Arthrosis or osteoarthrosis of the knee joint is a disease that occurs against the background of dystrophic changes with the subsequent growth of connective tissue.There are many factors affecting the development of the disease, but all of them ultimately lead to a violation of metabolism in cartilage.In the medical literature, arthrosis of the knee joint is called gonarthrosis.
According to statistics, gonarthrosis occupies a leading position in the frequency of occurrence among other arthrosis.The disease brings severe discomfort, which can develop into pain when walking and at rest.
Knowledge of early symptoms will help to suspect the development of pathology and cure it in the initial stages.
Reasons
According to medical classification, there is primary and secondary gonarthrosis or arthrosis of the knee joint.
Arthrosis of the knee joint can occur against the background of various diseases or act as their complication.When, due to an unclear history or clinical picture, the exact cause cannot be established, gonarthrosis is called primary, but if the cause is known, then such arthrosis is called secondary.
Arthrosis develops with age in almost all people, on average, this period begins after 45-50 years of life.
The course and pathogenesis of primary and secondary arthrosis are the same and do not depend on the cause of the occurrence.
The most common causes of arthrosis and osteoarthrosis of the knee joint are:
- traumatic damage to the knee;
- joint deformation inward and outside;
- shortening of one lower limb;
- abnormal hypermobility of the joint;
- chondroblast dysplasia;
- Calcinosis of cartilage;
- osteomyelitis of the femur and tibia;
- rheumatoid arthritis or arthritis of any other etiology;
- glucose metabolism;
- Metabolic diseases and hormonal diseases.
Injuries.After receiving the knee injury in the joint cavity, inflammation with a large focus of aliteration may develop.After the disappearance of pro -inflammatory agents, the processes of reparation or arthrosis are activated.
Most often, the disease occurs against the background of a fracture with a rupture of ligaments and damage to the bag and the cartilage surface of the joint.
Congenital deformations.Valgus or varior deformation is found very often and without proper correction can be complicated by sclerotic changes in the knee.This happens due to the fact that one of the knees falls more than the load than it should be.
Shortening of any of the lower extremities.As well as with deformations, in the pathogenesis of the development of the disease, improper distribution of weight on the knees plays the role.
Hypermors of the knee.In this state, wear of the cartilage tissue of the knee joint may occur with subsequent degeneration and degeneration into arthrosis.Hypermorsion often leads to spontaneous dislocations and sprains of the joint capsule.
Hand -haired dysplasia.Due to the improper development of the motor surface in the knee joint, a pathological growth of connective tissue occurs.
Calcinosis of the joint.The pathogenesis is based on the deposition of salts into the joint cavity and the formation of a specific precipitate, which causes calcification with subsequent osteoarthritis.
Osteomyelitis.Inflammatory bacterial disease in which the destruction of bones and joints occurs.First, ankylosis and only then sclerosis are formed.
Arthritis of any etiology.The most dangerous are rheumatoid arthritis, accompanied by autoimmune lesions of the heart and joints.
Diabetes, like metabolic disorders, leads to a violation of the flow of nutrients into the joint and the sprout of the cartilage.
Obesity.With a large weight of the body, large loads are on the knees when walking and in a standing position.As a result of constant pressure, blood flow to the knee joints decreases, and atrophy with dystrophy develops.
Symptoms
Symptoms with arthrosis of the knee joint depend on the stage of the pathological process.Based on this, analyzing the symptoms and pace of their growth, you can assess the scale of changes in cartilage tissue.
Symptoms of knee arthrosis:
- the presence of pathological sounds during movement;
- soreness after load or at rest;
- reduction of functions;
- edema and joint increase;
- pathological dislocations, fractures and subluxation;
- Temporary jamming that can occur when flexion and extension of the joint.
The click and crunch is not immediately noticed, and if they notice, they do not pay due attention.Pathological sounds encounter the idea that a pathological process with the deposition of salts or the formation of osteophytes occurs in the cartilage gap.
Pain occurs due to the formation of calcinates or osteophytes.At first, the pain syndrome is not expressed, later it appears only in the morning and passes after lunch, with the progression of the disease, pain can occur at rest.
A decrease in joint functions is manifested in the stiffness of movements and a decrease in their amplitude.Depending on the stage, the constraint of movements can last a certain time and pass at rest.
Edema occurs due to inflammation and hypersecretion of the synovial fluid.There are also options when the skin is inflamed over the joints.Such symptoms can be with scarlet fever or rheumatism.
Dislocations and subluxation occur for the reason that the process applies to the bones and ligaments of the knees.
