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knee osteoarthritis

Knee joint on x-ray

Knee osteoarthritis is a special disease that damages knee cartilage.

When this disease occurs, doctors will observe severe disturbances in the blood circulation process in the bone vessels, leading to deformation and destruction of cartilage tissue. Patients will feel severe pain, limit any movement of the legs and knees, and observe swelling and changes in the appearance of the knees.

In order to prevent the development of serious consequences of knee arthropathy (limb deformity and ankylosing - arthrodesis), the disease must be recognized and treated promptly when only joint replacement surgery can help the patient.In addition, do not use folk methods and advertised remedies for treatment alone, but only under the supervision of a qualified doctor.

What's the reason?

Medically, the mechanisms of joint disease are usually divided into:

  • basic- Occurs in old age due to the natural aging of body tissues and in the context of factors that trigger the disease, such as obesity (10% of cases), heredity and increased stress throughout life.
  • middle school- Accounts for 30% of all cases of knee arthritis; it usually occurs after an injury, tibia fracture, ligament rupture, or meniscal injury.In addition, for this type of knee joint, in most cases the symptoms of the disease appear after 3-4 years, but after a serious injury, they may even appear after 2-3 months.

In 50-60% of cases, the cause of knee arthritis is muscle spasm on the front surface of the thigh.

What happens to arthritic knees?

Due to excessive regular loading, genetic predispositions, metabolic disorders in the body, long-term muscle spasms and injuries, knee cartilage loses its smoothness and begins to thin.The soft sliding of the joint bones is replaced by intense friction, and first-grade arthropathy occurs, in which the cartilage loses its shock-absorbing properties.

The degradation process continues and shock malabsorption leads to flattening of the bone surface and the formation of osteophytes in the form of bone growth.In this case, the disease has reached the second degree and is accompanied by degeneration of the synovium and joint capsule.Lack of pumping and movement can cause the knee joint structure to shrink, the consistency of the knee joint fluid to become more viscous, and the nutritional process of the cartilage to be destroyed, leading to further deterioration of the patient's condition.

Thinning of the cartilage causes the distance between the joint bones to decrease by up to 80%.When walking, due to abnormal friction and lack of shock absorbers, the process of destruction of the joints rapidly increases, which quickly leads to third-degree arthropathy with obvious symptoms:

  • Pain when moving, especially going up or down stairs.
  • Pain during exercise and at rest, morning stiffness.
  • The patient begins to limp, trying to avoid the painful joints.
  • Severe cases of this disease require the use of crutches or canes.

Tertiary arthropathy of the knee is characterized by an almost complete absence of cartilage tissue, which results in minimal joint mobility.Therefore, there is no magic method, super drug or ointment that can restore worn cartilage tissue and normal function of the joint is not possible given the extent of bone deformation.In this case, only surgery can help.

Destruction of knee joint caused by joint

Stages of Arthropathy

As arthrosis progresses, it can be divided into the following stages or degrees:

  • The initial or first phase is often called the compensatory phase because obvious clinical pathological symptoms have not yet appeared.Patients may experience knee discomfort after physical activity that resolves quickly after rest; the joint remains fully functional.
  • With degree 2 joint decompensation, the symptoms of the disease are exacerbated.A significant pain syndrome develops but can be relieved by topical application of anesthetic ointments and gels.Motor activities are impaired and joint instability occurs.In the vast majority of cases, patients seek help from their doctors at this stage.
  • The third degree, decompensation, can also be called deformation.The knee joint is twisted, unstable, immobile and completely disabled.The pain syndrome is persistent and requires serious medical intervention.To take the load off the joints and move around, a person needs a cane.

Symptoms and first signs

Depending on the severity of symptoms, the development of the disease is divided into 3 stages.Symptoms of early development of knee joint disease vary widely and are not specific.

In the first stages of pathology, the following signs may appear:

  1. Knee pain when squatting or walking up stairs;
  2. Joint pain after prolonged exercise or cooling down;
  3. Knees can hurt at the end of the day or in the morning;
  4. Morning stiffness and soreness will disappear after each day's work.

