The joints of the human body withstand daily load, so they become susceptible to various kinds of destructive factors. Among the diseases of the joints, arthrosis is often found, and it affects both large and small joints. Arthrosis of the knee joint is degenerative-dystrophic damage to the knee joint, in which its motor activity is disturbed. In the absence of proper treatment, the disease can lead to disability.
Since the disease provokes characteristic deformations in joints, it is called deforming arthrosis of the knee joint, which rightly describes the typical characteristic of the pathology. The disease is chronic and is more often diagnosed in women, with excess weight and venous pathologies of the lower extremities, but there may be other causes. Due to age -related changes, people also arise in elderly people.
Young arthrosis can be provoked by injuries. As a result of degenerative-dystrophic changes, the cartilage softens, delays and is covered with cracks of various depths. Subsequently, he ceases to fulfill his function.
Reasons
Various causes lead to the appearance of deforming arthrosis of the knee joint. A traumatic factor is a common cause of occurrence. Post -traumatic arthrosis can develop due to the receipt of dislocation or fracture in the specified zone, as well as meniscus injuries. Typically, gonarthrosis of the knee joint appears in young people who are actively involved in sports, or in those people whose work is associated with increased mobility, lifting and weight transfer.
Few people know that such damage can be a consequence of treatment, when the injury itself is already cured, but during the long -term immobilization of the limbs there were circulatory disorders in this area. Because of this, gonarthrosis appeared.
Increased physical exertion on the knee is one of the leading factors in the appearance of the disease. Most often it affects athletes who have constant active loads on the knee. At a young age, arthrosis may not appear, usually rapid changes begin after the termination of physical activity.
There is also a risk of illness in those people who, even in adulthood, do not reduce the load on the joints. In such athletes, the risk of fractures and dislocations increases, microtraumas appear. Therefore, after forty years, doctors recommend that athletes reduce loads, switch to coaching work. Running and squats are best excluded, since it is these types of activity that most of all load the knee joint. Most often, one limb is affected and left -sided gonarthrosis or right -sided gonarthrosis occurs.
The removal of meniscus becomes an essential factor for the development of arthrosis of the knee joint. If for some reason the menisci were removed, then this in 90 percent of cases leads to the appearance of arthrosis-the so-called baking knee occurs, during which articular joints experience more friction than usual.
This is the case with arthroscopy of meniscus - a tear - which can become a trigger for arthrosis of the knee joint
The problem of excess weight is also relevant for people with arthrosis. Excess body weight creates unnecessary pressure on the joints. As a result, the cartilage itself is damaged, but the meniscus. And with a combination of overweight, acute arthrosis threatens varicose veins of the lower extremities.
The weak ligamentous apparatus in some patients is an innate feature, and sometimes the ligaments are affected by other diseases. One way or another, weak ligaments provoke increased mobility in the joint, which is why the articular surfaces are significantly abrasion. The consequences of weak ligaments can not be felt for a long time until patients experience the symptoms of true arthrosis.
Joint pathologies also lead to the development of the disease. Most often, arthrosis becomes the culprit of the occurrence of arthrosis - inflammation of the articular joints. With arthritis, typical signs are observed - a deterioration in the composition of the synovial fluid, pathological changes in cartilage, swelling, redness of soft tissues. Even after osteoarthritis, chronic processes lead to the appearance of arthrosis.
Violations of metabolic processes often lead to pathologies of the musculoskeletal system. Bones and joints do not receive nutrients and minerals, so necessary for tissue strength. With their lack of bone and cartilage surfaces are subject to destructive processes, therefore, even with a slight load, primary arthrosis appears.
Symptoms
Arthrosis of the knee joint is manifested by a complex of characteristics that are difficult not to notice. There are no signs only in the first degree of development of pathology, but the second and third degree gives clear symptoms of arthrosis of the knee joint:
- Pain is one of the key signs, which is not manifested by a rhinestone. It is interesting that with the development of arthrosis, the pain can not be felt even for several months or years until the disease is aggravated. Typically, the first pain signs are discomfort in physical exertion, walking or running, but it also manifests itself when a meniscus is pinched. In the second degree of arthrosis, the pain in the joint is felt stronger, and with the third degree of development, painful sensations appear even at rest. Attacks are aggravated even after short walks without a strong load on the joint, so patients try to spare their knees;
- Deformations - manifestations become increasingly pronounced in the third stage of development of arthrosis. The knee will maintain its usual shape, but looks slightly swollen, swollen. When arthritis is joined, the knee turns red, will become hot and painfully to the touch;
- Cryst with arthrosis appears in the second and third degree of development of the disease. Crispy sounds differ from healthy clicks, which can sometimes be heard when extending and bending the knee. With arthrosis, symptoms are characterized by a dry, rude sound, which occurs sharply and is accompanied by pain;
- Synovitis is the accumulation of a certain amount of liquid in the joint cavity. It is also contained there. But the accumulation of an excess amount leads to the development of a cyst - the baker cyst, which can be determined in the exposed position of the leg, is most noticeable;
- Limited mobility in the knee is a typical sign of pathology, since patients first try to protect themselves from pain consciously, and at a late stage of arthrosis, they cannot at all bend the limb. In the third degree of development, deforming osteoarthrosis of the knee joint (DOA) even leads to loss of movements. Patients adapt to move on bent legs, using the support products.
The degree of development
The arthrosis of the knee joint takes place in its development of three degrees.
