginous tissue, the destruction of ligaments, menisci, and the growth of connective tissue.
Diagnosis of arthrosis
To examine the patient, physical, laboratory, instrumental diagnostic methods are used:
- Blood analysis is general, biochemical, immunological.
- Synovial fluid analysis.
- Ultrasound of the knee.
- CT or MRI if indicated.
The examination plan is always individual and depends on the patient's condition.
Treatment of arthrosis of the knee joint
Therapy includes a set of procedures, medication, recommendations for lifestyle changes. It is important not to try to treat arthritis on your own. Often, patients in the early stages of the disease use anesthetic ointments and go to the doctor when the joint is already destroyed. The earlier treatment is started, the more effective it is.
The doctor prescribes drugs to relieve inflammation, swelling, to reduce pain, activate metabolic processes and tissue regeneration. Medicines are selected individually.
The following funds are available:
- Non-steroidal anti-inflammatory drugs(NSAIDs) in the form of tablets, ointments, injections. Means well relieve pain, swelling, improve the well-being of the patient.
- Glucocorticosteroidsin the form of injections directly into the knee joint. Injections are indicated in severe cases of the disease, when the limb is practically immobilized.
- Pain blockades. Help to cope with symptoms and alleviate the course of the disease.
- Chondroprotectors. The drugs contribute to the restoration of cartilage tissue and slow down the destruction of the joint.
shock wave therapy
The method is non-invasive, helps to remove salt deposits, improve connective tissue trophism. Physiotherapy improves blood circulation, favorably affects the elasticity of the ligaments. Shock wave therapy is carried out in courses of 4-10 procedures.
The patient's own platelet-rich plasma is injected into the joint. The course of plasmolifting accelerates tissue regeneration.
The method combines the effects of ultrasound and therapeutic ointments. Means for physiotherapy, as a rule, have a complex composition and are prepared in a pharmacy by prescription. Ultrasound increases the penetrating power of the active substance.
The procedure is contraindicated in the stage of exacerbation of arthrosis. When the inflammation is removed, the pain syndrome is reduced, you can start a massage course. Lymphatic drainage technique helps to prevent the accumulation of synovial fluid. Massage also improves blood circulation in the knee, relieves muscle spasm. The procedure is most effective after performing special exercises for arthrosis of the knee joint.
You can conduct a course at home as prescribed by a doctor or as part of a spa treatment. With arthrosis, radon, turpentine, hydrogen sulfide baths are indicated. The procedures have a beneficial effect not only on the knee, but also on the hip and ankle joints.
Medicinal leeches are placed around the deformed joint. The saliva of these creatures contains active substances that contribute to the restoration of cartilage. Hirudotherapy is usually prescribed for arthrosis of the 1st and 2nd degree to relieve swelling and reduce pain.
Gymnastics for arthrosis of the knee joint is an obligatory part of complex treatment. Special exercises help maintain muscle tone in the diseased limb, prevent congestion. Gymnastics begin to do in the morning without getting out of bed. Then, during the day, another 3-4 sets of exercises are performed for several minutes. It is useful to supplement therapeutic exercises for arthrosis of the knee joint with swimming.
Surgical intervention is indicated for arthrosis of 2 and 3 degrees:
- Puncture. With the help of a syringe, the accumulated fluid is pumped out of the joint cavity. Reduces internal pressure, reduces swelling, inflammation, improves mobility. The procedure is performed on an outpatient basis, at the surgeon's appointment.
- Arthroscopy. The method is used for the rehabilitation of the knee joint. Arthroscopy is carried out through small punctures, so the operation is tolerated quite easily, the rehabilitation period is short.
- Corrective osteotomy. The classical technique for the treatment of deforming arthrosis, which consists in correcting the deformed anatomical axis of the lower limb, followed by fixing the site of the wedge resection of the bone with a titanium plate. After an osteotomy, the patient needs rehabilitation for several months.
- Endoprosthetics. The installation of an artificial joint is performed with an extreme degree of deforming arthrosis of the knee joint and allows the knee to return to its previous range of motion without pain. After total arthroplasty, the patient needs a long (about 2-3 months) rehabilitation.
Minimally invasive method of treatment. A video camera and microsurgical instruments are introduced into the joint cavity. The doctor conducts a thorough examination of the joint, extracts particles of osteophytes, destroyed cartilage, scar tissue. Arthroscopy helps temporarily relieve pain and restore joint mobility.