Joint pathologies are the most common among musculoskeletal disorders. 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 osteoarthritis of the knee joint. Symptoms of pathology are more often acute and require professional help.
Causes of the disease
In medicine, the disease is also called osteoarthritis, gonarthrosis, deforming osteoarthritis (DOA). Arthrosis is the general name for all degenerative-dystrophic diseases of the joints and intervertebral joints. Damage to 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, which are characterized by the gradual thinning of the cartilage in the articular joint and the parallel development of bone growth.
This is the body's response to friction and increased pressure. The most likely causes of knee gonarthrosis symptoms are:
- Mild and severe traumatic injuries with long-term mobility impairment of the articular joint. Ligament tears or severe bruises often lead to the development of an inflammatory process, which in turn causes the appearance of gonarthrosis symptoms.
- Surgery on the knee joint to eliminate any defect or foreign body.
- Constantly prolonged and excessive physical activity. This may be due to professional sport or specialty. Constant tension in the joint area leads to 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 conservatively, so doctors require a minor surgical intervention that adversely affects the cartilage tissue.
- Arthritis of various forms and severity. In this case, the inflammatory process continues with a pronounced, sharp rise in temperature and after a certain time leads to the development of arthrosis.
- Gout often leads to pathology of the cartilage, with severe clinical manifestations and deformation of the joint junction.
- Weakened immunity, which causes the gradual dissolution of bone and cartilage tissue, as the body is unable to cope with the pathology.
- Bad habits - alcohol consumption, smoking - often become a predisposing factor in the appearance of signs of pathology.
- Severe autoimmune diseases.
- Common viral and catarrhal pathologies that cause 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 articular joints by 10 times, which will certainly affect the cartilage tissue.
It is worth noting that all these reasons most often trigger a secondary type of violation. There is also a primary one, which differs in that the disease is a consequence of the body's natural aging process. Bone and cartilage tissue wears down, increasing friction and stress. The result is gonarthrosis.
Types of pathology
There are many pathological conditions, each with its own characteristics. Depending on how the joint is affected, the following types of disorders can be distinguished:
- The right side is characterized by the appearance of cartilage tissue changes on the right side. It usually becomes the initial stage of the disease.
- The signs of gonarthrosis of the left side of the knee joint do not differ from the right side due to the nature of the clinical picture. But it should be 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 should be noted that the latter type is more often observed in elderly patients with primary tissue damage. Depending on the course of the pathological process, acute and chronic types are distinguished. The first is characterized by rapid progression and the development of complications, the second progresses slowly and does not bother the patient for several years.
Clinical picture
The signs and symptoms of gonarthrosis of the knee depend largely on the degree of damage to the joint. Currently, the pathological process has several stages, 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 describes this as overwork or increased exertion. He becomes lethargic, sleepy, and his performance is significantly reduced. Some patients experience mild stiffness in the affected joint during movement, especially in the morning. However, they often do not pay attention to this and do not consult a specialist. If an x-ray is taken of the joint at this stage, narrowing of the joint space can be seen, causing a violation.
- In the next stage, discomfort and stiffness do not disappear, but only increase. In the case of mild and short loading, the patient's knees experience severe pain, 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 cartilaginous tissue increases due to its exhaustion, the patient often hears a characteristic crunch during movements. Flexion function is also impaired, as the patient cannot fully bend the limb. At this stage, patients usually consult a specialist.
- The third stage is the most severe and is characterized by a pronounced pain syndrome that accompanies the patient not only during exercise, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Bloating can be observed continuously during this stage. The amount of synovial fluid in the joint bag 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 describes this as overwork or increased exertion. He becomes lethargic, sleepy, and his performance is significantly reduced. Some patients experience mild stiffness in the affected joint during movement, especially in the morning. However, they often do not pay attention to this and do not consult a specialist. If an x-ray is taken of the joint at this stage, narrowing of the joint space can be seen, causing a violation.
- In the next stage, discomfort and stiffness do not disappear, but only increase. In the case of mild and short loading, the patient's knees experience severe pain, 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 cartilaginous tissue increases due to its exhaustion, the patient often hears a characteristic crunch during movements. Flexion function is also impaired, as the patient cannot fully bend the limb. At this stage, patients usually consult a specialist.
- The third stage is the most severe and is characterized by a pronounced pain syndrome that accompanies the patient not only during exercise, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Bloating can be observed continuously during this stage. The amount of synovial fluid in the joint bag decreases sharply, which increases the load and increases friction in the joint.
The pain usually disturbs the patient's sleep, he becomes irritable and feels constant fatigue. Appetite weakens or disappears completely, which causes deterioration of the functioning of the digestive system and cardiovascular system.
