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knee joint disease

Knee joint disease (knee joint disease, osteoarthritis deformity)

Knee osteoarthritis is a disease of the musculoskeletal system that is manifested by the deformation and destruction of articular cartilage tissue, thereby disrupting the structure and function of the cartilage. The disease has several names - arthropathy, osteoarthritis deformity. There is no clear plan or single drug for the treatment of knee joint disease that will help everyone with this problem in the same way. Because arthropathy is a progressive disease, it is more common in overweight women, venous disease, and the elderly. A treatment plan is developed and prescribed individually for each patient.

Knee osteoarthritis can be unilateral or bilateral (depending on whether the disease develops in one or both legs). In the first symptoms, it is necessary to take proper treatment, because neglecting the problem can lead to the eventual destruction of the exposed cartilage and bone, which can lead to disability in the person.

The disease is divided into three stages:

  1. The early stage of knee joint disease is characterized by the loss of cushioning properties, so the cartilage rubs against each other during exercise, which brings serious discomfort to the patient. In the advanced stages of the disease, the cartilage becomes rough, deformed, dry—even covered in cracks.
  2. As depreciation decreases, bone deformation begins, leading to osteophyte formation (growth on the surface of the bone) - the second stage of the disease. The synovium and joint capsule are also deformed, and the knee joint gradually shrinks due to stiffness in motion. The density of the joint fluid also changes (it becomes more viscous), circulation is impaired, and the nutrient supply to the knee joint deteriorates. The lining between cartilage joints thins, reducing the distance between the joint bones.
  3. The disease progresses rapidly and rapidly progresses to the third stage, at which point the patient can barely move due to persistent pain in the knee. Cartilage tissue undergoes global and irreversible changes, resulting in human disability.

Most of the time, arthropathy or arthropathy develops after an injury or bruise, and a person suffers from constant severe pain in the knee which can severely hinder his movement.

Causes of joint disease

The treatment of knee osteoarthritis takes considerable time, but it manifests itself due to the following factors:

  1. Genetic susceptibility.
  2. Injuries: Dislocations, bruises, fractures. When treating an injured knee, the joint is immobilized and the person cannot bend and straighten the leg for a certain period of time. This can lead to a deterioration in blood circulation, which often triggers the development of post-traumatic arthropathy.
  3. Remove the meniscus.
  4. Excessive physical activity inappropriate for a person's age, resulting in injury or microtrauma, and joint hypothermia. For example, running on asphalt or squatting is not recommended for older adults because during these exercises, the knee joints are put under a lot of stress and wear out with age and cannot handle such loads.
  5. Overweight and obesity. This factor can lead to meniscus damage, which can lead to the development of knee arthropathy.
  6. Lax or weak ligaments.
  7. Arthritis or other acquired joint disease. The inflammatory process can lead to the accumulation or swelling of synovial fluid in the joint cavity. This can cause the destruction of the cartilage tissue of the knee joint, which can lead to knee arthropathy.
  8. Human metabolic disorders. Insufficient calcium levels can significantly worsen the condition of human bone and cartilage tissue.
  9. flatfoot. The wrong foot structure shifts the center of gravity and increases the load on the joints.
  10. Stress and nervousness.

Symptoms of knee osteoarthritis

The clinical manifestations of the disease include the following symptoms:

  1. Pain. The pain comes on suddenly and depends on the physical load on the knee joint. Pain can be of different nature. In the initial stages, these are mild back pains that usually go unnoticed. Periods of mild pain can be observed for months, sometimes years, until the disease enters a more aggressive stage.
  2. Knee deformity is seen. This symptom appears at a later stage. At first, the knee looks swollen or swollen.
  3. A buildup of synovial fluid in the joint cavity or Baker's cyst. This is a dense structure on the back wall of the knee joint.
  4. Cracked joints. A high-pitched crackling sound with pain is observed in patients in the second and third stages of disease development.
  5. Inflammatory response in the synovium of joints, leading to swelling and increased volume of cartilage.
  6. Decreased range of motion of the joints. See later. Bending the knee is nearly impossible and is accompanied by severe pain. In the final stage, the knee may be fully immobilized. Movement of a person becomes difficult or impossible (some patients bend their legs to move).

