The deforming arthrosis of the knee joint is called gonartrosis in medicine-this is a degenerative-dystrophic disease in the hyalin cartilage of the knee, which covers the condyles of the femoral and tibia.
With arthrosis of the knee joint, the symptoms develop gradually, for years, the main manifestation of the disease is pain, stiffness during movement.It is gonarthrosis that is considered the most common disease among arthrosis of other joints, such as hip arthrosis, arthrosis of the elbow or shoulder joints, and phalanges of the fingers.
Most often, the disease affects faces over 40, women are most susceptible to arthrosis.Sometimes it develops in young people against the background of injury or in athletes from excessive loads.
The causes of arthrosis of the knee joint
There is no only reason for the development of such a disease as arthrosis of the knee joint, as a rule, this is a set of several provoking factors that can lead to such a violation with age.
The mechanisms of the occurrence of arthrosis in medicine are customary to divide the:
- Primary- which occurs in old age from the natural aging of the body tissues and against the background of some factors that provoke this disease, such as obesity (10% of cases), heredity, increased loads during life.
- Secondary- He owns 30% of all cases of arthrosis of the knee joint, usually it manifests itself after an injury, a fracture of the lower leg, rupture of the ligaments, and damage to the meniscus.Moreover, with such arthrosis of the knee joint, the symptoms of the disease in most cases appear after 3-4 years, but after a serious injury, it is possible after 2-3 months.
There are also frequent cases (7-8% of cases) of arthrosis, when a person after 40 years suddenly sharply begins physical activity, especially running and intense squats.It is at this age that age -related changes in the joints already arise and sharp loads can provoke rapid dystrophic and degenerative changes in the joints.
Also, another reason for the occurrence of arthrosis of the knee joint can be not only injuries, serious damage, but also concomitant diseases - rheumatoid, reactive or psoriatic arthritis, gout, ankylide disease, overweight and varicose veins.
Classes of professional sports or just constant heavy physical exertion, weight lifting or frequent long -standing stairs in old age - can be the causes of the development of arthrosis of the knee joint.The risk of gonarthrosis during spinal injuries, with neurological diseases, with diabetes and other metabolic disorders, as well as with genetic weakness of the ligamentous apparatus (3-5% of cases), also increases.
In 50-60% of cases, the cause of arthrosis of the knee joint is the spasm of the muscles of the front surface of the thigh.Until the patient’s knees ill, such a muscle spasm does not show himself for a very long time, and a person only experiences lower back pain, fatigue, and heaviness in his legs.If the straight and iliac-lumbar muscle of the thigh is in a constant spasmodic state, then with age, “tightening” of the knees gradually occurs, which does not allow them to move freely.
Belgian surgeons - orthopedists recently discovered an unexplored and previously unknown ligament ALL, which is located in the human knee, from now on the anterolate or anterolateral was assigned.
The fact is that in some patients, even after successful operations after injuries and ruptures of the knee ligament, the instability of the knee joint and pain during physical exertion were felt.
The studies for 4 years on 40 knee joints allowed to find this ligament itself, which was not known to medicine at all.The main function of this ligament is the rotational movement of the tibia and during the injury of which the doctors did not even know about its surgical correction during operations.
The degree of arthrosis of the knee joint
Most often, arthrosis develops in one of the knee joints and taking into account the intensity of pathological processes in medicine, 3 degrees of gonarthrosis are distinguished:
- The first - with this degree of deformation of the bones of the joint, but the initial manifestations are characterized by stupid periodic pains after the load on the joint.The swelling of the joint may be observed, insignificant and independently disappearing.
- Arthrosis of the 2nd degree of the knee joint - while the symptoms of arthrosis begin to increase significantly, pain already occur with slight physical exertion, when walking, lifting weights, they are more intense and prolonged, a crunch in the joint appears, and a moderate movement restriction is possible in the second degree.
- 3 degree of arthrosis of the knee joint is characterized by the maximum symptoms of arthrosis of the knee joint.The patient's gait from constant pain and noticeable joint deformation is disturbed, and the joint mobility is limited.The pain intensifies depending on weather conditions, often they are so strong that a person cannot find a convenient position, a dream is disturbed, and the restriction of the joint mobility can be minimized.
What is the arthrosis of the knee joint with?
Even before the blood test with arthritis, there are all signs of inflammation: edema, redness, hot skin above the affected joint, violation of its movements.Arthrosis is pain in combination with radiological changes.
