Even in the initial phase, osteoarthritis of the knee joint begins to pose a threat to disability. Untimely detected signs, delayed treatment can lead to the fact that the joint loses mobility. This review of this disease describes the characteristic symptoms, discusses the causes of its occurrence, as well as effective methods of treating the disease of various degrees.
Facts and essence of knee osteoarthrosis
About a fifth of the total population sooner or later faces this ailment. In some countries, this figure is even higher. The disease has interesting trends – if women represent a large number of patients under the age of 55, then men suffer from the majority of patients with osteoarthritis after 55-60 years of age.
This pathology begins to manifest itself from the age of 40. However, under certain conditions and circumstances, it suffers and people are much younger.
Most often, the disease progresses in the knee joint, although its manifestation is not excluded in other joints.
The disease is manifested by dystrophic abnormalities – a decrease in the volume, mass, density of articular tissues. This is especially true for cartilage.
At the same time, other changes are occurring:
- Degeneration of the bones and cartilage of the joint;
- Joint shape deformation;
- Decreased synovial fluid volume;
- Change in the composition of the synovial fluid;
- The formation of osteophytes – growths on the bones.
Osteoarthrosis is a chronic disease accompanied by severe tissue destruction, impaired musculoskeletal function and significant pain. The danger of this ailment is manifested in the fact that it is difficult to detect in the first stage. And with further development, its signs are absolutely similar to the symptoms of such dangerous diseases as contracture, purulent arthritis, osteomyelitis, sepsis. At the same time, this disease, with low treatment efficiency or untimely seeking help, risks having secondary diseases, most often arthritis.
Another unpleasant fact regarding this disease is the impossibility of its complete cure. The disease is irreversible, and the only goal of treatment is to relieve pain, maintain knee mobility and stop the further development of the disease.
The consequence of the rapid development of the disease can be neoplasms, moreover, both benign and malignant in nature. In addition, this ailment can lead to a partial or complete loss of working capacity and mobility, which may be accompanied by disability.
It follows that even the smallest manifestations of the disease cannot be ignored. And for this you need to at least know them for sure. Similarly, treatment for osteoarthritis will be ineffective if you do not have an idea about the causes of its occurrence. This will be discussed further.
Where does the disease come from?
Over the years of life, any person has wear and tear on soft, bone and cartilage tissues. This trend does not bypass the musculoskeletal system. And one of the reasons for the manifestation of the disease is precisely the complex of age-related changes. This is especially true for people over 45 years old. The peak of the disease occurs in the age category of patients 55-65 years old.
Another urgent cause of the disease is injuries. And this is more true for people of a younger age. Extreme entertainment, sports and other circumstances characteristic of modern youth strongly contribute to the sudden onset of the disease. However, older people are not safe from injuries. In old age, it becomes more difficult to control your body, because more often falls, careless bruises, and so on.
At the same time, the causes of osteoarthritis in the knee joint are the following circumstances and factors:
- Reinforced physical stress during sports training, due to congestion in summer cottages;
- Increased load on the joint in representatives of certain specialties – metallurgists, movers, drivers, sellers;
- Extra kilograms in dead weight – overweight inevitably creates additional stress on the entire joint, and on the cartilage elastic tissue – in particular;
- Heredity – in some patients, a predisposition to abnormalities in the joint tissues is genetically embedded, including in the knees;
- Disorders in metabolic processes – a lack of certain mineral elements, vitamins, amino acids, collagen and other components depletes the composition of the articulation tissues;
- Dehydration – this fact applies to both individual tissues in the knee, and the entire body. If over the years organs and tissues do not receive the required amount of water, this leads to dryness, brittleness, fragility of the joint, which is one of the main signs of this disease.
Along with these reasons, knee osteoarthritis can provoke disorders in the endocrine system, a violation of the heart and anatomical abnormalities of blood vessels.
For example, any forms of arthrosis are actively developing against the background of an insufficient amount of oxygen supplied with blood to the articulation tissues. This happens due to the narrowing of the capillaries, against the background of varicose veins, with clogging of the lumen of blood vessels by blood clots and sclerotic plaques.
Signs of the disease
At different stages of the disease, the symptoms appear differently. The disease has four degrees. In the first two phases, the symptoms are less pronounced. Soreness with a disease of the first degree practically does not make itself felt – in extreme cases, there is some discomfort in the knee during movements and physical exertion. As you progress, soreness appears and intensifies. At the same time, a crunch sounds in the knee joint, characteristic clicks.