Diagnosis of knee osteoarthritis

If there are obvious or mild symptoms of knee joint disease, it is best to contact an orthopaedic or rheumatologist immediately. Diagnosis usually involves taking a patient's medical history and analyzing their general health. For more accurate conclusions, they also turned to X-rays or knee MRIs. Patients are also referred for laboratory tests - general blood and urine tests. Based on the data obtained, the doctor draws conclusions and prescribes the necessary treatment.

Treatment of knee joint disease

The treatment of knee joint disease should be comprehensive. To date, there are no drugs that can relieve the disease. One of the most important conditions for successful treatment is prompt diagnosis. The earlier treatment of knee joint disease begins, the more likely it is to prolong remission and prevent the destruction and deformation of cartilage and bone tissue.

During treatment, physicians and patients are faced with several tasks:

  1. relieve or relieve pain;
  2. Establishes the nutritional supply of the knee joint, thereby increasing its recovery function;
  3. activates blood circulation in the knee joint area;
  4. strengthen the muscles around the joints;
  5. increase joint mobility;
  6. Work on increasing the distance between the joint bones.

Depending on the stage of disease development, the treatment of the disease can be conservative and surgical.

Conservative treatment of knee joint disease

Analgesic and anti-inflammatory drugs

To relieve or reduce pain, patients are usually prescribed a course of nonsteroidal anti-inflammatory drugs (NSAIDs). It can be tablets, ointments and injections. The most common pain relievers can be used in two ways - internally or topically.

Often, patients prefer topical treatments in the form of gels, ointments, warm patches, etc. The effects of these pain relievers do not appear immediately, but after a few days (about 3-4 days). Maximum effect is achieved after a week of regular use of this drug. These drugs do not treat the disease, but only relieve pain syndromes because it is not possible to start treating the pain.

Painkillers should be taken strictly as prescribed by your doctor and only for severe pain, as frequent and prolonged use can cause side effects and even accelerate the destruction of articular cartilage tissue. In addition, with the long-term use of these drugs, there is an increased risk of adverse reactions, including gastric ulcers, duodenal ulcers, impairment of the normal function of the liver, kidneys, and allergic manifestations in the form of dermatitis are also possible.

Given the limited range of use, NSAIDs are prescribed with great caution, especially in elderly patients. The average course of treatment with NSAIDs is about fourteen days. As an alternative to nonsteroids, doctors sometimes offer elective medications. They are usually prescribed for long-term use for weeks to years. They do not cause complications and do not affect the structure of the cartilage tissue in the knee joint.

hormones

Occasionally, in the treatment of knee joint disease, a course of hormonal medication is prescribed. If NSAIDs have become ineffective and the disease itself begins to develop, it can be prescribed. Most of the time, hormonal medications used to treat this condition come in the form of injections.

The course of treatment with hormonal drugs is usually short and prescribed during severe exacerbations, when inflammatory fluid builds up in the joints. The hormone is injected into the joint about every ten days.

chondroprotective agent

To restore and nourish cartilage tissue in the initial stages of the disease, glucosamine and chondroitin sulfate, so-called chondroprotectants, are taken. It is by far the most effective treatment for osteoarthritis. They have few contraindications and, in rare cases, side effects.

Glucosamine stimulates the recovery of cartilage, improves metabolism, protects cartilage tissue from further damage and provides it with normal nutrition. Chondroitin sulfate neutralizes enzymes that damage cartilage tissue, stimulates collagen production, helps saturate cartilage with water, and also helps keep it inside. The effectiveness of chondroprotective agents is absent in the final stages of the disease because cartilage tissue is actually destroyed and cannot be recovered. The daily dose of glucosamine is 1500 mg and chondroitin sulfate is 1000 mg. In order to achieve the desired effect, the intake of these drugs must be strictly systematic. The course of treatment should be repeated 2-3 times a year. Both tools must be used in combination.

