Arthrosis (gonarthrosis) is a pathological change in the knee joint that has a chronic course and can develop over time. The disease extends to all components of the knee joint: cartilage, subchondral bone, menisci, synovial membrane, ligaments, capsule, and periarticular muscles.
The knee joint, which connects the femur and tibia, is subjected to heavy loads throughout life and is often injured. Sometimes minor damage is not noticed immediately, but makes itself felt in the second half of life. In this regard, joint damage is often detected in the elderly. However, young people also experience knee joint pathology as a result of sports or an active lifestyle.
To maintain maximum mobility and a high standard of living, you should see a doctor at the first problem with your knee joint. An experienced orthopedic traumatologist will diagnose your condition and prescribe the necessary treatment.
Types of arthrosis of the knee joint
In the joint, the bones are covered with cartilage tissue, which provides shock absorption, smooth sliding, and also prevents the bones from rubbing against each other. Cartilage tissue receives nutrition thanks to the synovial fluid located in the joint and the blood flowing through the vessels.
Cartilage has a spongy structure, so when resting it absorbs fluid, and when loaded, it replaces it. At the same time, during movement, the cartilage constantly receives microtraumas, and during rest it is restored.
If the result of a mechanical injury exceeds the joint's recovery capacity, then there is not enough nutrition for the cartilage, and as a result, regeneration does not occur. Damage accumulates and changes the structure of cartilage tissue. This is how arthrosis of the knee joint begins.
Depending on the cause, arthrosis of the knee joint is usually divided into two types: primary and secondary.
primary gonarthrosis
Degenerative changes that occur in the joints are associated with age. Among the reasons that cause it are as follows:
- deterioration or natural deterioration due to slowing down of metabolic processes in the body;
- overweight;
- sedentary lifestyle;
- Malnutrition;
- genetic predisposition.
As a rule, primary gonarthrosis affects both knees at once and is called bilateral.
Secondary gonarthrosis
Secondary arthrosis of the knee joint can occur at any age, as it can be caused by:
- various injuries - bruises, fractures, dislocations, ruptures and sprains of ligaments or meniscus;
- joint diseases: rheumatoid arthritis, osteochondritis dissecans, gout, gonitis, etc. ;
- regional vascular disorders;
- knee joint load during sports or due to specific work;
- endocrine diseases;
- The curvature of the legs is O-shaped and X-shaped.
Secondary arthrosis of the knee joint most often appears only on one leg and is called unilateral.
In rare cases, idiopathic gonarthrosis is identified - a disease that occurs for no apparent reason.
Stages and symptoms of arthrosis of the knee joint
Regardless of how arthrosis of the knee joint appears, experts distinguish three stages of its development, which are determined during an X-ray examination. Each stage is accompanied by characteristic symptoms:
Stage 1– mild pain that occurs after prolonged exercise, when climbing stairs, after heavy exercise, and disappears after rest. There is no restriction of movement, but sometimes subtle swelling of the joints may occur. This condition, if nothing is done, can last for years - at this time the new cartilage begins to lose its smoothness due to impaired blood supply. X-rays will show slight narrowing of the joint space and bone hardening.
- Stage 2– pain becomes severe and lasts for a long time even with light exercise. A humming sound is heard during flexion and extension of the joint. It becomes impossible to fully bend the leg due to severe pain. There is slight deformity, muscle wasting and limited range of motion. The pain can be relieved with painkillers or go away on its own after rest.
At this stage, the cartilaginous layer is already very thin, in some places until it disappears. Synovial fluid becomes thicker and more viscous, which affects its nutritional and lubricating properties. Osteophytes appear - bone growths.
- Stage 3– the pain increases and is always worrying, even at night. Joint deformities become apparent, gait changes, and lower limbs become bent. The range of motion in the knee joint is reduced - the leg cannot be fully bent or straightened. When walking, you need to use support in the form of a cane or cane. Pain medication no longer helps.
Cartilage is almost completely obliterated, the bones are compacted, the joint space is very narrow or absent. The presence of many osteophytes was observed.
One common symptom of arthrosis of the knee joint can be identified - pain of varying intensity, localized along the anterior-inner surface of the joint.
Diagnostics
If you notice symptoms similar to the development of gonarthrosis, you should see a doctor. At the initial appointment, the doctor will collect anamnesis, check the biomechanical ability of the joint, and prescribe the necessary examinations. Be sure to inform him about the injuries and illnesses experienced, lifestyle, diet, medications taken, and work characteristics.
The most informative and convenient way to confirm or refute the diagnosis is an x-ray of the knee joint - it allows you to carry out a differential diagnosis, determine the level of development of arthrosis and monitor the treatment process.
However, radiological signs appear later than morphological changes. Therefore, in the early stages, gonarthrosis is difficult to detect even on x-ray. In such a situation, the doctor may prescribe arthroscopy - a very accurate method to diagnose changes in the joint using special endoscopic equipment.
Additional research methods are ultrasound and MRI - they are prescribed when radiography is not informative enough.
