How is knee arthrosis diagnosed and treated?

Knee arthrosis is also called gonarthrosis or deforming osteoarthritis. The disease can have serious consequences, including disability. At the first signs of gonarthrosis, a doctor should be consulted for diagnosis and treatment. Therapy should be completed under strict adherence to conditions and other regulations.

General characteristics of the disease

Gonarthrosis is a progressive change in cartilage that involves the surface of the joint. As a result of such changes, joint function deteriorates and pain occurs.

Deforming osteoarthritis is chronic. In most cases, the disease progresses slowly, but certain factors can accelerate progression. This mainly affects the individual characteristics of the body, the patient's activity and physical activity, and the concomitant pathologies.

Two terms are often confused - arthritis and arthrosis. These pathologies are similar in some respects but different from the nature of the course. Only a specialist can make an accurate diagnosis and prescribe appropriate treatment.

In gonarthrosis, the mechanisms of cartilage feeding are disrupted, so its function is gradually disrupted. Of the various localized arthroses, knee pathology occurs in one in three patients.

Causes of primary osteoarthritis of the knee joint

This is the most common form of the disease. Elderly women are at risk of developing primary pathology, especially in overweight - 2 or 3 degrees of obesity.

Primary gonarthrosis is thought to have an average life expectancy. It has grown significantly over the past centuries and the joints simply wear out over time.

Gonarthrosis with natural aging is considered normal. If the articular cartilage is destroyed earlier, or this process is too intense, this condition is considered abnormal.

Causes of secondary knee arthrosis

Secondary gonarthrosis can be caused by the following factors:

• genetic predisposition, provided it can be clearly traced;
• leg fracture;
• displacement of the knee joint;
• meniscus injury;
• congenital dysplasia of the knee joint;
• extreme physical activity (typical of athletes);
• constant static loads;
• rheumatism;
• rheumatoid arthritis (not to be confused with rheumatism);
• ankylosing spondylitis;
• congenital deformity of the lower extremities - valgus or varus;
• congenital shortening of a limb;
• metabolic syndrome;
• gout;
• acromegaly;
• osteomyelitis;
• chondrocalcinosis;
metabolic
• pathologies;
• joint hypermobility - the tape device is inherently weak;
• hemochromatosis;
• diabetes mellitus;
• is ​​a pathology of the endocrine system.

Deformable osteoarthritis can have many causes, which is why this pathology is called polyetiological. Often, the exact cause of the disease cannot be identified, so primary (idiopathic) gonarthrosis is diagnosed.

Symptoms of gonarthrosis

In addition to pain (the main symptom), pathology may be accompanied by the following symptoms:

• Crunch and click.These symptoms usually occur while on the move and are often overlooked by patients. Knee cracking may indicate the appearance of furrows, osteophytes, ulcers on the joint surfaces.
• Restrained movements.This symptom is very important in diagnosis as it allows gonarthrosis to be distinguished from a number of other pathologies affecting the musculoskeletal system. The movement is usually stiff in the morning. When a person starts walking, this symptom disappears within half an hour. If the stiffness lasts for an hour or more, it may indicate an inflammatory process or other pathology.
• Reduced range of motion.This symptom means that the patient is unable to fully bend his knee. This is caused by pain syndrome, which softens the intensity that a person tries to move their legs less. Over time, this leads to shortening of the ligaments, which are called contractures.
• Stuck joint.Gonarthrosis can lead to joint obstruction in a given situation and is impossible to move due to severe pain. This is usually due to changes in the surface of the joints when the inner ligaments of the knee are stretched, protruding from the pineal glands. In this case, only the reverse movement of the belt can help. Less commonly, the cause of a joint blockage is the entry of a foreign body into the joint space. The source of the trouble may be part of the meniscus or a fragment of an osteophyte.

Classification of the disease

Each section has its own characteristics:

1. The first stageis ​​initial, also called easy. The first signs of pathology are considered the beginning, and the transition to the next stage is characterized by the appearance of bone deformities. They can be detected visually or on X-rays. In the first stage of the disease, fluid builds up in the joint - a phenomenon called synovitis. He causes pain, which so far only manifests itself when moving. Their intensity may vary.
2. In the second (moderate) stage of gonarthrosispathological changes are even visible visually. They manifest themselves with an increase in the size of the knee, with its deformation. On the x-rays, you can see that the bone tissue at the edge of the joint has grown and the joint has narrowed. At this stage, pain syndrome occurs from the slightest load, and when walking or squatting, the knee begins to crack.
3. The third (severe) stagedeforming osteoarthritis can be diagnosed when there is virtually no cartilage tissue in the joint. If the pathology is severe, the bones can grow together, causing complete immobility of the affected limb.