In pharmacies, glucosamine comes in the form of injections, powders, capsules, gels; chondroitin - in ampoules, tablets, ointments, gels. There are also combined preparations containing two chondroprotective agents. There are also so-called third-generation chondroprotective agents, which combine a chondroprotective agent with a non-steroidal anti-inflammatory drug.

Vasodilator

Vasodilators are prescribed to relieve spasm in small blood vessels, improve blood circulation and delivery of nutrients to the knee area, and eliminate pain in blood vessels. They are used with chondroprotective agents. If the knee joint disease is not accompanied by effusion, warm ointments, gels, and liquids are also recommended.

Hyaluronic acid

A second name for this drug is intra-articular fluid prosthesis. The composition of hyaluronic acid is very similar to that of intra-articular fluid. When the drug is injected into the joint, it forms a film that prevents the cartilage from rubbing against each other during movement. A course of hyaluronic acid treatment is prescribed only after the pain has been eliminated and the exacerbations have been eliminated.

physiotherapy

Exercise therapy sessions are only very useful and give good results when prescribed by a doctor and carried out under supervision with the advice of a specialist or trainer. Self-medication is harmful to health. Exercise therapy is used to further prevent the destruction of cartilage tissue, slow the development of stiffness, and relax muscle spasms that cause pain. It is contraindicated during exacerbations of exercise therapy. A special individual practice course, taking into account not only the stage of the disease and the condition of the cartilage, but also the age of the patient, should be formulated by a specialist in the field.

physiotherapy

As one of the methods of conservative therapy, physical therapy is used - electrophoresis, laser therapy, acupuncture, bikinetic current, UHF. The topical massage sessions also had positive results. Compressors based on dimethyl sulfoxide or bischlorophosphate, medical bile are widely used. Physical therapy methods work in several ways - they reduce pain, reduce inflammation, normalize metabolism within the joint and restore its usual function. The method and duration of the course of physical therapy is determined by the patient's medical history and should only be prescribed after a thorough diagnosis and study of the joint condition.

Patients need to strictly control their diet, as being overweight can put extra stress on the knee joint and accelerate the progression of the disease. Excessive physical activity is dangerous and should be avoided, but at the same time, exercise therapy is also necessary. Orthopedic surgeons recommend wearing comfortable shoes with special insoles and using canes to facilitate movement. Experts in the fields of rheumatology and orthopedics have developed many techniques for the treatment of knee osteoarthritis.

Physical therapy for pain relief includes:

  1. Medium-wave UV irradiation (SUV irradiation). Contact of the UV radiation with the skin of the knee continues until slight redness develops. A substance that reduces the sensitivity of nerve fibers is formed in the tissue, thereby achieving analgesic effect. The duration of the course of treatment is prescribed by the doctor according to the symptoms, frequency and intensity of pain. On average, the course of treatment is about 7-8 sessions.
  2. Local magnetic therapy is aimed at the full recovery of the patient's body. This process relieves inflammation, eliminates pain, and neutralizes muscle spasms. Effective for early stage knee joint disease. Sessions are usually limited to 20-25 procedures, each lasting about half an hour.
  3. Infrared laser therapy, low-intensity ultra-high frequency therapy, centimeter wave therapy (CMW therapy).
  4. Ultrasound, darsonvalization, therapeutic baths, interference therapy, are used to improve blood circulation in the joints.

Equally important is the treatment of hygienic resorts. This treatment is prescribed for dysmorphic and dystrophic osteoarthritis. These treatments, as well as those listed above, have their own contraindications, so the attending physician will carefully study the patient's medical history before recommending a hygienic approach to him.

