Arthrosis of the knee joint, also known as osteoarthritis of the knee, can significantly impair a person's quality of life. As the disease develops, there is a gradual loss of hyaline cartilage in the joint. Gradually the cartilage loses its density and height. Its razvlecheniya and thinning is noticed, and over time it completely disappears. Accordingly, there is no soft protective cushion in the bone, and this leads to increased stress on the end plate of the innervated articular surface of the bone. As a result of this stress, pain occurs. The ICD-10 code for osteoarthritis of the knee joint is M17.
The knee joint is often affected because the knee is subject to considerable stress when walking, exercising and running. In this case, uncomfortable movements can lead to injury to the soft tissues of the knee and cause osteoarthritis. This is why osteoarthritis of the knee is one of the main causes of disability. According to statistics, this disease affects about 20% of people on the planet to varying degrees.
This article explains why osteoarthritis develops, how the development of this disease can be prevented, which doctor treats osteoarthritis of the knee, and what treatment methods the doctor can recommend after the diagnosis.
Pathogenesis
The disease develops against the background of a mismatch between the load on the joint and its resistance. In this case, the properties of cartilage can be determined by genetics or change due to the influence of acquired exogenous and endogenous factors. The development and progression of osteoarthritis of the knee can occur with age against the background of obesity due to dysplasia of the femoral-patellar joint or changes in the axis of the lower extremity, disorders of the biomechanics of the joint, damage to the menisci and ligaments.
The basis of the pathogenesis is the predominance of catabolic over anabolic processes, which is found in the cartilaginous and subchondral bones, menisci and synovia. As a result, structural changes occur and the biological properties of the cartilage are lost. Furthermore, the pathological process spreads to muscles and ligaments.
The basis of the articular cartilage is the connective tissue matrix and the chondrocytes. The connective tissue matrix contains collagen and aggrecan molecules of type II. The damping properties of the cartilage are precisely provided by the connective tissue matrix.
The inflammatory process in osteoarthritis is not as intense as in arthritis. However, inflammation-promoting mediators are also present in osteoarthritis.
Classification
Depending on the origin of the osteoarthritis of the knee, a distinction is made between the following types:
- Primary (idiopathic)- develops without the influence of external causes.
- Secondary- certain factors lead to the development of the disease. Most often they are associated with injuries, fractures, surgical interventions on the joint, as well as inflammatory factors - acute and chronic arthritis.
The following degrees of knee osteoarthritis are also determined:
- 1st degree osteoarthritis- is determined in the period from the appearance of the first signs of the disease to the development of bone deformities that are visible on X-rays or during the examination. During this period, pain of varying intensity occurs during movement.
- In grade 2, unpleasant sensations are observed even with the slightest stress. When walking and squatting, the knee crunches, the mobility of the joint decreases. The picture shows the growth of bone tissue along the edges of the joint, as well as the narrowing of the joint space. An external examination can reveal that the knee is enlarged.
- At grade 3there is practically no cartilage tissue in the joint. As the disease progresses, the bones can grow together, resulting in complete immobility of the leg. Sleep is disturbed, it becomes impossible to move without a cane or crutch.
The following types of this disease are also distinguished:
- Patellofemoral osteoarthritis of the knee- a condition in which degenerative changes are detected in the back of the patella, that is, the patella. With this form of the disease, the pain is particularly disturbed when descending a flight of stairs or a mountain. Patellofemoral osteoarthritis can develop in runners. The disease is often diagnosed in young people.
- Post-traumatic arthrosis of the knee joint- a consequence of the injury. The post-traumatic type of illness may not initially appear. But later, a person loses full motor activity of the joint.
Causes of osteoarthritis of the knee joint
Today work is still being done to investigate the reasons for the development of such a pathology.
Currently, the causes of osteoarthritis of the knee are linked to the influence of the following factors:
- Age - From a certain age, degenerative changes in the tissues of a person begin and the ability of the cartilage tissue to regenerate decreases.
- Arthritis - Over time, arthritis can lead to the development of osteoarthritis.
- Postponed injuries and overloads - in addition to injuries, the development of the disease may create the need to frequently kneel, squat, and lift weights.