Damage to meniscus and blockade of the knee joint
This disease develops very quickly, with unsuccessful movement after a crunch, an acute pain appears in the knee, which subsides in 15 minutes, the edges of the knee occur the next day.
Arthritis - rheumatoid, reactive, psoriatic, articular rheumatism, gout, illness of Bekhterev
You can distinguish arthrosis from arthritis by blood test, with arthrosis, a general blood test does not show any changes, but a blood test for arthritis almost always indicates an inflammatory process (except, for example, cases of damage to a small joint of the hand).
Inflammation of the knee ligament (tendonite)
Such pain happens more often in women after 40 years when descending from the stairs or weighting;It is difficult to extend the legs in the joint, swelling can be observed.
Vascular knees
These are symmetrical pains that are in both knees simultaneously and mainly in young people during accelerated bone growth, occur when weather change, with colds, physical activity, and describes this condition as “twists knees”.
Symptoms of arthrosis of the knee joint in stages
This insidious disease develops gradually.First, only slight discomfort begins to bother the patient, pain during movement, descent and climbing the stairs.Sometimes a person describes his sensations as a tightening in the popliteal region and a slight chinology of the joint.A distinctive feature of arthrosis of the knee joint is a symptom of starting pain, that is, when a person from a sedentary position rises sharply and begins movement, pain occurs at the first steps, but as it moves, it softens or disappears completely.However, after a significant load, it occurs again.
In the first degree, the knee externally is no different from the healthy, only sometimes patients notice a slight swelling in the affected area.There are also cases when the liquid accumulates in the knee joint, it swells, becomes spherical, then the synovitis develops, the movement of the joint is limited, the severity is felt.Why do such pains and changes in the joint occur?
In the first degree of arthrosis, blood circulation in the intraosseous small vessels occurs, which is supplied with nutrients with hyalin cartilage.For this reason, the surface of the cartilage over time becomes not smooth, dry, cracks appear on the surface of the cartilage.The sliding of the cartilage during movement should be soft, and unhindered, and in this case they cling to each other, such a constant state of microtrauma is thinning cartilage, so it loses its amortization properties.
As pathological processes develop, changes in bone structures occur, when the joint platform is flattened, osteophytes appear along the edges of the joint - spikes or, as bone growths call them.The joint capsule is reborn, the synovial shell wrinkles, the joint fluid thickens.All this leads to an even more significant reduction in the supply of nutrition to the cartilage and degeneration begins to accelerate.
Therefore, with the 2nd degree of arthrosis of the knee joint, the symptoms are enhanced, the pain is localized more often on the anticipated side of the joint and occur even with weak loads, rest gives relief, but the movement again causes severe pain.
The mobility of the joint is also reduced, when trying to bend the leg, a sharp pain occurs, when moving, a rough crunch is heard.Synovites are already observed much more often than at the beginning of the disease, the fluid accumulates in larger quantities, the joint changes its configuration, it becomes expanded as it were.
With arthrosis of the knee joint of the 3rd degree, significant bone deformation occurs, they, as it were, are pressed into each other, the cartilage is almost absent, the restriction of the joint increases.The pains concern the patient and at night, and at rest, and when walking, bending or straightening the joint becomes problematic.The joint is deformed, the legs become X or about a figurative shape, the gait of the passing, unstable, often in severe cases, the patient needs crutches or canes.
Diagnosis and treatment of arthrosis
At the first degree of arthrosis, such a diagnosis is impossible to establish on a normal examination.At 2-3 degrees, the deformation of bones and joints, a change in the axis of the extremities, the stiffness of movement, the crunch is heard, and swelling, swelling, swelling are noticeable.
To date, in addition to standard radiography, modern methods of MRI and CT are used to diagnose arthrosis of the knee joint, which allow you to more thoroughly consider pathological changes in soft tissues and study violations of bone structures.
The treatment of this disease is generally a complex of procedures and drug therapy.Orthopeders prescribe physiotherapy, massage, therapeutic gymnastics, mud.
Drug treatment includes the prescription of chondroprotectors, drugs filling the synovial fluid.Sometimes the introduction of steroid hormones is intrastrostal.Sanatorium treatment is also indicated for patients.With the ineffectiveness of the treatment, if the patient of young age and arthrosis with severe pain and traffic restriction, then the joint endoprosthetics is possible with the subsequent rehabilitation period within 3-6 months.