Subsequently, symptoms characteristic of stages 2 and 3 appear (in increasing order):

  • The pain becomes severe and prolonged;
  • Swelling in the joint area;
  • Fluid may appear in the joint;
  • Between the articular surfaces, cartilage, menisci, and synovial villus particles may be squeezed, causing sharp immobility (and possibly sudden passage);
  • It’s difficult to put your feet on;
  • The joints are immobile.

result

If left untreated, the following knee complications may occur:

  • joint deformity.In fact, joint deformity is more likely not a complication but the final stage of the disease.
  • joint infection.Infection usually occurs due to microtrauma.They can be thought of as small cracks in cartilage tissue.Pathogenic microorganisms flow into the joint from other sites through the blood or lymph fluid.This usually occurs after an infectious disease.
  • Dislocations and fractures.These complications may be explained by knee joint dysfunction.With arthrosis, the load is distributed unevenly from the femur to the lower leg bones.The ligaments that normally strengthen the joints also become weak.Because of this, at some point (even during normal walking) the bones of the lower leg may be put under excessive stress, resulting in a fracture or dislocation.To avoid this, people with severe structural and functional damage to the knee joint should move with the help of crutches or canes.
  • Ankylosis.Ankylosis is when two bones that once held a joint fuse together.This complication is probably the most serious because the joint disappears.The tibia and femur gradually fuse, holding the tibia in one position.Movement is of course out of the question.

diagnosis

Diagnosing knee arthritis uses:

  • blood tests (general and biochemical);
  • radiography;
  • Arthroscopy;
  • ultrasound;
  • MRI.

The most important diagnostic method for confirming knee arthrosis is radiographic examination.Although the initial stages of the disease and the state of the cartilage tissue cannot be examined with X-rays, the skeletal changes in stages 2 and 3 are clearly visible.this:

  1. Joint space narrowing;
  2. The marginal spine is located on the outline of the bone, the edge of the patella - an osteophyte;
  3. Changes in the periosteum;
  4. The height of one of the condyles and other processes changes.

However, changes can be examined in more detail using arthroscopy.

Ultrasound and MRI can help detect changes in the soft tissue of the knee during early articulation.These methods also provide a good indication of the condition of cartilage tissue, synovium, and fluid.

How is joint disease treated?

Knee treatment is lengthy and sometimes painful.Duration is because once the disease appears, it will be a constant reminder as long as the person lives.

Therefore, in order to correctly treat joint disease, a considerable financial foundation and discipline are required.How seriously the patient takes treatment plays an important role, since in order to reduce the frequency of disease exacerbations, patients are often forced to change their daily activities, favorite occupations, engage in joint development, quit smoking and drink alcohol.

There are three main stages in the treatment of knee deforming arthropathy.

The first phase of treatment includes:

  • Communicate to patients the nature of their disease, risk factors, and secondary prevention measures;
  • Daily gymnastics that include stretching;
  • Contrast Shower;
  • Go to the swimming pool 2-3 times a week;
  • lose weight.

Phase II treatment includes:

  • External fixation of joints using calipers, bandages, elastic bandages, and orthotics;
  • Use NSAID-based ointments and creams to relieve inflammation and pain;
  • Use drugs from the chondroprotectant group to reduce the rate of cartilage destruction.

The third phase of treatment includes:

  • Oral NSAIDs of course;
  • Intra-articular injection of hormonal anti-inflammatory drugs;
  • Add drugs with obvious analgesic effects;
  • Surgery to replace diseased joints with implants.

In addition to drug treatment, modern medicine uses the following methods:

  1. exercise therapy.In this case, arthrosis of the knee joint is treated with special exercises.The load is chosen individually according to the degree of development of the disease and the patient's constitution.
  2. Ozone therapy.This is the effect of using ozone on sore knees.With this method of physical therapy, the substance is administered by injection or topical application.
  3. dietary supplements.Bioactive supplements are valuable alternatives to other medications.
  4. Homeopathy.It involves taking small doses of medication.The course of treatment lasts only a few weeks, but during this time, as long as the drug is properly chosen, blood circulation and normal nutrition of the cartilage tissue cells will be fully restored.
  5. practiseIt allows you to improve the blood circulation of the knee joint, restore the elasticity of the ligaments, improve the nutrition of cartilage tissue cells, and promote its repair.

drug treatment

All drugs used to treat knee arthropathy can be divided into drugs that help eliminate the main symptoms of the disease and drugs that restore the function of the knee joint and prevent the progression of the pathology.The first category of drugs includes nonsteroidal anti-inflammatory drugs and hormonal drugs.The second group includes chondroprotectants and hyaluronic acid.

NSAIDs

Medical treatment of joint disease begins with eliminating pain.They cause patients maximum mental and physical suffering and cause them to become incapacitated.Nonsteroidal anti-inflammatory drugs (NSAIDs) work well as pain relievers.

These medications can be used in two ways - topically or orally (tablets).Topical treatments (preferred) usually include patches, ointments, or gels.Typically, analgesia occurs on days 3-4 and is maximal on days 7-10.

