Articular pathologies are the most common among all disorders of the musculoskeletal system. Inflammatory and non-inflammatory diseases significantly worsen the quality of human life and in many cases cause disability. One of the most common diseases is arthrosis of the knee joint. Symptoms of pathology are more often acute and require qualified assistance.
Causes of the disease
In medicine, this disease is also called osteoarthritis, gonarthrosis, deforming arthrosis (DOA). Arthrosis is the general name of all degenerative-dystrophic diseases of articular and intervertebral joints. A violation in the region 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 the gradual thinning of the cartilage in the joint joint and the parallel formation of bone growths.
This becomes the body's response to friction and increased pressure. The most likely causes of the symptoms of gonarthrosis of the knee joint are as follows:
- Traumatic injuries of mild and severe forms with impaired mobility of the joint for a long time. Ligament tears or severe bruises often lead to the development of an inflammatory process, resulting in the appearance of gonarthrosis symptoms.
- Surgery on the knee joint to remove any defect or foreign body.
- Constantly prolonged and excessive physical activity. This can be related to a professional sport or specialty. Constant tension in the joint area leads to gradual thinning of the cartilage, which has a negative effect on the entire musculoskeletal system.
- Acute bursitis with the development of purulent inflammation in the articular cavity. As a rule, it is difficult to get rid of such a pathology conservatively, so doctors resort to minor surgical intervention that negatively affects the cartilage tissue.
- Arthritis of various forms and severity. In this case, the inflammatory process is pronounced, continues with a sharp increase in temperature, and after a certain period leads to the development of arthrosis.
- Gout also often causes cartilage pathology with severe clinical manifestations and deformation of the articular joint.
- Weakened immunity, which leads to the gradual dissolution of bone and cartilage tissue due to the inability of the body to cope with the pathology.
- Bad habits - alcohol abuse, smoking - are often a predisposing factor to the appearance of pathological symptoms.
- Severe autoimmune diseases.
- Frequent viral and catarrhal pathologies that lead to the development of the inflammatory process and degenerative-dystrophic changes.
- Excess weight and severe obesity also cause a violation, because each additional kilogram increases the load on the articular joints by 10 times, and this, of course, will affect the cartilage tissue.
It should be noted that all these reasons most often lead to secondary violations. There is also a primary one, which differs in that the disease is the result of the body's natural aging process. Bone and cartilage tissue wears down, which increases friction and stress. The result is gonarthrosis.
Pathological types
There are several types of pathological conditions, each with 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.
- Due to the nature of the clinical picture, the symptoms of left-sided gonarthrosis of the knee joint do not differ from the right. But it is noted that this type often develops in overweight patients.
- It refers to bilateral severe forms, affects all cartilages and is characterized by severe pain.
It is 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 one is characterized by rapid progress and the development of complications, the second one proceeds slowly and may not bother the patient for several years.
Clinical picture
Signs and symptoms of gonarthrosis of the knee joint mainly 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 obvious symptoms and the inability to visually recognize the pathology. The patient is more tired than usual, but writes it off as overwork or increased workload. He becomes lethargic, sleepy, and his performance drops dramatically. Some patients have mild stiffness in the affected joint, especially when moving in the morning. However, they often do not pay attention to this and do not consult a specialist. If an x-ray of the joint is performed at this stage, narrowing of the joint cavity can be observed, which causes a violation.
- In the next stage, anxiety 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 refer to a specialist.
- The third stage is the most severe and is characterized by an obvious 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. At this stage, swelling is constantly observed. 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 obvious symptoms and the inability to visually recognize the pathology. The patient is more tired than usual, but writes it off as overwork or increased workload. He becomes lethargic, sleepy, and his performance drops dramatically. Some patients have mild stiffness in the affected joint, especially when moving in the morning. However, they often do not pay attention to this and do not consult a specialist. If an x-ray of the joint is performed at this stage, narrowing of the joint cavity can be observed, which causes a violation.
- In the next stage, anxiety 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 refer to a specialist.
- The third stage is the most severe and is characterized by an obvious 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. At this stage, swelling is constantly observed. The amount of synovial fluid in the joint bag 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. Appetite weakens or completely disappears, which leads to a deterioration in the work of the digestive and cardiovascular systems.
