Arthrosis or osteoarthritis of the knee joint is a disease that occurs against the bottom of dystrophic changes with the subsequent growth of connective tissue.There are many factors that affect the development of the disease, but they all lead to a violation of metabolism in cartilage.In medical literature, knee articulation arthrosis is called gonarthrosis.
According to statistics, gonarthrosis occupies a leadership position in the frequency of occurrence among other arthrosis.The disease brings severe discomfort, which can become pain when walking and at rest.
Knowledge of initial symptoms will help suspect pathology development and cure it in the early stages.
Reasons
According to the medical classification, there is primary and secondary gonarthrosis or knee joint arthrosis.
Knee joint arthrosis can occur against the bottom of various diseases or act as a complication.When, due to a low clinical history or clinical image, the exact cause cannot be established, gonarthrosis is called primary, but if the cause is known, this arthrosis is called secondary.
Arthrosis develops with age in almost all people, on average, this period begins after 45-50 years of life.
The course and pathogenesis of primary and secondary arthrosis are the same and do not depend on the cause of the occurrence.
The most common causes of knee articulation arthrosis and osteoarthrosis are:
- traumatic knee damage;
- Joint deformation in and out;
- shortening of a lower limb;
- Abnormal articulation hypermobility;
- Condroblast dysplasia;
- Cartilage calcinosis;
- femur and tibia osteomyelitis;
- Rheumatoid arthritis or arthritis of any other etiology;
- glucose metabolism;
- Metabolic diseases and hormonal diseases.
Wounds.After receiving knee injury in the joint cavity, inflammation with a large focus of alliteration can develop.After the disappearance of pro -inflammatory agents, repair or arthrosis processes are activated.
Most of the time, the disease occurs at the bottom of a fracture with a rupture of ligaments and damage to the pouch and surface of the joint cartilage.
Congenital deformations.Valgo or Value deformation is found very often and, without proper correction, can be complicated by sclerotic changes in the knee.This is due to the fact that one knee falls more than the load than it should be.
Shortening of any of the lower ends.In addition to deformations, in the pathogenesis of disease development, inadequate distribution of weight in the knees plays the role.
Knee hypermres.In this state, knee joint cartilage tissue can occur with subsequent degeneration and degeneration in arthrosis.Hypermation usually leads to spontaneous dislocations and numbers of the joint capsule.
Dysplasia with manual hair.Due to the inappropriate development of the engine surface in the knee joint, a pathological growth of connective tissue occurs.
Joint calcinosis.Pathogenesis is based on the deposition of salts in the joint cavity and the formation of a specific precipitate, which causes calcification with subsequent osteoarthritis.
Osteomyelitis.Inflammatory bacterial disease in which bones and joints are destroyed.First, ankylosis and only then are sclerosis formed.
Arthritis of any etiology.The most dangerous are rheumatoid arthritis, accompanied by auto -immune lesions of the heart and joints.
Diabetes, such as metabolic disorders, leads to a violation of nutrient flow in the joint and cartilage sprout.
Obesity.With a large body weight, large loads are on their knees when walking and in standing position.As a result of constant pressure, blood flow to knee joints decreases and atrophy with dystrophy develops.
Symptoms
Symptoms with knee joint arthrosis depend on the stage of the pathological process.Based on this, analyzing the symptoms and pace of its growth, you can evaluate the scale of change in cartilage tissue.
Knee arthrosis symptoms:
- the presence of pathological sounds during movement;
- pain after loading or at rest;
- reduction of functions;
- edema and joint increase;
- pathological displacements, fractures and subluxation;
- Temporary interruption that can occur when flexion and extent of the joint.
The click and the crisis are not noticed immediately and, if they realize, do not pay due attention.Pathological sounds find the idea that a pathological process with the deposition of salts or the formation of osteophytes occurs in the cartilage gap.
Pain occurs due to the formation of calcincts or osteophytes.At first, pain syndrome is not expressed, later it appears only in the morning and passes after lunch, with the progression of the disease, the pain can occur at rest.
An decrease in joint functions manifests itself in the rigidity of the movement and a decrease in its amplitude.Depending on the stage, the restriction of movement can last for a while and pass at rest.
Edema occurs due to inflammation and hypersecretion of synovial fluid.There are also options when the skin is inflamed on the joints.Such symptoms may be scarlet fever or rheumatism.
Dislocations and subluxation occur because the process applies to knee bones and ligaments.