- Obesity and overweight - Due to the excessive body weight, the joints of the legs are more stressed. In addition, substances that cause their damage get from the pathological fat tissue into the blood and later into the joint.
- Heredity - In some cases, the development of the disease is determined by a defective gene that is responsible for the growth of cartilage tissue. As a result, this fabric can have poor resistance to damage. If close relatives had osteoarthritis, this increases the likelihood.
- Diseases that lead to metabolic disorders - the risk of this pathology increases with atherosclerosis, diabetes mellitus.
- Hormonal disorders - women get sick more often after 55 years.
- Sports - People who practice certain sports are more likely to develop this disease. This is typical for runners as well as soccer, tennis and basketball players.
Symptoms of knee osteoarthritis
As a rule, the symptoms of osteoarthritis of the knee joint slowly increase as the development process takes years. When multiple joints are affected, symptoms of polyarthrosis develop.
The manifestations of the disease depend on its severity, age and a number of other factors.
However, the main symptoms of osteoarthritis of the knee are as follows:
- Pain in the knee joint, aggravated by activity. The knee hurts less at rest.
- Swelling in the knee area.
- A feeling of warmth in the joint.
- Uncomfortable feelings of stiffness in the joint that occur after a person has been in a static position for a long time.
- Decreased range of motion in the knee joint, making it difficult for a person to get up from a chair, walk down stairs, or get out of a car.
- Crunching and crackling in the knee, most often with sudden joint movements.
- It is believed that changes in weather affect the degree of pain and discomfort.
Analyzes and diagnoses
In order to determine whether such a disease can be cured, the diagnosis must first be confirmed. During the diagnosis, the doctor examines and interviews the patient. However, the most informative study in this case is an x-ray of the knee.
To clarify the diagnosis, it is also advisable to undergo an ultrasound scan, which can rule out arthritis and measure the height of the articular cartilage.
If necessary, appoint additional examinations.
Treatment of knee osteoarthritis
In order for the treatment of this disease to be as effective as possible, it is first necessary to confirm the diagnosis and select the correct scheme for complex therapy. Treatment of osteoarthritis of the knee joint at home is possible if the patient carefully follows all the recommendations of a specialist and practices both drugs and additional methods of treatment. Only in this case can home therapy be effective.
Drug treatment and other therapeutic methods for this disease are applied depending on the degree of damage. The easiest treatment is for osteoarthritis of the 1st degree knee joint. In the case of a first-degree disease, a complex therapeutic regimen is used, with which you can achieve an effect in the shortest possible time. Therefore, if a person is diagnosed with Grade 1 osteoarthritis, the disease should be treated immediately.
Regarding the treatment of osteoarthritis of the 2nd degree knee joint, the doctor makes a decision based on the patient's condition. Since changes in the cartilage tissue begin at this point, treatment must be carried out immediately.
Whether it is possible to cure 3rd degree osteoarthritis of the knee depends on many factors. At Grade 3, the cartilage becomes thinner, so treatment at this stage is lengthy and the least effective.
Medicines
The medical treatment of knee osteoarthritis aims at an analgesic and anti-inflammatory effect. It is also important to reduce the severity of cartilage destruction.
The following drugs are used for this purpose:
- Nonsteroidal anti-inflammatory drugs - both tablets and local remedies are used - ointments, gels. The most effective local and systemic use of such funds.
- Chondroprotectors for osteoarthritis of the knee joint - chondroprotectors from the group of glucosaminoglycans (hyaluronic acid), chondroitin sulfates and others are used. Such drugs for osteoarthritis of the knee joint are prescribed as part of a comprehensive treatment. The price of chondroprotectors depends on the drug and varies significantly.
- For serious illnesses, drugs include steroids. Both injections for osteoarthritis of the knee joint can be given intramuscularly, and external agents with steroids can be used.
- External agents with skin irritation. In the description of folk remedies, you can also find annoying compresses.
