Knee osteoarthritis

The knee joint is often stressed. Running, walking, climbing stairs or just standing all affect the condition of the cartilage tissue in the knee. If the balance in the cartilage is disturbed, the development of arthritis of the knee joint - gonorrhea - begins.

Gonorrhea is an inflammatory arthritis that deforms the knee joint, accompanied by chronic damage to the surface of the hyaline cartilage, as well as bones - the femur and tibia. Symptoms of knee disease are pain that gradually increases when moving. Due to the accumulation of fluid in it, movement is limited. Subsequently, knee movements are limited due to the violation of support in the legs. Diagnosis of pathology is based on collecting the patient's history and complaints, the results of a visual examination, and examining the hardware of the knee joint. Age-related disorders of the musculoskeletal system appear in almost everyone in old age.

General information

Gonorrhea (from the Latin genus articulatio - knee joint) is the most common joint disease, a progressive degenerative-dystrophic lesion of the knee cartilage of a non-inflammatory nature. Women and the elderly often get gonorrhea. But after injuries during intense sports, gonorrhea occurs even in young people.

The cause of osteoarthritis lies in changes in the structure of the cartilage inside the joint, not in the deposition of salt there. With gonorrhea, salt deposits occur where the tendons attach to the ligamentous apparatus, but they cannot be the cause of painful symptoms. First, cracks appear in the cartilage, reducing its thickness in some areas. Gradually, the load is redistributed, the joint begins to come into contact with the bone, accelerating the painful process. As a result, the following changes occur in the knee joint:

• Knee cartilage thins until it disappears;
• synovial fluid changes in composition and quantity;
• bone damage in the knee due to friction;
• the appearance of osteoporosis;
• joint stiffness due to compression of the joint capsule;
• muscle spasms.

As a result, the knee joint is deformed and mobility is limited, which can lead to disability and loss of ability to work.

Knee osteoarthritis can be unilateral and affect only one knee of the right or left leg; in bilateral osteoarthritis, both knee joints are affected.

Symptoms of knee osteoarthritis

Symptoms of knee arthritis can vary widely:

• At first, a slight discomfort appears when climbing stairs, then the pain syndrome increases and torments even at rest;
• Joint stiffness occurs in the morning, at first lasts a few minutes, then can last up to half an hour;
• a strong crunching sound appears, accompanied by pain at the second level of damage;
• limited mobility, difficulty in bending and extending the knee due to pain, bone friction and the development of bone spurs, the joint may become blocked in the final stage (ankylosis);
• Unsteady gait due to muscle atrophy (reduction in muscle mass);
• knee joint deformity due to the growth of bones and changes in their shape, the appearance of inflammatory processes in muscles and ligaments that increase swelling around the tissues of the joint;
• Lameness due to progressive knee disease, in later stages the patient is forced to walk even using a walker.

Arthritis begins gradually. In the early stages of gonorrhea, patients feel a bit stiff and painful when going up or down stairs. The area below the knee can be tightened. The characteristic is that the pain begins to arise from the sitting position during the beginning of the ascent. As the patient moves away, the pain gradually decreases, but when exerted, the pain reappears.

There were no external changes in the knee. Sometimes there may be swelling and the development of synovitis - a buildup of fluid with swelling, joint swelling, and a feeling of heaviness and restricted movement.

In stage 2, severe pain occurs with prolonged exercise and intensifies with walking. Pain is often localized along the anterior surface inside the joint. After resting, the pain disappears but when moving, it reappears.

As arthritis progresses, the number of movements in the knee joint decreases. When you try to bend the leg as much as possible, pain and a rough crunch appear. Configuration changes, expansion joints. Synovitis appears with an even greater accumulation of fluid in it.

In stage 3, the pain becomes constant and makes you uncomfortable not only when walking but also when resting. The pain appears even at night. In order to fall asleep, the patient must take a lot of time to find a position for their legs. Flexion and extension of the joint is limited. Sometimes patients cannot straighten their legs completely. Joints are enlarged and deformed. Sometimes varus deformity of the legs occurs in patients, they become X-shaped or O-shaped. Due to deformity of the legs and limited movement, the patient's gait becomes unstable and waddles. . In severe cases of gonorrhea, the patient moves with the support of crutches.

