Joint pathologies are one of the most common among all diseases of the musculoskeletal system. Inflammatory and non-inflammatory diseases significantly impair the quality of human life and in many cases cause disability. One of the most common diseases is arthrosis of the knee joint. The symptoms of the pathology are more often acute and require qualified help.
Causes of the disease
In medicine, the disease is also called osteoarthritis, gonarthrosis, deforming osteoarthritis (OA). Arthrosis is a general name for all degenerative-dystrophic diseases of the joints and intervertebral joints. The disorder in the area of the knee joint is called gonarthrosis.
It is characterized by damage to the cartilage in the knee joint.
The pathology consists of degenerative-dystrophic changes in the bone and cartilage tissue, characterized by gradual thinning of the cartilage in the articular joint and parallel formation of bone growths.
This becomes the body's response to friction and increased pressure. The most likely causes of symptoms of gonarthrosis of the knee joint are the following:
- Traumatic injuries of mild and severe forms with impaired mobility of the articular joint for a long period of time. Rupture of the ligaments or severe bruising often provokes the development of an inflammatory process, which as a result provokes the appearance of gonarthrosis symptoms.
- Surgical intervention of the knee joint in order to remove a possible defect or foreign body.
- Prolonged and excessive physical activity on a regular basis. This could be due to a professional sport or major. Constant tension in the connection area leads to a gradual thinning of the cartilage, which negatively affects the entire musculoskeletal system.
- Acute bursitis with the development of purulent inflammation in the joint cavity. As a rule, it is difficult to get rid of such a pathology in a conservative way, so doctors resort to mild surgical intervention, which adversely affects the cartilage tissue.
- Arthritis of various forms and severity. In this case, the inflammatory process is pronounced, proceeds with a sharp increase in temperature and leads to the development of arthrosis after a certain period of time.
- Gout also often leads to cartilage pathology with severe clinical manifestations and joint deformity.
- Weakened immunity, which provokes a gradual breakdown of bone and cartilage tissue due to the inability of the body to cope with the pathology.
- Bad habits - alcohol abuse, smoking - quite often become a predisposing factor to the appearance of signs of pathology.
- Severe autoimmune diseases.
- Frequent viral and catarrhal pathologies that provoke an inflammatory process and the development of degenerative-dystrophic changes.
- Overweight and severe obesity also cause a violation, since each extra kilogram increases the load on the joints by 10 times, which will certainly affect the cartilage tissue.
It is worth noting that all these reasons most often provoke a secondary type of violation. There is also primary, which differs in that the disease becomes a consequence of the natural aging process of the body. Bone and cartilage wear away, increasing friction and stress. The result is gonarthrosis.
Varieties of pathology
There are several types of pathology, each of which has its own characteristics. Depending on how the joint is affected, the following types of disorders are distinguished:
- The right side is characterized by the appearance of changes in the cartilage tissue on the right side. As a rule, it becomes the initial stage of the disease.
- Signs of left-sided gonarthrosis of the knee joint by the nature of the clinical picture do not differ from the right. But it is noted that this type often develops in overweight patients.
- Bilateral refers to severe forms, affects the entire cartilage and is characterized by severe pain.
It is noted that the latter type is observed more often in elderly patients with primary tissue damage. Depending on the course of the pathological process, acute and chronic forms are distinguished. The first is characterized by rapid progression and development of complications, the second proceeds slowly, may not bother the patient for several years.
Clinical picture
Signs of gonarthrosis of the knee joint and its symptoms largely depend on the degree of damage to the joint. Currently, there are several stages of the pathological process, each of which has its own clinical manifestations:
- The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets more tired than usual, but writes it off as overtiredness or increased workload. He becomes lethargic, sleepy and his ability to work sharply decreases. Some patients have slight stiffness in the affected joint when moving, especially in the morning. Often, however, they do not pay attention to this and do not turn to a specialist. If an X-ray of the joint is taken at this stage, a narrowing of the joint space can be seen, which provokes a violation.
- At the next stage, discomfort and stiffness do not disappear, but only increase. With a light and short load, the patient develops severe pain in the knee, which disappears only after a long rest. In some cases, the joint swells and this swelling disappears at night, but reappears during the day. As the pressure on the cartilage tissue increases due to its depletion, the patient often hears a characteristic crunch during movements. Flexion function is also impaired, as the patient is unable to fully bend the limb. At this stage, patients usually turn to a specialist.
- The third stage is the most severe and is characterized by a pronounced pain syndrome that accompanies the patient not only during training, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Puffiness at this stage is constantly observed. In the joint bag, the amount of synovial fluid decreases sharply, which increases the load and increases friction in the joint.
- The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets more tired than usual, but writes it off as overtiredness or increased workload. He becomes lethargic, sleepy and his ability to work sharply decreases. Some patients have slight stiffness in the affected joint when moving, especially in the morning. Often, however, they do not pay attention to this and do not turn to a specialist. If an X-ray of the joint is taken at this stage, a narrowing of the joint space can be seen, which provokes a violation.
- At the next stage, discomfort and stiffness do not disappear, but only increase. With a light and short load, the patient develops severe pain in the knee, which disappears only after a long rest. In some cases, the joint swells and this swelling disappears at night, but reappears during the day. As the pressure on the cartilage tissue increases due to its depletion, the patient often hears a characteristic crunch during movements. Flexion function is also impaired, as the patient is unable to fully bend the limb. At this stage, patients usually turn to a specialist.