Treatment of arthrosis of the knee joint
After the diagnosis, the doctor chooses the optimal treatment, depending on the stage of the disease and individual characteristics. This solves three problems:
- relieves pain;
- stop the development of pathology;
- restoration of joint function.
Specialists choose a comprehensive solution, which can be adjusted during the treatment process.
In modern medicine, there are many ways to treat joint diseases. All of them can be divided into three types: conservative, minimally invasive, surgical.
Conservative methods of treatment of gonarthrosis
Usually used in stage 1-2 arthrosis of the knee joint. Treatment begins with reducing the load on the joint - the patient should avoid excessive vertical load on the joint: jumping, running, etc. If necessary, it is recommended to reduce excess weight. The doctor will recommend a diet and choose a gentle set of exercises that will reduce the impact of the axis and improve the nutrition of the cartilage tissue.
To improve blood circulation in the joint area, increase range of motion, and also increase the effect of medications, physiotherapy is prescribed:
- shock wave therapy - short-term effect on bones and connective tissue with low-frequency significant amplitude acoustic pulses;
- electrotherapy - exposure of the affected area to electric current, magnetic or electromagnetic fields;
- laser therapy - exposure to optical radiation produced by a laser;
- phonophoresis - exposure to the affected area with ultrasound and medicine applied to the skin;
- electrophoresis - exposure of the affected area to electricity.
Massage, compresses, wearing orthotics, and kinesiotaping have also proven themselves well in the treatment of arthrosis.
In addition, well-chosen drug therapy helps relieve pain, stop inflammation, and slow down the process of cartilage tissue destruction. For this purpose, anti-inflammatory drugs, hormones, antispasmodics, and chondroprotectors are prescribed. They can be in the form of tablets, injections or topical, depending on the situation.
Minimally invasive methods to treat gonarthrosis
If the above procedures have no effect, the doctor may prescribe an intra-articular injection:
- hyaluronic acid – as a synovial fluid replacement to improve friction, reduce pain and improve knee joint function. The average duration of drug action is 3-6 months;
- own plasma enriched with platelets - for nutrition and restoration of cartilage tissue;
- Corticosteroids - to reduce inflammation.
Surgical methods to treat gonarthrosis
If conservative treatment turns out to be ineffective, or you first turn to a specialist with the third stage of arthrosis of the knee joint, then the doctor may use surgical intervention:
- arthrodesis - artificial immobilization of the affected joint in a physiological position to eliminate pain;
- arthroscopic debridement - joint sanitation using an arthroscope;
- corrective osteotomy - elimination of bone defects by artificial fracture;
- endoprosthetics - replacing worn joints with artificial implants made of biocompatible materials.
The type of operation is chosen by the doctor based on the characteristics of arthrosis of the knee joint. But endoprosthetics are considered the gold standard, as they allow you to fully return to your normal lifestyle. At the same time, a good implant does not require replacement for 15-30 years. To fully recover after surgery, it is necessary to undergo a rehabilitation course that takes 3-4 months.
Complications
Gonarthrosis develops relatively slowly, but it can be detected in time and the necessary treatment can be started. Ignoring the disease and its symptoms can lead to serious consequences:
- persistent pain that does not go away with medication;
- complete immobility of diseased joints;
- inability to lean on the injured limb;
- severe deformation of the joints and curvature of the legs;
- damage to other parts of the musculoskeletal system;
- shorten the legs.
In very difficult situations and in the absence of timely treatment, arthrosis can lead to disability and deterioration in motor activity, even to the point of immobility.
It is important to remember that it is impossible to completely cure arthrosis. But it is quite possible to stop the progression of the disease and improve the quality of life.
Prevention
There is no preventive treatment for gonarthrosis. But people at risk are advised to follow certain rules:
- make sure your weight does not exceed the age norm;
- do not engage in sports that put heavy pressure on the knee joint;
- if possible, completely recover from infectious diseases without causing complications;
- don't be too cold or too tired;
- avoid injury and excessive load on joints;
- avoid stressful situations;
- don't forget about rest;
- engage in exercise therapy;
- wear orthopedic shoes.
Risk groups include the elderly, athletes and dancers. You can also add here those who lead a sedentary lifestyle, stand firm at work or lift weights, and are overweight.
Any change in the axis of the lower limb or the normal biomechanics of the joint, dysplasia, a decrease in the number and strength of the leg muscles, or trauma can also cause arthrosis.
Get regular checkups and take preventative measures.
Question answer
- What is the difference between knee arthritis and knee arthrosis?
Arthritis is a collective name for joint inflammation, and arthrosis is a degenerative-dystrophic process.
- Which doctor treats arthrosis?
Trauma-orthopedic specialist or rheumatologist.
- Is it possible to play sports with arthrosis of the knee joint?
Prolonged and heavy loads on the joints, as well as axial impact, should be avoided. But you shouldn't exclude sports from your life completely - when you move, your joints are more "maintained" and restored. It is important to observe the measurements and follow the recommendations of the doctor, who will choose the type and method of exercise.