A lack of normal sleep often leads to a nervous breakdown, especially in elderly patients or young people engaged in intensive physical work. Deterioration of memory and reduction of attention concentration are also consequences of the patient's insufficient rest.
Usually, the pathology occurs without temperature, but in an advanced stage, when the cartilages are completely destroyed, the friction of the bones and the pressure between them increases, which triggers an inflammatory process.
The body tries to restore balance and reduce the strain on the relationship. This is why osteophytes or bony growths develop in the joint. In the advanced stage of the pathological process, they become the cause of deformation.
The most dangerous complication of such violations will be the complete immobilization of the patient and disability. This usually happens in the absence of proper treatment or if the symptoms of osteoarthritis of the knee are ignored for a long time.
Diagnostic methods
For an accurate diagnosis, the doctor recommends that the patient undergo a full examination. This is necessary not only for identifying the cause, but also for the correct selection of drugs for therapy. The first step is to interview the patient and identify the likely causes. Lifestyle, professional activities and habits play an important role. The next step is 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 is to collect the anamnesis and identify chronic pathologies that may become a predisposing factor. After that, the patient donates blood for laboratory tests. The detection of signs of inflammation in the form of increased leukocytes indicates that some process caused the development of the disorder.
The mandatory moment of diagnosis will be an X-ray examination in order to accurately determine the degree of gonarthrosis. The image usually shows areas of complete cartilage destruction, as well as the number and location of osteophytes. This helps clarify the suspected diagnosis and prescribe the appropriate treatment.
Sometimes it is impossible to see the exact picture and extent of damage to the joint on the X-ray. In this case, an ultrasound examination of the joint is recommended.
In extreme cases, the patient is prescribed a CT scan. This is usually enough to get a complete picture of the disease.
Medical therapy
Conservative treatment of the pathological condition is possible only in stages 1 and 2, when the formation of osteophytes has not yet begun. The therapy is primarily aimed at slowing down the destruction of the cartilage and restoring it. The classic scheme includes the use of the following drugs:
- Means belonging to the group of pain relievers that help relieve pain. Let the patient feel better, improve night sleep. In a hospital, injections are effective and are administered 1-3 times a day under the supervision of a specialist. It is not recommended to use the funds for a long time, as they do not affect the course of the pathological process, but only relieve acute pain.
- Nonsteroidal anti-inflammatory drugs. The funds 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. In the case of regular intake for 7-10 days, a constant concentration of the active components of the drug can be observed in the patient's blood, which ensures a long-lasting effect. It is not recommended to take the medicines for a long time, as they often have a harmful effect on the digestive system. For this reason, patients with severe peptic ulcers or other disorders should not take them.
- Chondroprotectors help restore the cartilage in the affected joint and increase the amount of synovial fluid. Usually, 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 monitor improvement. Longer reception is also possible with bright signals.
- Glucocorticoids. It is used to treat advanced cases when the pain syndrome is not eliminated by traditional means. It helps reduce swelling and reduce pain. It can only be used in a hospital as an intramuscular or intravenous injection.
- Nonsteroidal anti-inflammatory drugs. The funds 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. In the case of regular intake for 7-10 days, a constant concentration of the active components of the drug can be observed in the patient's blood, which ensures a long-lasting effect. It is not recommended to take the medicines for a long time, as they often have a harmful effect on the digestive system. For this reason, patients with severe peptic ulcers or other disorders should not take them.
- Chondroprotectors help restore the cartilage in the affected joint and increase the amount of synovial fluid. Usually, 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 monitor improvement. Longer reception is also possible with bright signals.
- Glucocorticoids. It is used to treat advanced cases when the pain syndrome is not eliminated by traditional means. It helps reduce swelling and reduce pain. It can only be used in a hospital as an intramuscular or intravenous injection.
In addition to such bases, the patient is prescribed a course with an external agent in the form of an ointment, cream or gel. The latter option is the most advantageous because it quickly penetrates the joint cavity and has a therapeutic effect. They can be used within 14 days. It is not recommended to extend the course independently, as the risk of complications increases.
In the most severe cases, the patient is injected directly into the joint cavity. You can use traditional painkillers, but the best therapeutic effect is achieved with the introduction of hyaluronic acid preparations. 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 is able to move normally, and the pain syndrome almost completely disappears.
If none of the methods bring the expected results and the patient's condition worsens, a surgical intervention is performed to replace the joint with a prosthesis. Replace the entire joint or parts of it. This is usually recommended for arthrosis caused by a serious knee injury. The operation is performed under general anesthesia, the recovery period is quite long and difficult.
Gonarthrosis is a severe degenerative-dystrophic pathology that, in the absence of proper treatment, leads to the disability of the patient. We recommend that you consult a doctor immediately when the first signs of a violation appear.