Causes of knee osteoarthritis

Most cases of arthritis occur due to a number of reasons. These factors include:

• Injury.25% of gonorrhea occurs due to trauma: damage to the meniscus, torn ligaments. Gonorrhea usually occurs three to five years after the injury, sometimes the disease can develop earlier - after two to three months.
• Do exercise.Most often, gonorrhea occurs after forty years of age due to professional sports and excessive physical stress on the knee joints, which leads to the development of degenerative-dystrophic changes. Fast running and high-intensity squats are especially dangerous for the joints.
• Excessive weight.Excess weight significantly increases the load on the knee joint, causing injury. Gonorrhea is especially difficult if there are metabolic disorders and varicose veins.
• Sedentary lifestyle.

The development of gonorrhea increases with arthritis, due to gout or ankylosing spondylitis. The risk of gonorrhea is due to genetic weakness in ligaments and impaired nerve distribution in neurological diseases.

Pathogenesis

The knee joint is formed by the surfaces of the femur and tibia. In front of the knee joint surface is the patella. It slides as it moves between the grooves of the femur. The articular surfaces of the tibia and femur are covered with very strong, smooth and elastic hyaline cartilage up to 6 mm thick. When moving, cartilage reduces friction and acts as a shock absorber.

There are 4 stages of joint disease:

• State 1.There is a disturbance in blood circulation in the vessels that feed hyaline cartilage. Its surface becomes dry and small cracks appear, the cartilage gradually loses its smoothness, the cartilage tissue becomes thinner and instead of sliding softly, it clings, losing its ability to absorb shock. There are no visual symptoms of arthritis, X-rays show little misalignment.
• Phase 2.Changes occur in the structure of the bones and the joint area is flattened to withstand greater loads. The bone under the cartilage becomes denser. Along the edges of the joints, initial manifestations of calcification of the ligaments appear - bone spurs that look like spurs on X-rays; A narrowing of the space within the joint may also be seen. The synovium of the joint degenerates and becomes wrinkled. The fluid in the joint thickens, its viscosity increases, and its lubricating properties deteriorate. The degenerative process in cartilage accelerates, it becomes thinner, and in some places it disappears completely. After it disappears, friction in the joint increases and the degenerative process proceeds vigorously. Patients experience pain when exercising, climbing stairs, squatting, and standing for long periods of time.
• 3rd stage.X-rays show notable joint space narrowing, sometimes asymmetrically. Because the meniscus is deformed, the bones are deformed and pressed against each other. Movement in the joint is limited due to the large number of large bone spurs. There is no cartilage tissue. The pain constantly haunts the patient when resting, making it impossible to walk without support.
• 4th stage.The knee joint cannot move; X-rays showed complete deformity of cartilage and destruction of bones and joints, multiple bone spurs and bones that could fuse together.

Classify

Based on the pathogenesis of the disease, two types are distinguished: primary gonorrhea - idiopathic and secondary gonorrhea. Primary occurs without lesions, usually in older patients and on both sides. Secondary develops due to diseases and developmental disorders or due to trauma to the knee joint. It can occur at any age and is usually unilateral.

Diagnose

Diagnosis of arthropathy is made by an orthopedist or traumatologist in a medical clinic.

• The appointment begins with taking a medical history - the main complaints and symptoms that concern the patient. The doctor discovers complaints, the presence of chronic diseases, past injuries, fractures and injuries, and asks additional questions.
• On examination, the mobility, deformation and pain characteristics of the joint are revealed. In stage 1 of gonorrhea, the patient has no external changes. In the 2nd and 3rd stages, deformation and roughness of the joint contours, restriction of movement and curvature of the legs are detected. When the kneecap moves, a sharp crunching sound is heard. On palpation, the doctor detected pain in the inner part of the joint. Joints may increase in size. Joint swelling is detected. When touching the joint, you will feel the vibration.
• The patient is referred for laboratory tests. When doing a general blood test, inflammation is detected, while biochemical testing shows what may be causing the problem.
• Next, it is necessary to make an instrumental diagnosis of the patient. X-rays are used for this. X-rays are a diagnostic method that allows you to detect signs of knee osteoarthritis: narrowing of the space between joints, bone spurs and bone deformation. Arthrography is a technique that clarifies the diagnosis of pathological changes and dynamics of joint disease. At the beginning of gonorrhea, changes cannot be seen on X-rays. Then, narrowing of the joint space and compaction of the subchondral area are determined. Gonorrhea can only be diagnosed with X-rays and clinical tests.
• Nowadays, in addition to X-rays, to diagnose joint diseases, computed tomography (CT) is used, which helps to study bone changes in detail, as well as magnetic resonance imaging (MRI), which helps to evaluateVisualize the condition of the joint. joints and is used to identify changes in muscle and ligament tissue.
• When performing an ultrasound examination (ultrasound), the condition of the tendons, muscles and joint capsules is evaluated.
• Fluid is drained from the affected joint to allow a camera to be inserted to view inside the joint (arthroscopy).

