Arthrosis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease accompanied by gradual destruction of cartilage with gradual involvement of periarticular structures in this process.Lack of timely treatment leads to limitation of mobility and even damage to the patient.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over the age of 65 who turn to a doctor with complaints of knee pain.Elderly people are at risk because with age the articular cartilage becomes thinner, microcracks appear in it and it gradually breaks down.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes less, due to which the surfaces of the bones begin to touch and collapse;
- bone growths (osteophytes) appear;
- the joint capsule becomes denser, which causes joint stiffness;
- A spasm of the muscles around the joint occurs.
Without treatment, the knee deforms and the movements in it are significantly limited.It can affect one or both joints
According to statistics, every fifth person in the world has gonarthrosis.Most often, the disease is diagnosed in people over 40 years old, but the age factor is not the only reason for the development of the pathology.
Why does gonarthrosis occur?
In elderly patients, arthrosis of the knee joint occurs due to the natural wear and tear of cartilage tissue.Other causes of the disease:
- congenital diseases of the musculoskeletal system;
- hormonal changes, including endocrine diseases;
- knee injuries, including frequent microtraumas;
- previous surgical interventions;
- autoimmune diseases;
- chronic joint diseases;
- regular increased load on the knee joint, for example running or jumping, constant standing or kneeling;
- genetic predisposition.
At risk are women over 40 years of age, athletes, overweight patients, people with construction professions.
How to recognize arthrosis of the knee joint?
The disease develops slowly over several years and has a chronic course.Its changes are irreversible, so it is important to start treatment as early as possible when symptoms appear.
The first signs of gonarthrosis:
- stiffness in the knee;
- discomfort when standing or bending the knee joint, climbing or descending stairs;
- squeaking or clicking when moving;
- slight pain in the knee that occurs only after prolonged standing and disappears at rest.
Over time, the discomfort intensifies.There is severe stiffness, motor disturbances and severe pain that does not leave the patient even at rest.It is difficult for a person to walk, sit or stand.Without treatment, the knee joint deforms, leading to disability.
The severity of the changes, as well as the probability of recovery, depends on the stage of the disease.
Degrees of gonarthrosis
There are 4 degrees of severity of the disease:
- I degree.At the beginning of the disease, there are practically no symptoms.There is a slight discomfort in the knee after training, which does not interfere with leading a normal lifestyle.Pathological changes can only be detected with the help of X-rays.
- II degree.Crackling and intermittent pain occurs during physical activity, walking, climbing stairs, squatting or standing for a long time.X-rays can reveal narrowing of the joint space and initial signs of osteophyte formation.
- III degree.The pain syndrome becomes constant and does not leave the person even at rest.The knee hurts especially in the morning and in the evening;during the day the pain is painful and tolerable.Since degenerative processes begin at this stage, a person's gait changes, he begins to limp, and a crunch is heard when moving.There is a "joint mouse" - this is a condition in which a particle of destroyed bone or cartilage enters the synovial cavity, causing severe pain.The knee becomes deformed and can become inflamed and swollen.X-rays show signs of joint deformity, osteophytes, significant narrowing of the joint space, and damage to the meniscus.
- IV degree.Without treatment, the disease becomes extremely severe.Cartilage, ligaments and menisci are completely destroyed, which makes movement in the joint impossible, the joint surfaces are deformed, a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnosis
Diagnosing arthrosis of the knee joint is not difficult.Examination and treatment is carried out by an orthopedist-traumatologist.He examines the patient's knee, assesses motor activity, studies clinical manifestations and palpates to identify areas of swelling and the presence of effusion.
To confirm the preliminary conclusion, he prescribes an instrumental review:
- X-ray examination - allows you to identify narrowing of the joint gap, presence of osteophytes;
- CT of the joint is a more informative diagnostic method than X-rays;shows the condition of the joint cavity;
- Ultrasound of the joint - allows you to determine the volume of fluid in the joint cavity, the presence of osteophytes, assess the condition of the surrounding soft tissues, the thickness of the hyaluronic cartilage;
- MRI - suitable for examining not only bone and cartilage tissue, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method;during the procedure, the synovial fluid may be punctured.
In addition, a clinical and biochemical blood test, an immunological examination and a rheumatoid factor test may be required.
Treatment of arthrosis
The orthopedist should treat gonarthrosis, taking into account the clinical picture and the degree of damage to the joint.You cannot self-medicate.
The doctor can prescribe drugs from the following groups:
- anti-inflammatory non-steroidal drugs;
- chondroprotectors, which restore cartilage and prevent its further destruction;
- analgesic blockades that effectively eliminate pain;
- glucocorticosteroids, which are indicated in severe disease;
- antispasmodics to eliminate muscle spasms.
Drug therapy is complemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetotherapy, electro- and phonophoresis.Physiotherapy and massage are also prescribed.
You should definitely control your weight and try to get rid of extra pounds that put additional stress on the knee joints.It is important to stick to a dietary diet;the diet should contain foods that nourish the cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.This can be arthroscopy, osteotomy or endoprosthetics.
The most favorable prognosis is if arthrosis is detected at stage 1, then the changes can be slowed down and even stopped.Stiffness or pain in the knee is not normal;it is worth examining yourself to find out the cause of the discomfort.