- The third stage is the most severe and is characterized by a pronounced pain syndrome that accompanies the patient not only during training, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Puffiness at this stage is constantly observed. In the joint bag, the amount of synovial fluid decreases sharply, which increases the load and increases friction in the joint.
As a rule, the pain disturbs the patient's sleep, he becomes irritable and feels constant fatigue. The appetite weakens or completely disappears, which leads to a deterioration in the work of the digestive and cardiovascular systems.
The lack of normal sleep often leads to a nervous breakdown, especially in elderly patients or young people who are engaged in intense physical labor. Memory impairment and reduced concentration of attention also result from insufficient patient rest.
Usually, the pathology occurs without temperature, but in an advanced stage, when the cartilage is completely destroyed, the friction of the bones and the pressure between them increases, which provokes the inflammatory process.
The body tries to restore balance and reduce the load on the connection. Because of this, osteophytes or bony growths develop in the joint. They become the cause of deformation in the advanced stages of the pathological process.
The most dangerous complication of such disorders will be the complete immobilization of the patient and disability. As a rule, this happens in the absence of appropriate treatment or ignoring the symptoms of arthrosis of the knee joint for a long period of time.
Diagnostic methods
In order to make an accurate diagnosis, the doctor suggests that the patient undergo a complete examination. This is necessary not only for identifying the cause, but also for the correct selection of drugs necessary for therapy. The first step will be to interview the patient and establish the likely causes. Lifestyle, professional activities and habits play a special role. The next step will be to examine the affected limb and determine the degree of damage.
If there are no visible signs of pathology, the disease is in an early stage. The next step will be the collection of anamnesis and the identification of chronic pathologies that may become a predisposing factor. The patient then donates blood for laboratory tests. Finding traces of inflammation in it in the form of an increased level of leukocytes suggests that some process caused the development of the disease.
A mandatory moment in the diagnosis will be the X-ray examination to accurately determine the degree of gonarthrosis. The photograph usually shows areas of complete cartilage destruction, as well as the number of osteophytes and their location. This helps clarify the suspected diagnosis and prescribe appropriate treatment.
Sometimes it is impossible to see the exact picture and extent of joint damage on an X-ray. In this case, it is recommended to undergo an ultrasound examination of the joint.
In extreme cases, the patient is prescribed computed tomography. Usually this is enough to get a complete picture of the disease.
Medical therapy
Conservative treatment of the pathological condition is possible only in the 1st and 2nd stages, when the formation of osteophytes has not yet begun. The therapy is mainly aimed at slowing down the destruction of the cartilage and its restoration. The classic scheme includes the use of the following drugs:
- Means from the group of pain relievers that help relieve pain. Allow the patient to feel better, improve night sleep. In a hospital, the injections are effective and are given 1 to 3 times a day under the supervision of a specialist. It is not recommended to use means for a long time, since they do not affect the course of the pathological process, but only relieve acute pain.
- Nonsteroidal anti-inflammatory drugs. The means are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of the pathology, relieve local fever and swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active components of the drug is observed in the patient's blood, which ensures a long-lasting effect. It is not recommended to take medicines for a long time, as they often adversely affect the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other diseases.
- Chondroprotectors help restore cartilage in the affected joint and increase the amount of synovial fluid. As a rule, such drugs contain glucosamine and chondroitin. It is recommended to take them for a long time. A course of 8-12 weeks is usually prescribed with regular visits to a specialist to determine improvement. With clear indications, a longer reception is possible.
- Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. Helps relieve swelling and reduce pain. It is allowed to be used only in a hospital in the form of intramuscular or intravenous injections.
- Nonsteroidal anti-inflammatory drugs. The means are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of the pathology, relieve local fever and swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active components of the drug is observed in the patient's blood, which ensures a long-lasting effect. It is not recommended to take medicines for a long time, as they often adversely affect the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other diseases.
- Chondroprotectors help restore cartilage in the affected joint and increase the amount of synovial fluid. As a rule, such drugs contain glucosamine and chondroitin. It is recommended to take them for a long time. A course of 8-12 weeks is usually prescribed with regular visits to a specialist to determine improvement. With clear indications, a longer reception is possible.
- Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. Helps relieve swelling and reduce pain. It is allowed to be used only in a hospital in the form of intramuscular or intravenous injections.
In addition to such means, the patient is prescribed a course using an external agent in the form of an ointment, cream or gel. The last option is the most preferred, as it quickly penetrates into the joint cavity and has a therapeutic effect. They are allowed to be used within 14 days. It is not recommended to extend the course yourself, as the risk of complications increases.
In the most severe cases, the patient is injected directly into the joint cavity. You can use conventional analgesics, but the best therapeutic effect is achieved with the introduction of preparations with hyaluronic acid. Injections are given once every 7 days. 3-5 injections are enough to completely eliminate the pain. After such therapy, the effect lasts for 6 months. The patient has the ability to move normally, and the pain syndrome almost completely disappears.
If none of the methods lead to the expected result and the patient's condition worsens, a surgical operation is performed to replace the joint with a prosthesis. Replace the entire joint or individual parts. This is usually indicated in arthrosis provoked by a severe injury to the knee. The operation is performed under general anesthesia, and the recovery period is quite long and difficult.
Gonarthrosis is a severe degenerative-dystrophic pathology, which, if not treated correctly, leads to damage to the patient. It is recommended to immediately consult a doctor when the first signs of a disorder appear.