If necessary, the doctor prescribes additional studies and consultations with more specialized specialists.

Treatment of knee osteoarthritis

Treatment methods for joint diseases can be divided into three groups:

• medicine;
• physical therapy;
• surgery.

Joint disease is treated by traumatologists, rheumatologists, and orthopedists. Conservative treatment begins in the early stages. When arthritis becomes more severe, doctors recommend maximum joint rest. Patients are prescribed the necessary procedures: therapeutic exercise, massage, mud therapy.

When a patient is diagnosed with stage 1 and 2 disease, he or she will use medication and physical therapy. If the damage spreads, surgery and surgical intervention will be used.

Treatment medicine

Using medication properly can stop pain and inflammation, as well as slow the destruction of cartilage tissue. Therefore, it is important to consult a doctor promptly.

Important - do not self-medicate. Choosing the wrong medication independently and without consulting a doctor can only aggravate the situation and lead to serious complications.

Medical treatment for rheumatoid arthritis includes taking the following medications:

• Anti-inflammatory:reduces inflammation and joint pain;
• Hormonal:prescribed when anti-inflammatory drugs are ineffective;
• Antispasmodics:helps eliminate muscle spasms and alleviate the patient's condition;
• Chondroprotectors:improves joint metabolism and helps restore joint function, as do synovial fluid replacement drugs;
• Medicines to improve microcirculation:Improve nutrition and oxygen supply.

Depending on each specific condition, tablets, steroid hormone injections into the joints and topical forms of medication are used. The choice of medication is made by the attending physician. Sometimes a patient with arthritis is sent for treatment to a sanatorium and is advised to walk with crutches or a cane. To reduce the load on the knee joint, individual orthotics or special insoles are used.

In addition, complex non-drug methods for treating joint diseases are used:

• physical therapy (physical therapy)performed under the supervision of a specialist;
• massage coursein the absence of an inflammatory process;
• bone-strengthening effectin the treatment of joint diseases, it is aimed not only at the affected area, but also at restoring the resources of the entire body, since the pathological process occurring locally in the joint area is the result of many processes occurring throughout the body. body set. During osteopathy, work is carried out with the entire musculoskeletal system to achieve maximum restoration of distribution and mobility in the spine, pelvis, sacrum and eliminate compressionof nerves and blood vessels throughout the body!

Physical therapy

Physiotherapeutic methods are used to improve blood circulation in the joints, increase mobility and enhance the healing effect of drugs. Your doctor may prescribe the following procedures:

• Shock wave therapy:Ultrasound eliminates osteoporosis;
• Magnetic field therapy:Magnetic fields affect metabolism and stimulate regeneration;
• Laser therapy:laser heating of deep tissues;
• Electrotherapy (myostimulation):electric shock;
• electrophoresis or phonology:Use of chondroprotective and analgesic drugs using ultrasound and electric current;
• Ozone therapy:inject air into the joint cavity.

Surgery

Even when choosing the right treatment, in some cases the treatment is still ineffective. At that time, patients with severe pain syndrome are prescribed surgical treatment and surgical treatment of knee joint disease:

• Endoscopic:total joint replacement with a prosthesis;
• arthritis:fastened between bones to help immobilize them, relieve pain, and give a person the opportunity to lean on their legs;
• bone cutting:cut a bone to place it at an angle in the joint to reduce stress.

If endoscopic replacement is not possible, arthroplasty and osteotomy are used.

Prevent

Preventive measures and compliance with doctor's recommendations play an important role in the occurrence of gonorrhea. To slow down the process of osteoarthritis, it is important to follow the rules:

• engage in special physical activities: physiotherapy and gymnastics without unnecessary joint loading;
• Avoid strenuous physical activity;
• choose comfortable orthopedic shoes;
• Monitor your weight and daily routine - alternate special exercises and rest periods.

Diet

The condition of the affected cartilage depends largely on nutrition. In case of arthritis, it is necessary to exclude:

• soft drink;
• acoholic drink;
• fatty and overly spicy food;
• canned and semi-finished foods;
• Products contain dyes, preservatives, and artificial flavors.

The diet should contain: proteins, fatty acids, for example omega-3, collagen contained in gelatin. It is necessary to eat without increasing body weight.

Consequences and complications

Knee osteoarthritis develops slowly but if left untreated, serious complications can arise:

• joint deformities and changes in the overall shape of the knee due to muscle restructuring and curvature of the skeleton;
• shortening of the lower limbs;
• ankylosis – complete immobility of the joint in the knee;
• damage to the musculoskeletal system.