The exact stage of gonarthrosis is determined by a specialist. In this case, you should not focus on the symptoms of the disease, but on the X-rays you receive. Pathology does not always follow the usual pattern.

Diagnostics

Only instrumental diagnostics can help diagnose deforming osteoarthritis:

• X-ray;
• ultrasound scanning;
• tomography - computer or magnetic resonance imaging;
• arthroscopy;
• thermography;
• scintigraphy.

Often an X-ray is enough to detect gonarthrosis. They are implemented in two projections. If only one knee is affected, a picture of a healthy limb is taken to compare the results.

Which doctors should I ask for help?

In the case of osteoarthritis deformans, different specialists can be involved. In a traditional clinic, they usually see a doctor.

An arthrologist, rheumatologist, orthopedist usually deals with the problems of gonarthrosis. In addition, the participation of a chiropractor or arthroscope may be required. A physiotherapist, a physiotherapist, and a qualified massage therapist in a specialty are usually involved in the treatment process.

Treatment of gonarthrosis

Treating knee arthrosis takes quite some time. In most cases, outpatient care is sufficient. This includes a number of measures. Treatment is based on drug therapy, physiotherapy and exercise. In some cases, surgery is needed. Folk recipes are also allowed with gonarthrosis, but these should be combined with traditional medicine.

Drug therapy

The use of various medications is a major component of the treatment of gonarthrosis. Such a disease requires an integrated approach, which includes the possibility of using the following drugs:

• Non-steroidal anti-inflammatory drugs.These drugs are prepared in various forms, but in the case of osteoarthritis, tablets for oral administration, solutions for injection, agents for external use in the form of creams, ointments, gels are preferred. Nonsteroidal anti-inflammatory drug groups not only fight inflammation but also reduce pain.
• Corticosteroids.Such drugs are usually used when the disease is severe or drugs in the nonsteroidal anti-inflammatory group are ineffective. They are usually used as an injection, the medicine is injected into the joint capsule. Corticosteroids are used as symptomatic therapy to relieve inflammation and severe pain.
• Analgesics.The severity of pain syndrome is taken into account when prescribing such medications. If the pain syndrome is of high intensity, they resort to strong opiates.
• Chondroprotectors.Thanks to these drugs, cartilage tissue is saturated with nutrients that stimulate cell growth. The effect of chondroprotectors is manifested for a long time, so they are used for long therapeutic courses. Such drugs are suitable for 1 or 2 degree pathology.
• Anticonvulsants and muscle relaxants. Such medications are needed when the pathology is accompanied by muscle cramps.
• vasodilators.Such drugs improve blood flow, relieve spasms of small blood vessels. The combination of vasodilators and chondroprotectors is effective because cartilage tissue in this case is more saturated with nutrients.
• Warming ointmentsto improve blood circulation. Such funds are appropriate in the absence of synovitis.

This medicine will be prescribed by a doctor. Only he can determine what medications are needed in each case, according to what schedule they should be taken, and how long the therapeutic course of each prescribed medication should be.

Physiotherapy

Various physiotherapy methods are used in deforming osteoarthritis. It is used for a variety of purposes: to reduce pain, relieve inflammation, activate the blood supply, and speed up healing.

The following physiotherapy methods are effective in knee arthrosis:

• Phonophoresis.This technique is ultrasound therapy combined with pharmacological effects. Due to the high-frequency vibrations, the tissues of the knee joint become warm, which ensures a deeper penetration of medicinal substances into them.
• Shockwave therapy.The procedure uses a special device that generates radial acoustic waves. Under their influence, the blood supply to the periarticular region is activated, which stimulates the restoration of cartilage and bone structures.
• Ozone therapy.This procedure involves the use of active oxygen. It has an analgesic and anti-inflammatory effect on tissues.
• Electrostimulation.This technique is often used during rehabilitation and in the presence of contraindications to exercise. Electrical impulses increase muscle tone and improve blood circulation.
• Diathermy.This technique is for electrotherapy and involves the use of high heat high frequency currents.
• Cryotherapy.This technique is also called cold treatment. The affected skin surface is exposed to low temperatures for a short time. This method restores metabolic processes, increases blood circulation, reduces the severity of inflammation, eliminates pain, relieves muscle cramps.
• Hirudotherapy.This technique is considered an alternative. The leeches are placed around the affected joint. The procedure relieves pain, relieves swelling and stimulates regeneration.
• Laser therapy.This technique is usually used in the early stages of pathology. It has an anti-inflammatory, analgesic and stimulating effect.
• Plasma therapy.This procedure is also called joint plasma lifting. This includes intra-articular injections. For them, the patient’s own blood plasma, which is saturated with platelets, is used. This procedure relieves inflammation and promotes cartilage tissue regeneration.
• Spas- turpentine, radon, hydrogen sulfide.
• Acupuncture.Such a procedure is usually used in the early stages of the pathology. This technique relieves swelling, eliminates pain, and allows joint mobility to be restored.