Surgical treatment of knee joint disease

This is a fundamental treatment for knee arthropathy that partially or completely restores the function of the joint. The method and form of surgical intervention depends on the degree of joint damage and the patient's medical history.

Advanced arthropathy of the knee joint can only be treated by surgery - the knee joint is completely or partially replaced with an endoprosthesis. Surgical treatment not only improves health, but also restores the patient's ability to work in the final stages of knee disease. A significant disadvantage of surgery is that many believe that the use of exercise therapy, mechanical therapy, and other methods requires a long recovery period.

There are several types of surgery for knee osteoarthritis:

  1. Arthrodesis. The principle of the surgery is to immobilize the lower extremity in the most functional position for it, and to fix it in the area of the knee joint. Damaged cartilage is completely removed. This is a radical approach, used in extreme situations. The result is pain relief, but the patient is disabled for life.
  2. Arthroscopic debridement. This surgical intervention has temporary but long-lasting effects. It is mainly used in the second stage of disease development. During the procedure, the damaged part of the cartilage tissue is removed, thus eliminating the pain. The efficiency can be maintained for two to three years after operation.
  3. Internal prosthesis. The most popular treatment for this disease. The knee joint is completely or partially removed. In their place are endoprostheses made of ceramic, metal or plastic. As a result, the patient resumed motor activity and pain was eliminated. The effectiveness of the operation has been maintained for more than fifteen to twenty years.

recovery period

The recovery period after this type of surgery takes about three months. The purpose of rehabilitation is to:

  1. Recovery of athletic activity.
  2. Improve muscle and joint function.
  3. Provides protection for prosthetic limbs.

Drains are removed on the second or third postoperative day. Special preparations with cooling effect are used to relieve pain. It is recommended to start exercise activities immediately after removal of the drain. A week later, the patient was transferred to a rehabilitation center. A physical therapist monitors a patient's condition.

For some time after surgery (about a year), the patient still feels pain due to the implantation of the prosthesis. The older the patient, the longer the prosthesis implantation process. NSAIDs are used to reduce inflammation and reduce pain. Doctors sometimes prescribe hormonal medications that guarantee a steady effect.

The mandatory program is the course of exercise therapy. Lessons should be designed individually for each patient and strictly implemented on a daily basis. Increase physical activity gradually to avoid injury.

After discharge from the clinic, the patient must follow certain instructions regarding further lifestyle. Physical activity such as dance or yoga is allowed six months after surgery. Do not use loads that could damage the prosthesis (fast running, jumping, vigorous movements). It is not recommended to lift more than twenty-five kilograms after surgery. In the house where the patient will live, all handrails on stairs will need to be reinforced, showers will need to be equipped with handrails, and all chairs and other furniture will need to be carefully checked for accessibility. By following these simple tips, the prosthesis will last a long time.

Despite adherence to recommendations and prescriptions, postoperative knee arthropathy is most commonly observed after such surgical intervention (after approximately 2-3 years).

Prevention of knee joint disease

To avoid this disease, at-risk groups (athletes, the elderly, overweight people, corporate employees) must comply with certain requirements:

  1. Proper nutrition and weight loss. It is necessary to exclude harmful foods from your diet - fat, frying, alcohol, but it is best to consult a nutritionist who will individually help you choose the right diet.
  2. As you exercise, monitor the load on the joints and reduce if necessary.
  3. Monitor your own health and treat infectious diseases before they become chronic.
  4. Prompt and adequate treatment of spinal disorders, if any, and development of correct posture.
  5. Physical activity (biking, swimming, walking, special gymnastics for joints).
  6. No self-medication! Contact the clinic at the first symptoms of knee joint disease.
  7. Avoid stress and get a good night's sleep.
  8. Systematically boost your immunity (harden or take vitamins at least 2-3 times a year).
  9. Avoid hypothermia of the body, especially the lower extremities.

A healthy lifestyle and timely treatment are the best means to prevent knee joint disease.