Lack of normal sleep often leads to a nervous breakdown, especially in elderly patients or young people engaged in intense physical labor. Memory impairment and reduced concentration of attention are also the result of insufficient rest of the patient.
Usually, the pathology continues without temperature, but in advanced stages, 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 relationship. It is for this reason that osteophytes or bone growths develop in the joint. They cause deformation in the advanced stages of the pathological process.
The most dangerous complication of such violations will be complete immobilization and disability of the patient. As a rule, this happens when there is no proper treatment or when the symptoms of knee osteoarthritis are ignored for a long time.
Diagnostic methods
To make an accurate diagnosis, the doctor suggests that the patient undergo a complete examination. This is necessary not only for determining the cause, but also for the correct selection of drugs for therapy. The first step will be to talk to the patient and identify possible causes. Lifestyle, professional activity 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 at an early stage. The next step will be to collect anamnesis and identify chronic pathologies that may become a predisposing factor. After that, the patient donates blood for laboratory examination. The detection of traces of inflammation in the form of an increase in the level of leukocytes indicates that some processes are responsible for the development of the disorder.
An obligatory moment in the diagnosis will be an X-ray examination to accurately determine the degree of gonarthrosis. The image usually shows areas of complete destruction of cartilage, as well as the number and location of osteophytes. This helps to clarify the probable diagnosis and prescribe the appropriate treatment.
Sometimes it is not possible to see the exact picture of the joint and the degree of damage in the X-ray. In this case, joint ultrasound examination 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 the 1st and 2nd stages, before the formation of osteophytes. Therapy is mainly aimed at slowing the destruction of cartilage and its regeneration. The classic scheme involves the use of the following drugs:
- Means from the group of painkillers that help relieve pain. Let the patient feel better, improve night sleep. Injections made 1-3 times a day under the supervision of a specialist in a hospital are effective. It is not recommended to use the means for a long time, because they do not affect the course of the pathological process, but only relieve acute pain.
- Non-steroidal anti-inflammatory drugs. Means are available in the form of tablets and injections, they can not only relieve acute pain, but also slow down the development of pathology, eliminate local fever and swelling, and improve motor function. When taken regularly for 7-10 days, a stable concentration of the active components of the drug is observed in the patient's blood, which ensures long-term action. It is not recommended to take medicines for a long time, because they often have a negative effect on the digestive system. For this reason, it should not be taken by patients with severe stomach 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. Typically, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. Longer reception is possible with clear indications.
- Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not relieved by traditional means. It helps to relieve swelling and reduce pain. It is allowed to be used as an intramuscular or intravenous injection only in a hospital.
- Non-steroidal anti-inflammatory drugs. Means are available in the form of tablets and injections, they can not only relieve acute pain, but also slow down the development of pathology, eliminate local fever and swelling, and improve motor function. When taken regularly for 7-10 days, a stable concentration of the active components of the drug is observed in the patient's blood, which ensures long-term action. It is not recommended to take medicines for a long time, because they often have a negative effect on the digestive system. For this reason, it should not be taken by patients with severe stomach 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. Typically, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. Longer reception is possible with clear indications.
- Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not relieved by traditional means. It helps to relieve swelling and reduce pain. It is allowed to be used as an intramuscular or intravenous injection only in a hospital.
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 because it quickly penetrates into the joint space and has a therapeutic effect. Their use is allowed for 14 days. Since the risk of complications increases, it is not recommended to extend the course yourself.
In the most severe cases, the patient is injected directly into the joint cavity. You can administer the usual analgesics, but the best therapeutic effect is achieved by the application of hyaluronic acid preparations. Injections are given once every 7 days. 3-5 injections are enough for complete pain relief. 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 gives the expected result and the patient's condition worsens, a surgical operation is performed to replace the joint with a prosthesis. Replace the entire assembly or its individual parts. It is indicated for arthrosis, which is usually triggered by a severe knee injury. The operation is performed under general anesthesia, and the recovery period is quite long and difficult.
Gonarthrosis is a severe degenerative-dystrophic pathology that causes disability of the patient if not properly treated. When the first signs of a violation appear, it is recommended to consult a doctor immediately.