Osteoarthritis of the knee (in the medical literature, you can also come across the term "osteoarthritis") is called pathology, with dystrophic and degenerative in nature, resulting in deformation and destruction of cartilage of the knee joint. The disease is accompanied by intense pain and can lead to loss of functionality of joint immobilization. Osteoarthritis often develops in women, in addition, contributing factors to developing this disease are overweight and varicose veins. Depending on one or two joints affected, knee osteoarthritis can be single or double - sided.
During microscopic examination of the affected cartilage was revealed that the first pathological changes occur at the molecular level, which inevitably leads to all the big changes in the physico-chemical properties. The cartilage loses its natural elasticity and firmness, gradually becomes thinner, the surface of the cartilage appear pinholes. If untreated, over time the articular surface of the bone is fully exposed, leading to disruption of normal mobility in the joint.
The causes of osteoarthritis of the knee
The causes that trigger the occurrence of osteoarthritis may be different, often there is a combined effect of several negative factors causing the arthritis.
- Injury. Traumatic external influence on the joint — a common cause of osteoarthritis, especially in young people. The knee joint is one of the most difficult arranged in the human body, such a structure due to the high load on the joint, associated with bipedalism. In addition to the cartilage-covered articular surfaces of the femur, more and fibula bones forming the joint, there are ligaments holding the bones and the meniscus — semilunar cartilage that provides shock absorption for the joint. Front joint protected by the patella. Injury disrupted the integrity of the joint to its anatomical structures, deteriorating blood circulation in the tissues in the joint cavity may begin to build up in the fluid and on the surface of the joint capsule and cartilage — appearing calcification. Combined with pain at the movement, forcing the victim to protect the joint, it is dystrophic process, eventually leading to the destruction of cartilage. A greater role played by the menisci, which, when damaged have to be removed. In this case, the knee loses the natural shock absorber articular surfaces of the bones are experiencing excessive load and the overlying cartilage wears away quickly. Up to 9 out of every 10 cases, removal of the meniscus conclude with osteoarthritis of the knee.
- Excessive physical activity. Too intense sports (especially running, squats, especially with weights), or exhausting physical work, coupled with a high load on the knee (lifting, walking stairs) lead to injury and premature wear of the cartilage tissue.
- The excess body weight. By itself, a high percentage of fatty tissue in the body no effect on the composition of cartilage and the biochemical processes in the cells has not. However, a large body weight invariably becomes an extra load on the menisci.
- Inflammatory diseases of the joints. A frequent prerequisite to the arthritis becomes arthritis of the knee joint, regardless of its etiology (rheumatoid, reactive, juvenile, psoriatic). Chronic inflammatory process in the tissues of the joint leads to degeneration of cartilage and its destruction.
- The innate mobility of the joints, weakness of the ligaments. Some people have inborn excessive elasticity, softness ligaments. As a rule, it complements the high mobility of the joints. These people take advantage of the flexibility of the body, they are easily given exercises to stretch. However, the mobility of the joints has its drawback: the articular surface in "soft" joint, easily displaced relative to each other, which causes microdamages of the cartilage, which will eventually become the arthritis.
- Of metabolic disorders, including, minerals. Any metabolic disorders inevitably affect the structure and physiological properties of the tissues of the body, and cartilage is no exception. In particular, on its density affects the level of calcium in the body.
- Age-related changes. Over time in the body increase a natural physiological aging process. Microcirculation in the tissues worsens, their diet deteriorates, accordingly, increases the degenerative processes. Damage restoration while slowing down. Do not become exception and knee joints, in which age-related changes imposed on the gradual wear of the cartilage.
How does osteoarthritis of the knee?
The earliest symptom of osteoarthritis — the feeling of stiffness, tightness in the joint, especially in the morning, immediately after rising from bed or during the day, after prolonged sitting in one place. The patient needs to walk a bit to the discomfort disappeared.
One of the most characteristic symptoms in osteoarthritis of the knee pain. It gradually increases, accordingly the degree of involvement of cartilage in the pathological process. With arthrosis of first-degree soreness is minor, may disturb in the morning or after exercise on the affected joint. In case of arthrosis in the second degree, the pain is more intense, occurs not only after exertion but also at rest, for osteoarthritis of the third degree it becomes permanent. Often the pain is worse when the weather changes that is due to fluctuations in atmospheric pressure. A healthy hip joint responds to a change in intra-articular pressure, however, when the inflammation of the joint compensatory abilities of tissues decrease and the balance between the pressure outside and inside the joint, which causes pain.
Crunching in the knee when moving the knee — another characteristic symptom of osteoarthritis. It is connected with the violation of the density of forming the joint cartilage and the appearance on the articular surfaces, osteophytes — outgrowth of bony tissue.