Clushing is a condition during which the movement in any axis is completely limited.Such a symptom indicates the neglect of the process and the need for complex treatment.
Degree of arthrosis
Classify osteoarthritis according to the following signs:
- radiological symptoms;
- clinical manifestations;
- Laboratory data.
The most common and convenient classification is radiological, it is simple and understandable even for people without medical education.
Based on x -rays, four degrees of arthrosis in the knee joint are distinguished:
- reduction of the joint gap is small, and there are no osteophytes;
- The interspoint gap is not tedled up, but there are signs of small calcinates or osteophytes;
- The interspoint gap has a narrowing expression, there is osteophytes, the joint deformation begins;
- Lack of joint gap, bone deformation, ankylose and dystrophy.
Regarding the clinical picture, the following stages are distinguished:
- Mild degree-symptoms are insignificant, occur in the morning and pass 30-60 minutes after waking up;
- The average degree is a pronounced symptoms, the feeling of discomfort passes before lunch, the swelling is insignificant, it progresses quickly without treatment;
- A severe degree - characterized by constant aching pain, discomfort at rest, morning stiffness does not pass until dinner, ankylose, burgis and sinusitis of the knee joint develop.
Laboratory tests are taken into account, the indicators of soy and leukocytes are evaluated.It is also necessary to check the presence of a rheumatoid factor.
Diagnostic methods
The diagnosis of arthrosis of the knee joint is not complicated, but requires certain skills from the doctor.
Two types of diagnostic measures are distinguished:
- laboratory diagnostics;
- Instrumental diagnostics.
For the correct diagnosis, each of the methods should be taken into account and analyze the picture as a whole.
Laboratory
If arthrosis is suspected, the attending doctor prescribes the following tests:
- general blood and urine test;
- biochemical blood test;
- determination of antibodies to the rheumatoid factor;
- Determination of antibodies to their own cells.
Laboratory data does not carry out information about the stage of development of the disease.
Instrumental
The instrumental diagnosis of arthrosis includes the following methods:
- radiography in two standard projections;
- minimally invasive arthroscopy;
- UZD examination;
- CT;
- MRI;
- Scintigraphy (according to indications).
Radiation diagnostics is aimed at determining changes in the joint and for assessing the condition of cartilage.
Treatment
Treatment of arthrosis of the knee joint is a long process.The duration of treatment is due to the fact that the reparation of cartilage tissue occurs very slowly, and in some cases it is completely impossible to restore the joint.
Modern methods of treating arthrosis in the knee joint include comprehensive measures that are aimed at removing inflammation, normalizing the lifestyle, and improving the metabolism of cartilage tissue.
There are such methods of therapy:
- drug therapy;
- Exercise therapy and massage;
- folk medicine;
- surgical interventions.
The doctor prescribes treatment based on the duration of the disease, the stage of its development and clinical manifestations.
Medicines
Drug therapy is aimed at relieving pain and inflammatory reaction.For this purpose, the following drugs are prescribed:
- non -steroidal anti -inflammatory;
- chondroprotectors;
- glucocorticoid;
- cytostatic.
Tablets from arthrosis of the knee joint have many side effects, in the treatment it is necessary to monitor the state of the gastrointestinal tract and kidneys.
Often, medicines for arthrosis are prescribed for a long period, so the least toxic drugs should be selected.
Exercises
Treatment of arthrosis using exercise therapy is aimed at strengthening the muscles and ligaments of the knee.With dosed loads in the cartilage of the diseased joint, metabolism improves, and regenerative processes are accelerated.
Exercises should be selected individually taking into account the stage of the patient's disease and physical capabilities.
Massage
Massage of the knee joint allows you to improve blood flow and relieve discomfort.Proper massage can prevent the appearance of ankyloses and false joints.
Folk
Treatment of arthrosis of the knee joint at home should not be the main method of combating pathology, or can only act as an addition to the drug.
House treatment includes:
- decrease in body weight;
- normalization of labor hygiene and compliance with the regime of the day;
- The fight against inflammation.
The anti -inflammatory effect is possessed by such herbs:
- Tincture from thyme and St. John's wort;
- burdock leaves;
- white cabbage leaves;
- Infusions and decoctions from dandelion and chamomile.
Operation
The operation is prescribed with the ineffectiveness of conservative therapy or at the request of the patient.One of the main indications for surgical intervention is the 4th stage of the disease by radiological characteristics.
During the operation, surgeons can completely replace the joint with an endoprosthesis or change one of its parts.