Knee osteoarthritis: diagnosis and treatment

Osteoarthritis or osteoarthritis of the knee joint is a disease that occurs against the background of the spread of connective tissue after degenerative changes. There are many factors that affect the development of the disease, but all of them eventually lead to metabolic diseases in the cartilage tissue. In the medical literature, osteoarthritis of the knee joint is called gonarthrosis.

According to statistics, gonarthrosis is the leading cause of occurrence among other osteoarthritis. Illness is a serious concern that can turn into painful feelings during walking and rest.

Knowing the initial symptoms will help to suspect the development of pathology and treat it in the early stages.

Reasons

According to the medical classification, there are primary and secondary gonarthrosis or arthrosis of the knee joint.

Osteoarthritis of the knee joint can occur against the background of various diseases or act as a complication of them. When the exact cause cannot be determined due to an uncertain date or clinical picture, gonarthrosis is primary, and if the cause is known, such osteoarthritis is called secondary.

Osteoarthritis develops in almost all people with age, on average, this period begins after 45-50 years.

The course and pathogenesis of primary and secondary osteoarthritis are the same and do not depend on the cause.

The most common causes of osteoarthritis and osteoarthritis of the knee joint are:

  • traumatic knee injury;
  • internal and external deformation of the joint;
  • shortening of a lower limb;
  • abnormal joint hypermobility;
  • chondroblast dysplasia;
  • cartilage calcification;
  • osteomyelitis of the thigh and tibia;
  • rheumatoid arthritis or arthritis of other etiology;
  • impairment of glucose metabolism;
  • metabolic diseases and hormonal disorders.

Injuries. After a knee injury, inflammation can develop, which is the focus of a large change in the articular cavity. After the disappearance of pro-inflammatory substances, the processes of recovery or osteoarthritis are activated.

Often the disease occurs against the background of a fracture with rupture of ligaments and damage to the bursa and cartilage surface of the joint.

the main causes of knee osteoarthritis

Congenital deformities. Hallux valgus or varus deformity is very common and can be complicated by sclerotic changes in the knee without proper correction. This is because one of the knees is overloaded.

Shortening any of the lower extremities. As with deformities, improper weight distribution on the knees plays a role in the pathogenesis of the disease.

Knee hypermobility. In this case, degeneration and degeneration of the cartilage tissue of the knee joint, followed by arthrosis, can occur. Hypermobility often causes spontaneous dislocation and twisting of the joint capsule.

cartilage dysplasia. Due to the abnormal development of the motor surface in the knee joint, a pathological spread of connective tissue occurs.

Calcification of the joint. The pathogenesis is based on the formation of a specific precipitate that causes the deposition of salts in the joint cavity and calcification, followed by osteoarthritis.

Osteomyelitis. An inflammatory bacterial disease in which bones and joints are destroyed. Ankylosis first occurs, and only then sclerosis.

Arthritis of any etiology. The most dangerous is rheumatoid arthritis, which is accompanied by autoimmune damage to the heart and joints.

Diabetes mellitus, like metabolic diseases, disrupts the supply of nutrients to the growth zone of the joints and cartilage.

Obesity. With a large body weight, there are heavy loads when walking on the knees and standing. As a result of constant pressure, blood flow to the knee joints decreases and atrophy develops with dystrophy.

symptoms

Clinical manifestations of osteoarthritis of the knee joint

The symptoms of osteoarthritis of the knee joint depend on the stage of the pathological process. Based on this, it is possible to assess the degree of changes in cartilage tissue by analyzing the symptoms and their growth rate.

Symptoms of osteoarthritis of the knee:

  • presence of pathological sounds when moving;
  • pain after stress or at rest;
  • reduction of functions;
  • swelling and enlargement of the joint;
  • pathological dislocations, fractures and subluxations;
  • Temporary wedges that may occur during flexion and extension of the joint.

Clicking and clicking are not immediately noticeable, and if they do, they don't pay enough attention. Pathological sounds indicate a pathological process with the deposition of salts in the cartilage cavity or the formation of osteophytes.

Pain is caused by calcification or osteophytes. At first the pain syndrome is not expressed, then it appears only in the morning and passes in the afternoon, with the development of the disease, the pain may be at rest.

The decrease in joint function is manifested in a decrease in stiffness and amplitude of movements. Depending on the stage, the stiffness of the movements may last for some time and may pass at rest.

Edema occurs due to inflammation and hypersecretion of synovial fluid. There are also options when the skin on the joints is inflamed. Such symptoms may be red fever or rheumatism.

The process of dislocation and subluxation occurs because it extends to the bones and knee joints.