With arthrosis of the 1st degree, painful pain and occurs only with active physical exertion on the knee joint. Already in the first extent, liquid in the cavity can accumulate, which in the second and third is already a cyst. With progression, pain occurs in the process of movement, but quickly pass. Externally, the deformation of the knee joint is invisible, so the diagnosis of arthrosis of the knee joint can be difficult.
Arthrosis pain appears even when the external signs of the disease are not noticeable
With a second degree disease, the damage to the cartilage tissue is more significant. If you take an x -ray, then the stage of bone growth is already noticeable on it. With any movement, acute sudden pain appears in the knee, but, returning to a convenient position, the knee no longer hurts. In the second stage of DOA, you can hear a crunch typical of arthrosis. When progressing, problems with extension and flexion of the knee are aggravated. Deformation becomes noticeable in appearance.
Osteoarthrosis of the knee joint of the third degree is characterized by a significant thinning of cartilage. Gradually, the cartilage is soaked so much that the bone is exposed in some areas. The X -ray picture shows a significant amount of osteophytes - bone growths, salts that appeared in the joint cavity. Externally, the changes are clearly visible, and the patient is concerned with constant pain. It is easy to make a diagnosis-there is enough visual examination and a retigen control is carried out.
With the progression of this degree, arthrosis can lead to a complete loss of functionality. In any degree of development of pathology, osteoarthritis of the knee joint can join.
Treatment
Conservative
A group of the most active drugs against arthrosis is non -steroidal anti -inflammatory drugs. These are primarily cyclooxygenase-2 inhibitors, they can perfectly relieve inflammation, swelling and contribute to the speedy recovery as possible. These drugs have significant restrictions, so they cannot be used without the recommendation of the doctor. For example, they are able to aggravate a stomach ulcer, heart disease, and urinary organs pathologies. Non -steroidal anti -inflammatory drugs are prohibited during pregnancy.
The second group of funds is chondroprotectors that improve the characteristics of cartilage. They are used for arthrosis to restore the correct structure of the cartilage, because in the process of resolution it loses very important components - chondroitin and glucosamine. Therefore, almost all chondroprotectors have both of these substances, but some drugs are one -component. With the help of these drugs, you can help the patient at the first and second stage of the development of the disease, but not in the third, when irreversible changes occurred.
In the course of conservative therapy, the doctor will give recommendations for nutrition. If a patient or patient has overweight, it is necessary to adhere to a diet to normalize weight. How to strengthen the stable weight - the doctor will also tell. It is also not recommended to eat a lot of salt, but it is better to fill the diet with calcium, vitamins and minerals. Jelly, jelly, will be useful.
Operational
The most common type of surgical intervention for arthrosis is arthroscopy, but other interventions are carried out. Treatment of arthrosis of the knee joint is usually carried out in the second and third degree, when conservative therapy no longer helps.
If necessary, minimally invasive intervention, for example, when accumulating a liquid in the knee joint, it is possible to do with a puncture. In the cavity of the knee joint, a puncture is made and excess fluid is pumped out. This method can be diagnosed with the disease, so it is simultaneously applied for treatment. The liquid is taken at the initial stage in a minimum amount, but this already significantly improves the well -being of patients. Then, after the study of biomaterial, another part is removed, and corticosteroids are introduced into the joint cavity.
Endoprosthetics is sometimes the only way out for patients with arthrosis of the third degree
Arthroscopy is most common. Through a small incision, several tools are introduced in the skin, which allow you to conduct a joint examination and the necessary manipulations in it. With the help of arthroscopy, you can remove particles of fabrics that are separated from the cartilage, but there is always a risk that secondary gonarthrosis will appear.
With severe damage, there is a need to carry out a periosemantial osteotomy. This is a larger effect on the joint, as a result of which it is slightly fed and installed at the right angle. After the operation, the rehabilitation is longer, but the effect lasts longer.
Significant destruction of the articular elements lead to complete immobilization of the limb. The joint does not fulfill its function, which means that it needs to be replaced and you need to do the operation. Endoprosthetics of the knee joint is an expensive operation, but one it makes it possible to return the movement to the patient in the limb. Various knee prostheses are installed - plastic, ceramic or metal. These are durable constructions that allow you to forget about the problem for several decades.
Physiotherapeutic
Physiotherapy methods can only be used when the acute period has passed and the patient is recovering.
Among the techniques are actively used:
- Ozonotherapy is the effect on the affected joint of the ozone, and the substance can be introduced in injection or applied as external treatment. This type of assistance to patients is very effective, therefore it is often used in the treatment of various pathologies, including arthrosis. Treatment makes it possible to activate blood circulation in the problem area, to achieve an anti -inflammatory and analgesic effect. At the same time, treatment with glucocorticoids is carried out;
- Kinesiotherapy - treatment is carried out using a special set of exercises. The load is formed taking into account individual data, and when performing exercises, special simulators are used that strengthen the joints. The difference between kinesiotherapy and physiotherapy exercises in active effects not only on the osteoarthritis of the knee, but also on the whole organism as a whole.
They use not only ozonotherapy and kinesiotherapy, but also physiotherapy exercises. Good results are given by copyright methods to eliminate the knee arthrosis - exercises in Bubnovsky, Evdokimenko, Dikul. In the course of exercises and after them, we need to wear a special knee pad - an orthosis, to strengthen the right or left knee joint.