Articular pathologies are among 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 osteoarthritis of the knee joint. Symptoms of pathology are more often acute and require qualified assistance.
Causes of the disease
In medicine, the disease is also called osteoarthritis, gonarthrosis, deforming osteoarthritis (DOA). Arthrosis is a generalized name for all degenerative-dystrophic diseases of the articular and intervertebral joints. Violation in the area of the knee joint is called gonarthrosis.
It is characterized by damage to the cartilage in the knee joint.
Pathology consists in degenerative-dystrophic changes in bone and cartilage tissue, characterized by a gradual thinning of the cartilage in the articular joint and the 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. Ligament rupture or severe bruising often provokes the development of an inflammatory process, which as a result provokes the appearance of symptoms of gonarthrosis.
- Surgical intervention on the knee joint in order to eliminate any defect or foreign body.
- Prolonged and excessive physical activity on an ongoing basis. This may be due to professional sports or specialty. 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 articular cavity. As a rule, it is difficult to get rid of such a pathology in a conservative way, so doctors resort to minor 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 deformity of the articular junction.
- Weakened immunity, which provokes a gradual resolution 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.
- Excess weight 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 provoke a secondary type of violation. There is also a primary one, which differs in that the disease becomes a consequence of the natural aging process of the body. Bone and cartilage tissue wears out, which increases friction and stress. The result is gonarthrosis.
Varieties of pathology
There are several types of pathological condition, 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 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 does not differ from the right-sided. But it is noted that this type often develops in patients with overweight.
- Bilateral refers to severe forms, affects the entire cartilage 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 is characterized by rapid progression and the development of complications, the second proceeds slowly, may not disturb 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 tired more than usual, but writes it off as overwork or increased workload. He becomes lethargic, drowsy and performance is sharply reduced. Some patients have mild stiffness in the diseased joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If at this stage an X-ray of the joint is taken, one can notice a narrowing of the joint space, which provokes a violation.
- At the next stage, discomfort and stiffness do not disappear, but only increase. With a slight 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 in the daytime. Since the pressure on the cartilaginous tissue increases due to its depletion, the patient often hears a characteristic crunch during movements. The flexion function is also impaired, since the patient is not able 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, which accompanies the patient not only during exercise, but also at rest. In severe cases, 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 is sharply reduced, 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 tired more than usual, but writes it off as overwork or increased workload. He becomes lethargic, drowsy and performance is sharply reduced. Some patients have mild stiffness in the diseased joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If at this stage an X-ray of the joint is taken, one can notice a narrowing of the joint space, which provokes a violation.
- At the next stage, discomfort and stiffness do not disappear, but only increase. With a slight 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 in the daytime. Since the pressure on the cartilaginous tissue increases due to its depletion, the patient often hears a characteristic crunch during movements. The flexion function is also impaired, since the patient is not able 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, which accompanies the patient not only during exercise, but also at rest. In severe cases, 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 is sharply reduced, which increases the load and increases friction in the joint.
As a rule, pain disturbs the patient's sleep, he becomes irritable and feels constant fatigue. Appetite is weakened or completely disappears, which causes deterioration 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 a decrease in concentration of attention also become the result of insufficient rest of the patient.
Usually, the pathology proceeds 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 connection. It is for this reason that osteophytes or bone growths develop in the joint. They become the cause of deformation at the advanced stages of the pathological process.
The most dangerous complication of such violations will be the complete immobilization of the patient and disability. As a rule, this happens in the absence of proper treatment or ignoring the symptoms of osteoarthritis of the knee for a long period.
Diagnostic methods
In order to make an accurate diagnosis, the doctor suggests that the patient undergo a complete examination. This is necessary not only to identify the cause, but also for the correct selection of drugs necessary for therapy. The first step will be to interview the patient and identify probable causes. Lifestyle, professional activities and habits play a special role. The next step will be to examine the diseased 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 an anamnesis and identify chronic pathologies that could become a predisposing factor. After that, the patient donates blood for laboratory testing. The detection of traces of inflammation in it in the form of an increased level of leukocytes suggests that some process caused the development of the disorder.
An obligatory moment in the diagnosis will be an X-ray examination in order to accurately determine the degree of gonarthrosis. The picture usually shows areas of complete destruction of cartilage, as well as the number of osteophytes and their location. This helps to clarify the presumptive diagnosis and prescribe the appropriate treatment.
Sometimes it is impossible to see the exact picture and degree of damage to the joint 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 to undergo a CT scan. This is usually sufficient to obtain a complete picture of the disease.
Medical therapy
Conservative treatment of the pathological condition is possible only at the 1st and 2nd stages, when the formation of osteophytes has not yet begun. Therapy is mainly aimed at slowing down the destruction of cartilage and its restoration. The classical scheme involves the use of the following drugs:
- Means from the group of painkillers that help relieve pain. Allow the patient to feel better, improve night sleep. In a hospital, injections are effective, which are made 1 to 3 times a day under the supervision of a specialist. It is not recommended to use funds for a long time, since they do not affect the course of the pathological process, but only relieve acute pain.
- Non-steroidal anti-inflammatory drugs. The funds are available in tablet and injectable form, 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 prolonged action. 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 disorders.
- 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 in order to detect improvement. A longer reception is possible with clear indications.
- 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 use only in a hospital in the form of intramuscular or intravenous injections.
- Non-steroidal anti-inflammatory drugs. The funds are available in tablet and injectable form, 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 prolonged action. 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 disorders.
- 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 in order to detect improvement. A longer reception is possible with clear indications.
- 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 use only in a hospital in the form of intramuscular or intravenous injections.
In addition to such funds, the patient is prescribed a course using an external agent in the form of an ointment, cream or gel. The latter option is most preferable because 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 on your own, as the risk of complications increases.
In the most severe cases, the patient is injected directly into the joint cavity. You can drive conventional analgesics, but the best therapeutic effect is achieved with the introduction of hyaluronic acid preparations. Injections are made 1 time in 7 days. For complete elimination of pain, 3-5 injections are enough. After such therapy, the effect persists for 6 months. The patient has the ability to move normally, and the pain syndrome almost completely disappears.
If none of the methods brings 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 its individual parts. This is usually indicated for arthrosis, provoked 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, which, if not properly treated, leads to the patient's disability. It is recommended that you immediately consult a doctor when the first signs of a violation appear.