Deforming osteoarthritis of the knee joint, in medicine is called gonarthrosis, is a degenerative-dystrophic disease of the hyaline cartilage of the knee, which covers the condyles of the femur and tibia.
With osteoarthritis of the knee joint, symptoms develop gradually, over the years, the main manifestation of the disease is pain, stiffness when moving. It is the gonarthrosis considered the most common disease among the osteoarthritis of other joints, such as osteoarthritis of the hip, arthrosis of the elbow or shoulder joints, the phalanges of the fingers.
Very often the disease affects people over the age of 40, women are more susceptible to osteoarthritis. Sometimes it develops in young people against the background of injury or in athletes from excessive exertion.
Causes of osteoarthritis of the knee joint
There is no single reason for the development of such a disease as osteoarthritis of the knee joint, as a rule, it is a combination of several provoking factors that can lead to a similar ailment with age.
The mechanisms of osteoarthritis in medicine are usually divided into:
- Primary- which occurs in old age due to the natural aging of body tissues and against the background of certain factors that provoke this disease, such as obesity (10% of cases), heredity, increased stress during life.
- Secondary- owns 30% of all cases of osteoarthritis of the knee joint, usually occurs after an injury, leg fracture, ligament rupture, damage to the meniscus. Also, with such arthrosis of the knee joint, the symptoms of the disease in most cases appear after 3-4 years, but after a serious injury it is possible even after 2-3 months.
In addition, there are frequent (7-8% of cases) cases of osteoarthritis, when a person after the age of 40 suddenly begins physical activity, especially intense running and squats. It is at this age that age-related changes in the joints already occur, and acute loads can provoke rapid dystrophic and degenerative changes in the joints.
In addition, another cause of osteoarthritis of the knee joint can be not only injuries, severe injuries, but also concomitant diseases: rheumatoid, reactive or psoriatic arthritis, gout, ankylosing spondylitis, overweight and varicose veins.
Practicing professional sports or simply constant intense physical exertion, lifting weights or long-term climbing stairs in old age can be the reasons for the development of osteoarthritis of the knee joint. The risk of gonarthrosis also increases with spinal injuries, neurological diseases, diabetes mellitus and other metabolic disorders, as well as with genetic weakness of the ligament apparatus (3-5% of cases).
In 50-60% of cases, osteoarthritis of the knee is caused by a muscle spasm in the anterior surface of the thigh. Until the moment when the patient's knees hurt, such a muscle spasm does not manifest itself for a long time, and the person feels only lower back pain, fatigue, heaviness in the legs. If the rectus and iliopsoas muscles of the thigh are in a constant spasmodic state, the knees gradually "stiffen" with age, which does not allow them to move freely.
Belgian orthopedic surgeons recently discovered an unexplored and previously unknown ALL ligament, located in the human knee, hereafter referred to as anterolateral or anterolateral.
The fact is that in some patients, even after successful operations after injuries and ruptures of the knee ligaments, instability of the knee joint and pain were felt during physical exertion.
Research conducted for 4 years on 40 knee joints revealed this ligament itself, which was not known to medicine at all. The main function of this ligament is the rotational movement of the tibia, and when injured, doctors did not even know about its surgical correction during operations.
Degree of knee osteoarthritis
Most often, osteoarthritis develops in one of the knee joints and, taking into account the intensity of pathological processes in medicine, 3 degrees of gonarthrosis are distinguished:
- First of all, with this degree of deformation of the bones of the joint there is no, however, the initial manifestations are characterized by periodic dull pain after loading the joint. There may be swelling of the joint, insignificant and disappear on its own.
- Arthrosis of the 2nd degree of the knee joint - at the same time, the symptoms of arthrosis begin to increase significantly, pains already occur with little physical exertion, when walking, lifting weights, are moreintense and prolonged, a creak appears in the joint, at the second degree deformity may develop joint and moderate limitation of movement.
- Grade 3 osteoarthritis of the knee joint is characterized by the highest symptoms of osteoarthritis of the knee joint. The patient's gait is impaired by constant pain and noticeable deformation of the joint, as well as by the limitation of joint mobility. The pain intensifies depending on the weather, they are often so severe that a person cannot find a comfortable position, sleep is disturbed, and the limitation of joint mobility can be minimized.
What is knee osteoarthritis confused with?
Even before the blood test for arthritis, there are all the signs of inflammation: swelling, redness, warm skin on the affected joint, impaired movement. Osteoarthritis is pain combined with radiological changes.
