Arthrosis of the knee joint (gonarthrosis) is a degenerative-dystrophic disease, which is accompanied by the gradual destruction of cartilage with the gradual involvement of periarticular structures in this process.Lack of timely treatment leads to limited mobility and even disability of the patient.
Description of the disease
Gonarthrosis is diagnosed in 70-85% of patients over 65 years of age who consult 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 collapses.New pathological changes appear:
- the composition of the synovial fluid changes, it becomes less, which is why 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 surrounding the joint occurs.
Without treatment, the knee becomes deformed, and movements in it are significantly limited.May affect one or both joints
According to statistics, every fifth person in the world has gonarthrosis.Mostly the disease is diagnosed in people over 40 years of age, but the age factor is not the only reason for the development of 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 loads 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, and people in 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 straightening or bending the knee joint, going up or down stairs;
- crunching or clicking noises when moving;
- slight pain in the knee, which occurs only after prolonged standing and goes away with rest.
Over time, the discomfort intensifies.Severe stiffness, motor disturbances, and severe pain appear, which does not leave the patient even at rest.It is difficult for a person to walk, sit down, or stand up.Without treatment, the knee joint becomes deformed, leading to disability.
The severity of the changes, as well as the likelihood 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 onset of the disease, there are practically no symptoms.There is minor discomfort in the knee after exercise, which does not interfere with leading a normal lifestyle.Pathological changes can only be detected using x-rays.
- II degree.A crunching sound and periodic pain appear during physical activity, walking, walking up stairs, squats, or standing on your feet for a long time.X-ray images can reveal a narrowing of the joint space and initial signs of osteophyte formation.
- III degree.The pain syndrome becomes permanent and does not leave the person even at rest.The knee hurts especially badly in the morning and in the evenings; during the day the pain is aching and tolerable.Since degenerative processes begin at this stage, a person’s gait changes, he begins to limp, and a crunching sound 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 may become inflamed and swollen.X-rays show signs of joint deformation, 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, articular surfaces are deformed, and a large number of osteophytes appear.These changes cause severe pain and disability.
Diagnostics
Diagnosing arthrosis of the knee joint is not difficult.An orthopedist-traumatologist performs examination and treatment.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 examination:
- X-ray examination - allows you to identify narrowing of the joint space, the presence of osteophytes;
- CT scan of the joint is a more informative diagnostic method than x-rays; it 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 hyaluronic cartilage;
- MRI - suitable for studying not only bone and cartilage tissue, but also ligaments, menisci, synovium and other structures;
- Arthroscopy is an invasive diagnostic method; during the procedure, synovial fluid can be punctured.
Additionally, a clinical and biochemical blood test, an immunological study, and a test for rheumatoid factor may be required.
Treatment of arthrosis
An orthopedist should treat gonarthrosis, taking into account the clinical picture and the degree of damage to the joint.You cannot self-medicate.
The doctor may 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 for severe disease;
- antispasmodics to eliminate muscle spasms.
Drug therapy is complemented by physiotherapeutic procedures: shock wave therapy, laser therapy, magnetotherapy, electro- and phonophoresis.Additionally, physical therapy and massage are prescribed.
You definitely need to control your weight and try to get rid of extra pounds, which cause additional stress on your knee joints.It is important to adhere to a dietary diet; the diet should contain foods that nourish cartilage tissue.
In advanced cases, when the cartilage is severely damaged, surgery is required.This may be arthroscopy, osteotomy or endoprosthetics.
The most favorable prognosis is if arthrosis is detected at stage 1, then changes can be slowed down and even stopped.Stiffness or pain in the knee is not normal; it is worth getting examined to understand the cause of the discomfort.