The course of NSAIDs should be limited to 10-14 days.NSAIDs have limited use and caution should be exercised when treating elderly patients.

Hormone drugs

If treatment with NSAIDs is not enough and the disease continues to progress, your doctor may prescribe hormone injections.They are a "heavy hit" method that helps to quickly relieve pain and relieve inflammation and swelling of surrounding tissues.

Due to many side effects, hormone drugs can only be used for short-term treatment in the acute stage of the disease and when inflammation accumulates in the joint cavity.This medication should not be injected into the joint space more often than once every 10 days.

chondroprotectant

To prevent further damage to the articular cartilage surface, chondroprotectants are required.

These medications also help relieve pain and reduce signs of inflammation in the surrounding soft tissues.In addition, chondroprotectants slow down the destruction of joint tissue and stabilize disease due to their shock-absorbing and lubricating properties.Chondroprotectants improve the nutrition of cartilage, normalize the composition and properties of fluid within joints, and protect pain receptors from excessive stimulation.

hyaluronic acid

Hyaluronic acid is known as a liquid prosthesis for intra-articular fluid.Its properties are similar to natural synovial (intra-articular) fluid, which nourishes cartilage tissue and cushions the knee joint during movement.

A hyaluronic acid preparation is injected into the joint to form a thin protective film that prevents the cartilage surfaces from rubbing against each other.Injections are given only after the acute phase of the disease has passed.

Exercise therapy and joint exercises

Physical exercise helps restore and strengthen joint function.This should be done slowly and carefully to avoid straining, and without exceeding the allowable load.

The following exercises are considered the most effective:

  1. While lying on your stomach, slowly raise your straight legs, one at a time.This exercise uses the thigh and calf muscles.Transferring loads to the rear is not allowed.You also shouldn't lift your legs too high.Mainly tighten the muscles at the highest point;
  2. This exercise is similar to the first, except now you should lift your legs and bend your knees.At the top, the thigh muscles should be further tense.The number of exercises must be the same for each leg;
  3. Lying on the floor (lying on your stomach), lift your straight legs up, then spread them apart and bring them together.This exercise requires strong, well-trained abdominal muscles and is not suitable for all patients.Additionally, doing this may cause your blood pressure to rise.Best avoided in patients with hypertension or other diseases of the cardiovascular system;
  4. For the next exercise, you need to lie on your side, bend one leg on the floor at the knee, slowly lift the other leg and keep it at the highest point.It is important that each leg performs at the same angle;
  5. You will need a chair to perform this exercise.Sit on it, straighten your legs one by one, lift them up and hold them in the straight position for as long as possible;
  6. It is useful to stand on your tiptoes while holding onto the back of a chair or bed.As with other exercises, you need to stay at the top for a few seconds and tense your leg muscles extra;
  7. Smooth movements from toes to heels activate blood circulation in the lower limbs.These movements should be performed alternately: one leg on the toes, the other on the heel, or vice versa.All movements must be smooth;
  8. Lean on the back of a chair or bed and stand on your heels for one minute, lifting your toes.If you cannot maintain this posture for the prescribed time, you should start with less and gradually increase;
  9. Massage performed in a standing position.The legs should be rubbed with firm movements from the knees to the thighs.Massage needs to be done by stroking the skin.

The doctor will perform several in-office treatments and demonstrate basic techniques so that the patient can massage the problematic knee on his or her own.Effective action can improve the condition of damaged areas.

Massage and self-massage

Use the palms of your hands, edges of your hands, fingertips, or fists to self-massage.Apply gentle pressure to the sore knee, maintaining firm pressure on the affected area: hard tapping, blowing, and actively kneading the tissue will often worsen the condition.

Basic techniques:

  • The first stage is gentle clockwise stroking, and the second stage is counterclockwise circular motion;
  • Place the palm of one hand on the sore knee and tap lightly with the fingertips of the other hand;
  • Keep your palm in its original position and tap not with your fingers, but with the edge of your palm;
  • Gently stroke your knees in circular motions, gradually increasing the pressure (but moderately);
  • During treatment, massage the affected area twice a day for 10-15 minutes each time.For preventive purposes, a light massage every 7 days is enough.

Before surgery, apply an anti-inflammatory ointment or gel to your sore knee.

physical therapy

All physical therapy methods can be divided into several groups:

  1. relieve pain;
  2. Reduce inflammation;
  3. Restore joint nutrition and accelerate joint function recovery.