- During treatment, the doctor may prescribe injections into the knee. Various drugs can be used for injections into the knee joint for osteoarthritis. In particular, corticosteroids are injected to relieve severe inflammation. Reviews of injections show that steroids are the fastest and most effective in this form. Knee blocks can be performed not only with glucocorticosteroids, but also with anesthetics. Blockage reviews show this method is effective in relieving even severe pain. An injection into the knee can also be performed during treatment with chondroprotectors. It improves metabolic processes, activates collagen production. However, at least five injections must be given to achieve the effect. In addition, hyaluronic acid is injected intra-articularly, which improves the quality of the intra-articular fluid and provides effective protection of the cartilage tissue. Vitamins can also be administered intra-articularly.
- Plasmolifting method - its essence is the introduction of platelet-rich blood plasma into the affected knee.
- Medical bile against osteoarthritis of the knee joint - is used for compresses. It should be noted that medicinal bile can be an effective remedy only if its use is prescribed by a doctor according to a certain scheme. Therefore, the "We treat at home" option is not acceptable in this case without consulting a doctor.
Procedures and Operations
With osteoarthritis and polyarthrosis, non-drug treatment methods are also used, the application of which is no less effective.
Physiotherapy. Various techniques are used including the method of shock wave therapy, myostimulation, phonophoresis, ozone therapy, kinesitherapy, and others. Physiotherapy can relieve pain, reduce inflammation. Any physical therapy prescribed by a doctor should be carried out exactly in the complex recommended by the doctor.
Laser therapy- produces decongestant, analgesic and anti-inflammatory effects.
Ozone therapy- relieves pain, has anti-inflammatory effects and makes it possible to reduce the amount of hormones used.
Knee pads for osteoarthritis of the knee joint- wearing such devices reduces the severity of the pain. In addition, the knee brace protects you from instability. However, in order to achieve the desired effect, it is necessary to choose the right knee pads or a knee brace. There are many general tips for choosing knee pads for knee osteoarthritis. In addition, many different models of such knee protectors are offered - with movement restrictions, amplifiers and the like. Still, for those looking to buy knee pads for osteoarthritis, it is advisable not to rely on user reviews, but rather on the doctor's recommendations. The price of an orthopedic knee pad depends on various properties - material, quality. Knee pads are particularly relevant if the patient develops post-traumatic osteoarthritis. But patellofemoral osteoarthritis, as well as other types of the disease, can be treated with this method.
Therapeutic gymnastics for knee osteoarthritisis an effective method that can improve the condition and prevent surgery, provided that the person regularly and persistently performs exercise therapy for knee osteoarthritis. Physical therapy exercises will help strengthen the muscles of the legs and stop the development of the pathological process. However, a number of exercises for osteoarthritis of the knee joint must be performed in a certain order, and this gymnastics is selected individually. Therefore, it is best if the basis for the lesson is not a gymnastics video, but a series of exercises developed by a doctor. In this case, not only charging is important, but full-fledged exercise therapy.
With a similar pathology, different types of exercise therapy can be practiced.
Special gymnastics.Such exercises are recommended both during treatment and for people over 40 for prevention. Knee exercises should be done every day. These exercises are also suitable for older adults as they can be done at a calm pace.
Massage and manual therapy- suitable for patients with limited mobility, can be combined with exercise therapy. If there is no opportunity to visit a massage therapist, self-massage can be carried out according to the scheme demonstrated by the specialist.
As additional methods of improving the patient's condition and active rehabilitation, yoga, acupuncture, stretching the joints and special exercises on simulators (exercise bikes and others) can be practiced.
If conservative methods prove ineffective, surgical treatment is carried out.
The following techniques can be used:
- Puncture- Removing excess fluid in the joint can reduce the symptoms of inflammation and restore mobility.
- Arthroscopy- can be performed with endoscopy. With this technique, the joint surfaces are cleaned of fragments of damaged cartilage tissue.
- Periarticular osteotomy- During such an operation, one of the bones that make up the knee joint is sawed and fixed again at a different angle. As a result, the severity of the pain decreases and the mobility of the knee increases. The intervention is effective in the first and second degrees of the disease.
- Endoprosthetics- replacement of the knee joint with a special biocompatible construction. This is a very complex intervention that is done with the third degree of the disease.