With frequent or heavy loads, the legs seem to buckle, weaken when walking – this is due to the onset of atrophy of the muscle tissue in the joint.
Almost always with a disease of the second degree, deformation of bone tissue and the onset of bone growths are noted. As a result of this, the knee also deforms and sometimes increases in volume.
Signs become much more noticeable in the third stage of the disease. Lameness becomes noticeable, the swelling of the knee is amplified by a crisp sound.
Soreness begins to manifest itself with stronger sensations and often it arises even at rest. The inactivity of the joint, the impossibility of its complete bending, is noted.
Pathology of the knee can occur in other parts of the musculoskeletal system discomfort, decreased mobility. Muscle spasms begin to occur more often in the area of the knee joint, and convulsions sometimes appear. By the end of the third degree of osteoarthrosis, redness of the skin on the knee is noted.
How to treat osteoarthritis
It is already impossible to completely get rid of this pathology – its process is irreversible, and cartilage cannot be restored. However, with timely access to medical care, the patient has every chance of preventing complications and further development of the disease.
Initially, the initial cause, as well as the provoking factors of the disease, should be eliminated. You should seriously take a daily diet to get rid of excess weight. Do not overly get involved in physical exercises and hard manual work.
At the same time, it is desirable to undergo a general course of treatment, including such methods:
- Drug therapy;
The effect will be more noticeable if all three treatment methods are applied in a complex. In addition, you need to try to avoid being in one position for a long time – this often happens with representatives of office professions, those who spend a lot of time in front of a TV or computer.
At the time of treatment, it is necessary to reduce physical activity, although this does not apply to exercise therapy exercises.
At the same time, it is recommended to use orthopedic drugs, designed to ensure the fixation of the affected joint in a normal position and limit its deformation.
Pharmacy drugs can quickly cope with the manifestations of the disease, its consequences, contribute to its suspension. In the period of progression of the second and third degree of the disease, the removal of pain is mandatory. To relieve joint pain, medications in the form of tablets or injections are recommended.
Anesthetics of the analgesic group are considered ideal in this regard:
In order to prevent the inflammatory process and the transition of the disease into one of the forms of arthritis, non-steroidal anti-inflammatory drugs are prescribed. They partially reduce pain in the joint.
This group includes:
With a disease of the third and fourth degree osteoarthrosis of the knee, there is already a need for relief of muscle colic, elimination of spasms and increasing soreness.
For this purpose, such drugs of antispasmodic spectrum of action are introduced into the complex of drug therapy.
The use of medicines that ensure the preservation of the structure of cartilage in the knee joint is important. They are called chondroprotectors and are designed to stop the destruction of cartilage, promote the production of chondrocytes, the building materials of tissue, and also increase the volume of synovial fluid production in a natural way.
In the treatment of osteoarthritis of the knee, such drugs of this group are prescribed:
To improve local metabolic processes in the knee, to normalize the functioning of the circulatory system in the affected area and to stabilize hormonal functions, the use of medications based on hyaluronic acid, complexes of mineral components with calcium, phosphorus, magnesium and potassium are shown. In addition, vitamins B, A, C, and D are prescribed to the patient.
Therapeutic gymnastics (LFK)
Exercises of the treatment-and-prophylactic complex are designed to ensure normal blood circulation, improve metabolic processes and restore, as far as possible, the mobility of the joint.
For this, gymnastic exercises are prescribed with rotation of the joint, its flexion and extension, and rotations.
It is important to control the intensity of the load, choose a gentle mode of conducting such training and not overload the knee. During classes, you need to do short-term exercises, alternating loads with a period of rest.
The purpose of physiotherapy is to relieve pain in the knee, swelling of the joint, normalize blood flow, prevent the risk of inflammation, and eliminate cramping. These treatments are a great addition to drug therapy.
Topical for knee damage to osteoarthritis are:
- Laser therapy;
- Thermal applications peat, ozokerite, paraffin;
- Shortwave diathermy;
- Balneotherapy with radon, hydrogen sulfide, turpentine, bromine iodide.
Ultrasound procedures, hirudotherapy, electrophoresis, exposure to electromagnetic fields are also effective.
All these methods in joint application are useful in the first stage, are absolutely indispensable for osteoarthritis of the second degree knee. And, of course, they should be a salvation for patients with a disease of 3-4 degrees. However, before that it would be better to prevent the disease. This will help knowledge of the described symptoms and timely access to medical care.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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