movement therapy

Physiotherapy is required for gonarthrosis. The various exercises should be supervised by a trained professional. The main goal of movement therapy is to restore joint mobility and achieve a certain range of movement. It is also necessary to increase strength and muscle endurance.

Exercise is not used during the period of disease exacerbation. At this time, the joint needs rest and maximum relief. Musculoskeletal activity is allowed once the inflammation and pain have been relieved, at least 5 days should elapse from this point on.

The exercise program should be tailored to each patient. The peculiarities of the course of the disease, the degree of its severity, and the individual characteristics of the patient must be taken into account.

Tournament

At home, a patient with gonarthrosis can do some exercises on their own. You need to do it intermittently - you need to warm up first, then do strength exercises and finish stretching.

Warm up as follows:

• Place your feet shoulder-width apart and lower your arms along your body or lean on the back of the chair. Slowly rise on your toes, lingering for 3 seconds at the extreme point, then smoothly transfer the weight to your heels, raising your toes as high as possible. Perform 10 repetitions without sudden movements.
• The starting position remains the same. The bent leg at the knee should be raised to the level of the waist and then lowered. Do 15 reps alternately on each leg. Movements should be slow and fluid.
• Lie on your back, raise your knees bent to your knees, and simulate the rotation of your bike pedals. You have to turn in one direction for half a minute and then in the other. Move slowly.
• Place your feet shoulder-width apart, straighten your back, and bend your elbows. Simulates running in place, alternating weight from one leg to the other. The movements should be performed on the toes, not leaning on the heel. Perform the exercise for about 5 minutes.

Surgery

Deforming osteoarthritis may require surgical treatment. They use the following options:

• Puncture.This procedure is minimally invasive. He is resorting not only to the study of intraarticular fluid, but also to the removal of its excess. As a result of such manipulations, inflammation is reduced and joint mobility is restored, but sometimes only partially.
• Arthroscopy.This procedure can be performed as an independent operation or as one of its stages. This technique is endoscopic and does not require dissection of the joint cavity. Special thin and flexible instruments are used for the operation, and all manipulations are controlled by a micro-video camera. When arthroscopy is used as a stand-alone operation, it cleans the joint surfaces of fragments of the affected cartilage tissue.
• Periarticular osteotomy.This type of surgery is quite traumatic. It is used to redistribute the load on the knee, thus reducing the pain syndrome and making the joint more mobile. During surgery, the bone involved in the formation of the knee joint is sawn and then fixed in another position. Such surgery is appropriate for grade 1 or 2 deforming osteoarthritis.
• Endoprosthetics.Such an operation is used when the third degree of gonarthrosis is diagnosed. During surgery, the knee joint is replaced with a biocompatible construct. The previous range of motion and the patient's normal quality of life should be restored. Endoprosthesis is a rather complicated operation and therefore requires a long rehabilitation period.

Diet and general recommendations

Although pathology affects the knee joint, its treatment involves adherence to the diet. You must adhere to the following principles:

• If necessary, normalize your weight. The BMI should not be more than 20. Weight loss should be gradual - 2-3 kg per month.
• Reduce carbohydrates and animal fats.
• Most of the fat consumed should be of vegetable origin.
• Eat fish at least 1-2 times a week.
• Eat in fragments. The dose should be small, but 5-6 meals a day.
• Finish each meal with vegetables or fruits.
• For cooking, you must choose cooking, including steaming, steaming, baking.
• Watch your drinking system. On average, a person needs 2 liters of fluid a day and most of the time should be clean water without gas.
• Drink water before eating. A glass is enough half an hour before a meal.
• Reduce salt intake.
• Avoid alcohol, carbonated and sugary drinks.
• Beef, pork, semi-finished products, hot peppers, white cabbage, sour fruits should be excluded from the diet.
• Useful for jelly meat, gelatin jelly, cheese, cottage cheese, chicken, legumes.

Traditional Medicine

Unusual methods are also appropriate for the treatment of osteoarthritis deformans. In this case, you should consult a specialist, as even the use of natural remedies is contraindicated.