Meniscus injury and knee block
This disease develops very quickly, with unsuccessful movements after the crunch of the knee, acute pain appears that disappears in 15 minutes, knee swelling occurs the next day.
Arthritis - rheumatoid rheumatoid, reactive, psoriatic, joint rheumatism, gout, ankylosing spondylitis
It is possible to distinguish osteoarthritis from arthritis by a blood test, with osteoarthritis, a general blood test does not show any changes, but a blood test for arthritis almost always indicates an inflammatory process (except, for example, in cases of damage to the small joint of the hand).
Inflammation of the knee ligaments (tendonitis)
This pain occurs most often in women after 40 years of age when walking down stairs or carrying heavy objects, it is localized on the inner or outer side of the knee, at the base of the patellar attachment. Extension of the leg into the joint is difficult, edema can be observed.
Vascular pain in the knee
Symmetrical pains that occur in both knees at the same time and mainly in young people during accelerated bone growth, occur when the weather changes, with colds, physical exertion, patients describe this condition as "rotation of the knees".
Symptoms of knee osteoarthritis in stages
This insidious disease develops gradually. At first, the patient begins to be bothered by only mild discomfort, pain when moving, descending and climbing stairs. Sometimes a person describes their sensations as constriction in the popliteal region and a slight stiffness in the joint. A hallmark of osteoarthritis of the knee joint is an initial pain symptom, that is, when a person suddenly gets up from a sitting position and begins to move, the pain occurs in the first steps, but as it moves it softens or disappearsaltogether. However, after a significant load it appears again.
First, the knee does not look different from a healthy one, only sometimes patients notice a slight swelling in the affected area. There are also cases when fluid accumulates in the knee joint, swells, becomes spherical, then synovitis develops, movement in the joint is limited, and heaviness is felt. Why do such pains and changes occur in the joint?
In the first degree of osteoarthritis, blood circulation is impaired in the small intraosseous vessels that supply nutrients to the hyaline cartilage. Because of this, the surface of the cartilage eventually becomes non-smooth, dry, cracks appear on the surface of the cartilage. The sliding of the cartilage during movement must be soft and unimpeded, and in this case they cling to each other, such a constant state of microtrauma thins the cartilage tissue, thus losing its cushioning properties.
As pathological processes develop, changes in bone structures also occur, when the joint area flattens, osteophytes appear along the edges of the joint - spikes or as they are called bone growths. The joint capsule degenerates, the synovium narrows, the joint fluid thickens. All this leads to an even more significant decrease in the supply of nutrition to the cartilage, and degeneration begins to accelerate.
Therefore, with the 2nd degree of arthrosis of the knee joint, the symptoms intensify, the pains are localized more often on the anterior-inner side of the joint and also occur with light loads, rest gives relief, but the movement still causes severe pain.
The mobility of the joint is also reduced, when trying to bend the leg to the maximum, severe pain occurs and a rough crunch is heard during movement. Synovitis is already observed much more often than at the beginning of the disease, the fluid accumulates in larger quantities, the joint changes its configuration, becomes, as it were, expanded.
In grade 3 arthrosis of the knee joint, significant deformation of the bone occurs, they seem to be pressed into each other, cartilage tissue is already practically absent, restriction of movement of the joint increases. The pain bothers the patient day and night and at rest and when walking, bending or straightening the joint becomes problematic. The joint is deformed, the legs become X or O shaped, the gait is swaying, unstable, often in severe cases the patient needs crutches or canes.
Diagnosis and treatment of osteoarthritis
In the first degree of osteoarthritis, such a diagnosis cannot be established during a routine examination. At 2-3 degrees, already on examination, deformities of the bones and joints are noted, a change in the axis of the limbs, stiffness of movement, a crunch is heard, with synovitis, swelling and swelling are noticeable.
Today, in addition to standard radiography, modern methods of MRI and CT are used to diagnose osteoarthritis of the knee joint, which allow a more thorough examination of pathological changes in soft tissues and the study of disorders of bone structures.
Treatment of this disease consists of a whole complex of procedures and drug therapy. Orthopedists prescribe physiotherapy, massages, corrective gymnastics, mud therapy.
Drug treatment includes the appointment of chondroprotectors, drugs that replace synovial fluid. Intra-articular administration of steroid hormones is sometimes indicated. Patients are also shown a spa treatment. If the treatment is ineffective, if the patient is young and has arthrosis with severe pain and limited movement, joint replacement is possible, followed by a rehabilitation period of 3-6 months.