The squeeze is a condition during which movement on any axis is completely limited.This symptom indicates the neglect of the process and the need for complex treatment.
Degree of arthrosis
Classify osteoarthritis according to the following signs:
- radiological symptoms;
- clinical manifestations;
- Laboratory data.
The most common and convenient classification is radiological, is simple and understandable even for people without medical education.
Based on X -rays, four degrees of arthrosis in the knee joint are distinguished:
- The reduction of joint gap is small and there are no osteophytes;
- The interpuint gap is not used upwards, but there are signs of small calcincts or osteophytes;
- The gap between Aspoint has a narrow expression, there are osteophytes, joint deformation begins;
- Lack of joint gap, bone deformation, ankylosis and dystrophy.
Regarding the clinical picture, the following stages are distinguished:
- Light degree symptoms are insignificant, occur in the morning and pass for 30 to 60 minutes after waking up;
- The average degree is a pronounced symptom, the feeling of discomfort passes before lunch, swelling is insignificant, progresses quickly without treatment;
- A severe degree - characterized by painful pain, resting discomfort, morning stiffness does not pass to dinner, ankylosis, burgis and knee joint sinusitis develop.
Laboratory tests are taken into consideration, soybean and leukocyte indicators are evaluated.It is also necessary to verify the presence of a rheumatoid factor.
Diagnostic methods
The diagnosis of knee joint arthrosis is not complicated, but requires certain physician skills.
Two types of diagnostic measures are distinguished:
- laboratory diagnosis;
- Instrumental diagnosis.
For the correct diagnosis, each method must be taken into consideration and analyze the image as a whole.
Laboratory
If arthrosis is suspected, the assistant doctor prescribes the following tests:
- General Blood and Urine Test;
- Biochemical blood test;
- determination of antibodies for the rheumatoid factor;
- Determination of antibodies to their own cells.
Laboratory data does not perform information about the disease development stage.
Instrumental
The instrumental diagnosis of arthrosis includes the following methods:
- Radiography in two standard projections;
- minimally invasive arthroscopy;
- UZD exam;
- CT;
- Magnetic Resonance;
- Scintigraphy (according to indications).
The diagnosis of radiation aims to determine changes in the joint and to evaluate the condition of the cartilage.
Treatment
The treatment of knee joint arthrosis is a long process.The duration of treatment is due to the fact that repair of cartilage tissue occurs very slowly and, in some cases, it is completely impossible to restore the joint.
Modern knee arthrosis treatment methods include comprehensive measures aimed at removing inflammation, normalizing lifestyle and improving cartilage tissue metabolism.
There are such therapy methods:
- Drug Therapy;
- Exercise and massage therapy;
- Folk medical;
- surgical interventions.
The doctor prescribes treatment based on the duration of the disease, the stage of its development and clinical manifestations.
Medication
Drug therapy aims to relieve pain and inflammatory reaction.For this purpose, the following drugs are prescribed:
- anti -non -esteroids inflammatory;
- Condropoprotectors;
- glucocorticoid;
- cytostatic.
Knee joint arthrosis tablets have many side effects, in treatment it is necessary to monitor the state of the tract and gastrointestinal kidneys.
Frequently, arthrosis drugs are prescribed for a long time;Therefore, less toxic medications should be selected.
Exercises
The treatment of arthrosis using therapy with exercise aims to strengthen knee muscles and ligaments.With cargo dosed in sick joint cartilage, metabolism improves and regenerative processes are accelerated.
Exercises should be selected individually taking into account the stage of the disease and the physical capabilities of the patient.
Massage
Knee joint massage allows you to improve blood flow and relieve discomfort.Proper massage can prevent the appearance of false anquiles and joints.
Folk
The treatment of knee articulation arthrosis at home should not be the main method for combating pathology or can only act as an addition to the medicine.
House treatment includes:
- decreased body weight;
- normalization of work hygiene and compliance with the day regime;
- The fight against inflammation.
The anti -inflammatory effect is possessed by these herbs:
- Type of thyme and hill of St. John;
- Bardana leaves;
- white cabbage leaves;
- Lion and chamomile tooth infusions and decoctions.
Operation
The operation is prescribed with the ineffectiveness of conservative therapy or at the patient's request.One of the main indications for surgical intervention is the fourth stage of the disease due to radiological characteristics.
During operation, surgeons can completely replace the joint with an endoprosthesis or change one of its parts.