With the progression of the disease develops deformity of the affected joint. At the first stage of gonarthrosis of the knee may have some swelling in connection with the development to joint tissue inflammation, synovitis and fluid accumulation in the articular gap. In the later stages of the disease, with progression of the inflammatory process, the joint is deformed.
Reduced mobility in the knee is a symptom characteristic of the advanced stage of gonarthrosis. Pronounced inflammatory changes in the tissues of the joint, osteophytes on the articular surfaces, the accumulation in the joint fluid, joint deformity, pain cause the patient loses the ability to freely bend and straighten the leg. With the progression of the pathological process in the joint may lose mobility.
The degree of arthrosis of the knee joint
The osteoarthritis of 1 degree is manifested by joint stiffness in the morning, minor tenderness in the morning or after a heavy load on the joint. Occasionally bother moderate pain associated with weather changes. Soreness usually resolves on its own without medication. Perhaps the accumulation in the joint cavity, a small amount of liquid and in this regard, a moderate swelling of the joint. When x-ray changes are not visible, in some cases, it may be noticeable thinning of the cartilage on the articular surfaces. 2 the extent of a knee manifested severe pain when moving the knee that pass alone. When bent in the knee you hear a crunch. Often in the joint cavity accumulates a significant amount of fluid which leads to severe deformation of the joint, visible to the naked eye. Over time, the joint mobility is considerably reduced.
On radiographs noticeable thinning of the cartilage covering the articular surfaces of the bones, increased bone growths, may be narrowing of the joint space or, on the contrary, its extension. The joint can deform the accumulated fluid inside. Osteoarthritis of the knee 3 degrees is manifested the intense constant pain in the knee that does not go without pain medicine. Deformed bones forming the joint due to severe pain, inflammation and deformities of movement in the joint is practically impossible. The x-rays it is possible to see a marked thinning of the cartilage until the exposure of the articular surfaces of bones, degenerative changes in cartilage adjacent to the bone tissue, the intensive formation of osteophytes and the deposition of salts in the joint cavity.
Osteoarthritis of the knee: treatment
The program of treatment of osteoarthritis of the knee, its volume depends on at what stage of the pathological process, the patient asked for help. Of course, the best solution is to visit a doctor at the first stages of arthrosis, when troubling exceptionally lightweight stiffness in the morning and slight pain in knee after exertion. At this stage you can do without painkillers, focusing on the reception of chondroprotectors. It is drugs that stimulate the recovery of metabolic processes in cartilage tissue, normal structure and functionality of cartilage. Well-proven glucosamine sulfate , the active ingredient of which is glucosamine sulfate, a natural component of balanced cartilage. Glucosamine sulfate inhibits the processes of destruction of cartilage and stimulates the production of structural components of proteoglycans. Complement chondroprotectors vitamin-mineral complexes, it's also possible the use of nonsteroidal anti-inflammatory drugs (NSAIDs) local action, in the form of ointments or gels applied to the skin over the affected joint. Early treatment not only guarantee the elimination of pain and discomfort, but also the best prevention of the progression of the disease.
Gonarthrosis on the second or third stage of full-scale treatment is enormous — it is only possible to remove an acute inflammation, eliminate pain and expressed to some extent to improve the structure of damaged cartilage. To relieve the acute inflammation and pain NSAIDs are applied total (in the form of tablets, injections) and local action (gels, ointments), they can be supplemented by reception of narcotic painkillers. In the third stage of the disease NSAIDs, as a rule, replace the glucocorticosteroid drugs. In the acute phase of arthrosis, it is important to minimize the load on the affected joint to avoid further destruction of cartilage in it.
After the transition of the pathological process in the stage of remission, treatment of the knee arthrosis is aware of chondroprotectors to restore cartilage tissue, improvement of metabolism in it. In addition, remission with the arthritis of any degree is recommended physiotherapy, as well as a modern method of treatment related physical therapy: physiotherapy, which will serve as an incentive for the restoration of the microcirculation in the tissues of the joint, and in the later stages of the disease to avoid immobilization of the patient's joint. Also recommended Hiking in sufficient volume to activate the patient but not cause the overload of the affected knee. Active movement not only helps to restore mobility but also stimulate the production of serotonin in the body and endorphins are biologically active substances that eliminate pain and enhance mood.
During a remission of gonarthrosis the patient shows physical therapy: mud therapy, electrophoresis, radiation, ozone therapy, impact of ultrasound and magnetic waves. In the absence of effect of conservative treatment of knee osteoarthritis, inability to perform the movements of the joint, a considerable deformation of the patient surgical treatment: knee replacement. After surgery and undergoing a period of rehabilitation joint mobility is restored, and the patient can return to active life and work.
Osteoarthritis of the knee — heavy, and if untreated, a crippling disease that significantly reduces quality of life. Timely treatment for medical help in the very beginning of the disease, the first discomfort has not yet fallen into the pain, proper treatment, including employment of chondroprotectors, will stop disease progression and restore structure of the cartilage.