Knee osteoarthritis: causes, signs and symptoms.

Joint 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 acute and require qualified assistance.

Causes of the disease

In medicine, the disease is also called osteoarthritis, gonarthrosis, osteoarthritis deformans (DOA). Arthrosis is a generalized name for all degenerative-dystrophic diseases of 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.

The pathology consists of degenerative-dystrophic changes in the 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 the symptoms of gonarthrosis of the knee joint are the following:

• Traumatic injuries of mild and severe forms with reduced mobility of the articular joint for a long period. Rupture of ligaments 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 remove any defect or foreign body.
• Prolonged and excessive physical activity on a continuous basis. This may be due to professional or specialty sports. Constant tension in the connecting 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 joint cavity. As a rule, it is difficult to get rid of such a pathology conservatively, so doctors resort to minor surgical intervention, which negatively affects cartilage tissue.
• Arthritis of various forms and severity. In this case, the inflammatory process is pronounced, continues 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 joint deformity.
• Weakened immunity, which causes 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) often become a predisposing factor for the appearance of signs of pathology.
• Serious 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 additional kilogram increases the load on the articular joints by 10 times, which will undoubtedly affect the cartilage tissue.

It is worth noting that all these reasons often provoke a secondary type of violation. There is also a primary one, which differs in that the disease becomes a consequence of the body's natural aging process. Bone and cartilage tissue wear down, increasing friction and stress. The result is gonarthrosis.

Varieties of pathology.

There are several types of pathological conditions, each of which has its own characteristics. Depending on how the joint is affected, the following types of disorders are distinguished:

1. 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.
2. Signs of gonarthrosis of the left side of the knee joint by the nature of the clinical picture do not differ from the right side. But it is observed that this type often develops in overweight patients.
3. 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 seen 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 progresses slowly, it may not bother 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:

1. The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient becomes more tired than usual, but dismisses this as overwork or increased workload. He becomes lethargic, drowsy, and performance is drastically reduced. Some patients have mild stiffness in the diseased joint when they move, 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, a narrowing of the joint space can be noted, which provokes a violation.
2. At the next stage, the discomfort and stiffness do not go away, 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 goes away at night but returns during the day. Since the pressure on the cartilaginous tissue increases due to its depletion, the patient often hears a characteristic crunch during movements. Flexion function is also affected, as the patient cannot fully bend the limb. At this stage, patients usually see a specialist.
3. The third stage is the most severe and is characterized by a pronounced 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 her condition. Swelling 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 on the joint.

4. The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient becomes more tired than usual, but dismisses this as overwork or increased workload. He becomes lethargic, drowsy, and performance is drastically reduced. Some patients have mild stiffness in the diseased joint when they move, 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, a narrowing of the joint space can be noted, which provokes a violation.
5. At the next stage, the discomfort and stiffness do not go away, 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 goes away at night but returns during the day. Since the pressure on the cartilaginous tissue increases due to its depletion, the patient often hears a characteristic crunch during movements. Flexion function is also affected, as the patient cannot fully bend the limb. At this stage, patients usually see a specialist.
6. The third stage is the most severe and is characterized by a pronounced 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 her condition. Swelling 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 on the joint.

As a rule, pain disturbs the patient's sleep, he becomes irritable and feels constant fatigue. Appetite weakens or disappears completely, which causes a deterioration in the work of the digestive and cardiovascular systems.

Normal sleep deprivation often leads to a nervous breakdown, especially in elderly or young patients who are engaged in heavy physical labor. Memory impairment and decreased 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 bony growths develop in the joint. They become the cause of deformation in 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 time.

Diagnostic methods

To accurately diagnose, the doctor suggests that the patient undergo a comprehensive examination. This is necessary not only to identify the cause, but also for the correct selection of the necessary drugs 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 may become a predisposing factor. After that, the patient donates blood for laboratory tests. The detection of traces of inflammation 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 to accurately determine the degree of gonarthrosis. The image usually shows areas of complete cartilage destruction, 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 image and degree of joint damage 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 enough to get a complete picture of the disease.

medical therapy

Conservative treatment of the pathological condition is possible only at stages 1 and 2, when the formation of osteophytes has not yet begun. The therapy is primarily aimed at slowing down the destruction of cartilage and its restoration. The classic scheme involves the use of the following drugs:

1. Means from the group of analgesics that help relieve pain. Let the patient feel better, improve night sleep. In a hospital, injections are effective, which are carried out 1-3 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.
2. Non-steroidal anti-inflammatory drugs. Means are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of 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 prolonged action. It is not recommended to take medications for a long time, since they often negatively affect the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
3. Chondroprotectors help restore the cartilage of 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. A course of 8-12 weeks with regular visits to a specialist for improvement is usually prescribed. A longer reception is possible with clear indications.
4. 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 be used only in a hospital in the form of intramuscular or intravenous injections.
5. Non-steroidal anti-inflammatory drugs. Means are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of 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 prolonged action. It is not recommended to take medications for a long time, since they often negatively affect the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
6. Chondroprotectors help restore the cartilage of 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. A course of 8-12 weeks with regular visits to a specialist for improvement is usually prescribed. A longer reception is possible with clear indications.
7. 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 be used only in a hospital in the form of intramuscular or intravenous injections.

In addition to such funds, the patient is prescribed a course with an external agent in the form of an ointment, cream or gel. The latter option is the most preferable, because it quickly penetrates into the joint cavity and has a therapeutic effect. It is allowed to use within 14 days. Extending the course on your own is not recommended, as it increases the risk of complications.

In the most severe cases, the patient is injected directly into the joint cavity. You can handle conventional painkillers, but the best therapeutic effect is achieved with the introduction of hyaluronic acid preparations. Injections are made 1 time in 7 days. For the 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 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 gasket or its individual parts. It is usually indicated for osteoarthritis, caused by a serious injury to the knee. The operation is performed under general anesthesia and the recovery period is quite long and difficult.

Gonarthrosis is a serious degenerative-dystrophic pathology that, if not treated properly, leads to the patient's disability. It is recommended that you immediately consult a doctor at the first signs of a violation.