Doctors can determine what type of treatment a patient needs based on existing symptoms and accompanying medical conditions.

joint surgery

Surgical treatment refers to the fundamental method to partially or completely restore knee joint function.Surgical treatment methods vary in the degree of intervention in the affected joint.

  1. ArthroscopyRefers to the mildest form of surgical treatment.This technique is less invasive and can be used as a therapeutic measure even in the early stages of joint disease.Its main goal is to extend the life of damaged joints.Arthroscopy is performed using an endoscope, a flexible probe with a camera on the end.A small puncture is made on the knee joint and the endoscope and ancillary instruments are inserted.During the surgery, the damaged areas of tissue causing pain are removed.The procedure is best suited for young people and can be repeated several times if necessary.
  2. endoprosthesisRefers to the most thorough surgical technique.In this case, full function of the joint can be restored by replacing the entire knee joint or part of it with an implant.This method is the best alternative to the previously existing technique of arthrodesis (complete immobilization of a damaged joint).Currently, endoprosthetic replacement has a positive outcome of up to 90% and significantly improves the patient's quality of life.
  3. OsteotomyIt is used when the joint is significantly deformed and joint function is significantly affected.Osteotomy involves creating an artificial fracture in a pre-planned location.Subsequently, the various parts of the bone are aligned in the correct physiological position and allowed to grow together.Sometimes artificial immobilizers of bone fragments may be used during surgery, which help to make the position of the bone more stable.

folk remedies

Traditional medicine can also help.Many patients have long used various lotions to relieve swelling and pain.Here are some helpful recipes:

  1. Burdock leaves.Take 5 burdock leaves and steam them in boiling water.Lubricate sore knees with vegetable oil and apply steamed leaves.Wrap your legs in plastic wrap and a warm scarf.Leave the lotion on for a few hours.
  2. Cabbage leaf lotion.It is made from fresh cabbage leaves soaked in May honey and spread on the legs.Insulation made from woolen fabric or plastic film can enhance the effectiveness of the treatment.This product is suitable for people of all ages.
  3. Eggshells, Kefir.Grate the shells of 2 eggs and mix with 1 spoon of kefir.Apply the mixture to your knees, wrap them in a cloth and plastic wrap, and lie down under a blanket.Leave it like this for a few hours, then rinse off the composition with water.This treatment can be used every day.
  4. horseradish dressing.According to this folk recipe, in order to enhance the medicinal properties of horseradish, it is recommended to crush it and boil it first.It must then be applied to the affected area.
  5. turpentine– An excellent warming agent for sore joints.Before going to bed, rub your knees with turpentine and tie them tightly with a woolen scarf.After the first surgery, the patient's symptoms were significantly relieved.The course of treatment is chosen individually for each person.

diet

Therapeutic diet involves avoiding or minimizing canned, smoked, and fried foods (to suppress appetite).To restore damaged cartilage, it is necessary to provide the body with complex carbohydrates (porridge, whole grain products).Juices (carrot, beetroot, apple) should also be included in the diet.They remove toxins from the body and reduce the effects of inflammatory processes.

The diet should include fish and aspic, which act as chondroprotectants and help form new cartilage.It is worth remembering that you cannot make a diet plan for yourself - only a nutritionist (diet expert) can choose the best option.

Menu example:

  • Breakfast: oatmeal with water (no butter or sugar), juice, hard-boiled eggs;
  • Second breakfast: a cup of low-fat natural yogurt;
  • Lunch: steamed meat or fish, stew, unsweetened tea;
  • Afternoon snack: cheese casserole with nuts, a glass of juice;
  • Dinner: vegetable salad, apple, sugar-free tea;
  • Second dinner: A cup of low-fat kefir.

prevention

Prevent joint diseases:

  • Reduce load on the legs during active exercise;
  • Develop a diet that includes foods and dishes containing calcium, magnesium, and gelatin;
  • If the job involves lifting or moving heavy objects, follow safety rules and do not lift loads that exceed certain limits;
  • Practice regular self-massage to prevent joint disease, especially if you are under constant pressure on your legs;
  • Eat right and limit “bad” foods;
  • Weight control (excess weight means extra stress on joints);
  • Regular examination and treatment of acute and chronic diseases.

forecast

If knee arthrosis is diagnosed at an early stage, the causes of the pathological process are eliminated and adequate treatment is provided, the prognosis is good.The treatments offered can result in long-term relief, but treatment is usually lifelong.

Without the necessary treatment, or if the patient does not comply with the doctor's instructions, knee arthrosis can become a cause of disability.