Congestion is a condition in which movement is completely restricted on any axis. This symptom speaks of the indifference of the process and the need for complex treatment.

Osteoarthritis rate

degree and stage of development of knee osteoarthritis

Osteoarthritis is classified according to the following characteristics:

  • radiological symptoms;
  • clinical manifestations;
  • laboratory data.

The most common and convenient classification is simple and understandable even for people without radiological or medical education.

X-ray images show four degrees of osteoarthritis in the knee joint:

  • there is little reduction in the joint space and no osteophytes;
  • The intervertebral space is not very narrow, but there are signs of minor calcification or osteophyte;
  • there is an expression of narrowing of the intervertebral space, there are osteophytes, the joint begins to deform;
  • Absence of joint space, bone deformity, ankylosis and dystrophy.

The following stages differ depending on the clinical picture:

  • Mild - minor symptoms, occur in the morning and disappear within 30-60 minutes after waking up;
  • moderate - severe symptoms, anxiety disappears before dinner, swelling is insignificant, progresses rapidly without treatment;
  • severe - persistent aching pain, restlessness, morning stiffness does not last until lunch time, ankylosis, bursitis and sinusitis develop in the knee joint.

Takes into account laboratory test data, evaluates SOE and leukocyte counts. It is also necessary to check for rheumatoid factor.

Diagnostic methods

Diagnosis of osteoarthritis of the knee joint is not difficult, but requires certain skills from the doctor.

There are two types of diagnostic measures:

  • laboratory diagnostics;
  • instrumental diagnostics.

For a correct diagnosis, each method must be considered and the whole picture must be analyzed.

Laboratory

If you suspect osteoarthritis, the attending physician will prescribe the following tests:

  • general analysis of blood and urine;
  • biochemical blood test;
  • determination of antibodies against rheumatoid factor;
  • Assignment of antibodies to their own cells.

Laboratory data do not provide information on the stage of development of the disease.

Instrumental

instrumental diagnosis of osteoarthritis of the knee joint

Instrumental diagnosis of osteoarthritis includes the following methods:

  • radiography in two standard projections;
  • minimally invasive arthroscopy;
  • ultrasound examination;
  • CT;
  • MRI;
  • scintigraphy (according to indicators).

Radiation diagnostics aims to identify changes in the joint and assess the condition of the cartilage tissue.

Treatment

Treatment of osteoarthritis of the knee is long. The duration of treatment is due to the fact that the recovery of cartilage tissue is very slow and in some cases it is completely impossible to restore the joint.

Modern treatment of osteoarthritis of the knee joint includes a set of measures aimed at eliminating inflammation, normalizing lifestyle and improving the metabolism of cartilage tissue.

The following therapies are available:

  • drug treatment;
  • Sports therapy and massage;
  • traditional medicine;
  • surgical interventions.

The doctor prescribes treatment based on the duration, stage of development and clinical manifestations of the disease.

Medications

The drug aims to relieve pain and inflammation. The following drugs are prescribed for this purpose:

  • non-steroidal anti-inflammatory drugs;
  • chondroprotectors;
  • glucocorticoid;
  • cytostatic.

Pills for osteoarthritis of the knee have many side effects, it is necessary to monitor the condition of the gastrointestinal tract and kidneys during treatment.

Medications for osteoarthritis are often prescribed for a long time, so the least toxic medications should be chosen.

Exercises

Treatment of osteoarthritis with exercise therapy is aimed at strengthening the muscles and ligaments of the knee. Dosed loads on the cartilage tissue of the diseased joint improve metabolism and accelerate regenerative processes.

Exercises should be chosen individually, taking into account the stage of the disease and the physical capabilities of the patient.

Massage

Massage the knee joint improves blood flow and relieves discomfort. Proper massage can prevent the formation of ankylosis and false joints.

popular

Home treatment of osteoarthritis of the knee joint should not be the main method of combating the pathology, it can only act in addition to medication.

folk remedies for the treatment of osteoarthritis of the knee

Home treatment includes:

  • weight loss;
  • normalization of occupational health and adherence to daily routine;
  • Fight inflammation.

The following herbs have anti-inflammatory effects:

  • thyme and St. John's wort tincture;
  • burdock leaves;
  • white cabbage leaves;
  • infusions and decoctions of dandelion and chamomile.

Operation

Surgery is prescribed when conservative therapy is ineffective or at the patient's request. One of the main indications for surgery is the 4th stage of the disease according to radiological signs.

During the operation, surgeons can completely replace the joint with an endoprosthesis or replace one of its parts.