Use the following folk recipes effectively:

• Grease the back of the burdock leaf with honey, apply to the affected area, secure with cellophane foil and insulate. Keep the compression for up to 4 hours.
• You can use cabbage leaves instead of burdock. You can knead it with your hands or prick it in several places. Honey is optional.
• For internal use, you can use burdock root tincture. The raw materials must be finely chopped, evaporated with boiling water and adhered to. Drink one tablespoon five times a day.
• Rinse the potato sprouts, place in a glass jar and cover with alcohol. Stand in the dark for 3 weeks, filter and use three times a day to rub the affected areas.
• Heat the honey in a water bath to a liquid state and massage it into the affected knee. Cover the treated area with gauze or bandage and insulate. The procedure is repeated every day for a week and a half.
• Steam 5 tbsp. l. rolled oats and cook on low heat for 5-8 minutes. Wrap the cooled mixture in a natural cloth, apply to the affected area and secure with polyethylene. Every time you need to make a fresh mix.
• Mix iodine evenly with honey and glycerin, leave for 3 hours. Dip a cotton pad into the resulting composition and process the knee and adjacent area with bottom-up movements.
• Cut a head of garlic and add a glass of vegetable oil. Stick to a week in the dark, tired and apply to the affected areas before going to bed.
• Grind the white school chalk and mix with yogurt or sour cream to get a thick slurry. Wrap in natural fabric and compact for 2, 5 hours, insulated with polyethylene. Repeat the procedure every day.
• Boil two large onions with peel in a liter of distilled water, drain. Drink the received infusion three times daily before meals.

Treatment for gonarthrosis should not be limited to conventional medicine. This disease requires an integrated approach, which necessarily includes drug therapy and exercise.

Prediction, possible complications

The overall prognosis for deforming osteoarthritis is unfavorable due to the progressive nature of the disease. The process of tissue breakdown and joint deformation cannot be reversed, but can be stopped or significantly slowed down.

The following factors affect the prognosis of gonarthrosis:

• Age of the patient.The younger you are, the less favorable the prognosis. The pathological process develops gradually, so with damage to the joints of young people into old age, the disease can reach its final stage and cause various complications.
• Type of arthrosis.In primary pathology, only the joint is involved, and the disease usually progresses slowly. In the case of a secondary disease, other disorders can also accelerate this process or cause complications.
• Follow medical instructions.This includes taking the necessary medications, physiotherapy, exercising, and ensuring that the joint is unloaded. It is also important to monitor the duration of medication, as most medications need to be taken regularly at certain courses.
• Body weight. If the patient is overweight, the joints experience increased stress, which negatively affects the course of the disease.
• Profession.This factor is very important in the prognosis of the disease. Professional athletes who are under regular stress or are constantly on their feet always suffer more. Sedentary work when the joint is in a position for a long time can also negatively affect the course of the disease.

Deforming osteoarthritis progresses slowly, but without proper treatment can cause a number of complications:

• Joint deformity.This occurs in the last stage of the disease. The foot can bend at an unnatural angle, which is not only aesthetically uncomfortable, but can also cause a complete loss of joint functionality.
• Infection.For example, microtrauma, a rupture of cartilage tissue, can provoke such a complication. The pathogen can enter the joint along with the flow or lymph from the focus of the infection. Surgery - arthroscopy, diagnostic stabbing can also be the cause of infection. Infections entering the joint can cause aseptic necrosis.
• Dislocation, fracture.Such complications occur in the background of functional damage to the knee joint, in which the load is not properly distributed, can lead to excessive injury.
• Ankylosis.In this case, the bones grow together at the site of the missing joint. This is one of the most serious disorders, as locking the lower leg in one position results in loss of motor function.

In most cases, complications are due to the fault of the patient, who neglected his illness or disregarded the doctor's instructions.

Prevention

Some preventative measures should be taken to avoid knee osteoarthritis:

• Maintain a normal body weight;
• avoid heavy loads and strong pressure on the knees;
• provides regular and adequate physical activity;
• avoid joint damage;
• If an injury occurs, timely, competent and complete treatment is required;
• Strengthen the periarticular muscles.

Secondary prevention measures should also be highlighted. They are needed once gonarthrosis has been diagnosed and the rate of development needs to be reduced. In this case, you should take the following actions:

• to take a chondroprotector course every six months or annually;
• treats arthritis in a timely, fast and effective manner.

Arthrosis of the knee joint is a serious condition with a poor prognosis and can cause a number of complications. In order to slow down the pathological process, treatment should be started as early as possible. Therapy should be comprehensive, some techniques should become part of the lifestyle: diet, exercise, taking certain medications.