Treatment of osteoarthritis of the knee joint with folk remedies
Numerous reviews of the treatment of folk remedies for this disease confirm that such methods can be used as an aid, which will facilitate the patient's condition. However, such methods should not replace the main treatment. Folk remedies are used for rubbing, compresses, bathing, swallowing. Each thematic forum contains a lot of advice on the subject.
- Rub with garlic. Several cloves of garlic should be peeled and chopped. Mix the resulting gruel with 200 ml of vegetable oil and insist in a dark place for a week. Apply to the knee overnight with a film and a warm towel.
- Mustard grinding. To prepare the remedy, take 50 g of camphor and mustard powder, 500 ml of vodka, the protein of an egg. All are mixed and placed in a jar in a dark place for a week. Next, it is necessary to rub the product into the knee three times a day.
- Elecampane Grind. Pour 50 g of elecampane root with 125 ml of vodka and leave for two weeks. Rub in twice a day.
- Velcro compressions. Burdock is a popular folk remedy for treating osteoarthritis. Several leaves of burdock should be folded with the fluffy side down and greased with vegetable oil. Attach them to your knee and cover them with cellophane and a warm towel. Burdock leaves can also be greased with vodka. The compress is applied at night. A treatment with horseradish leaves is also carried out.
- Cabbage leaf. It is also applied to the sore area at night. It is pre-smeared with honey, cologne or vodka.
- Honey compress. It is necessary to mix equal parts of honey, ammonia (10%), glycerin and medicinal bile and add a few drops of iodine. Leave the premixed product in a dark place for 10 days. Warm up before applying the compress.
- Onion stock. It is taken internally. To prepare the broth, you need to take two large onions, cut them and pour 1 liter of water. Cook until the onions are tender. Take a brew of 100 ml three times a day.
- Celery juice. In a blender, grind the celery stalks and squeeze out the juice. Drink 100 ml of juice three times a day.
- Gelatine. In the case of osteoarthritis, it is recommended to eat foods containing gelatin. It is recommended to include jelly, jelly and other dishes with gelatin in the menu.
- Bath with pine needles. Pour boiling water over 1 kg of pine needles and leave to rest for several hours. Put in a warm bath, in which you can also dissolve 0. 5 kg of salt. Take a bath for 20-30 minutes.
Prevention
In order to prevent the development of osteoarthritis of the knee joint, the following preventive measures must be observed:
- Eat right and incorporate a variety of foods that contain vitamins and minerals into your diet.
- Avoid excessive strain on the knee joint and protect it from injury.
- End bad habits.
- monitor weight and prevent obesity.
- Treat all diseases in good time and get preventive checks.
- Go in for sports and prefer gentle physical activity.
- Wear quality shoes that are as comfortable as possible.
- Ensure correct posture.
Diet against osteoarthritis of the knee joints
- Effectiveness: healing effect
- Terms: permanent
Diet is very important during treatment and rehabilitation. First of all, food should be healthy and light - it is important to prevent excessive weight gain, which can aggravate the condition and provoke acute osteoarthritis. However, the acute course of the disease requires not only treatment, but also weight loss.
It is also important to include foods in your diet that contain important components for cartilage tissue:
- poultry, rabbits.
- sea fish.
- soy products.
- eggs.
- greens, zucchini, carrots, pumpkin.
- nuts.
- fruits, berries.
- vegetable oils.
- dishes with gelatine.
At the same time, you have to limit the consumption of such products:
- Beans, sorrel, spinach, tomatoes.
- Flour dishes.
- Animal fat.
- spices, vinegar.
- alcohol.
- Red meat
You often need to eat in small portions. You should also drink about 2 liters of fluids per day.
Consequences and complications
If treatment is not carried out immediately, osteoarthritis can lead to the following complications:
- Inflammatory process of the periarticular tissue.
- Restriction of the mobility of the joints.
- Change the shape of the joints.
- Degeneration of the hip joint.
Such complications can lead to the development of disabilities and irreversible changes.
Forecast
It is important to treat the disease in a timely manner. The most favorable prognosis is if you start treatment at one or two stages of the disease.