Arthrosis of the knee joint is a degenerative-dystrophic pathology that leads to deformation and destruction of articular cartilage. Gradually the limb loses mobility. According to statistics, almost every third person on the planet suffers from arthrosis, and this number is not decreasing. Elderly people, especially those who are overweight, are at risk. After 65 years, arthrosis is diagnosed in 70-85% of cases of treatment for knee pain.
A rheumatologist helps maintain a patient’s quality of life with joint pathology.
Causes of arthrosis
- Destruction of the joint due to natural wear and tear (aging of the body).
- Hormonal disorders (menopause, endocrine diseases).
- Congenital defects of the musculoskeletal system.
- Injuries, surgery on the knee joint.
- Professional sports.
- Monotonous physical work with increased load on the knee joints.
- Excess body weight.
- Genetic predisposition.
- Autoimmune diseases.
MESSAGE FROM THE CHIEF DOCTOR:
Often, when examining a patient, doctors pay attention only to the bones, ligaments, and joints. At the same time, nothing is said about muscles
, the function of contraction of which plays a significant role in human life. Weakened muscles lead to thinning and deformed bones.
Unfortunately, common methods of therapy only aggravate the situation, leading to even more severe pain, muscle atrophy and a deterioration in the quality of life of patients.
Effective treatment is impossible to imagine without muscle restoration. Unique kinesitherapy technique
consists in a therapeutic effect, which implies, first of all, muscle activity during the methodical execution of a set of exercises on special simulators.
All exercises are performed by patients sitting or lying down, so there is no excessive stress on the joints and circulatory system, and our instructors-methodologists correct the technique of movements
and monitor the correct execution of actions.
Remember that diseases of the spine and joints are not a death sentence; if the patient wishes and the right approach to treatment, everything can be corrected!
Symptoms of the disease
Deforming arthrosis of the knee joint (gonarthrosis) develops slowly and is chronic. In the early stages, the disease does not cause pain: the person feels only discomfort and stiffness in the lower limb. Gradually, motor restrictions increase. Without adequate treatment, the knee becomes noticeably deformed. Motor functions are so impaired that it is difficult for a person to walk, sit down, or stand up. Deforming arthrosis progresses to the point of disability of the patient. To preserve the joint, you must consult a doctor when the first symptoms of pathology appear.
Depending on the severity, there are three degrees of arthrosis of the knee joint:
- 1st degree. Clinical manifestations of the disease are mild. Most patients do not pay attention to the symptoms and continue to lead their usual lifestyle. With grade 1 arthrosis, a person may feel discomfort in the knee after standing for a long time, intense walking, or physical activity. On an x-ray, a narrowing of the joint space is visible, osteophytes growing inside the joint are visible. If arthrosis is accidentally detected in the first stage, for example, during a medical examination, its development can be significantly slowed down and even stopped.
- 2nd degree. Pain with arthrosis of the knee joint becomes intense and difficult to ignore. The leg is especially bothersome early in the morning or in the evening. During the day, at rest, aching pain persists. Degenerative processes in the joint are reflected in the gait: the person begins to limp. When moving, a crunching sound is heard in the knee. Arthrosis of the 2nd degree can be complicated by a “joint mouse” - this is a condition in which a particle of bone or destroyed cartilage enters the synovial cavity. A foreign body causes severe pain that interferes with the movement of the limb. On examination, deformity of the knee is obvious. Possible inflammation and swelling. The x-ray shows a narrowed joint space and osteophytes, thickening of the bone.
- 3rd degree. A severe form of the disease that develops without treatment. Arthrosis of the 3rd degree is the cause of permanent disability. The pain in the knee is very severe, mobility is limited, the person cannot walk independently, every step is painful. The leg becomes deformed and begins to crunch heavily. On an x-ray, the doctor determines degeneration of cartilage tissue, destruction of ligaments, menisci, and proliferation of connective tissue.
Diagnosis of the disease
To make a diagnosis, radiography is the most informative, allowing one to identify all compensatory changes in bone tissue. This is flattening of the bone platform, compaction of the subchondral zone, and the formation of multiple osteophytes (bone spines) at the edges of the articular surfaces.
X-ray examination also helps to differentiate grade 2 osteoarthritis from other diseases, for example, the presence of tumors in the tibia and femur. Other tests are performed to confirm the diagnosis:
- MRI, CT for a more detailed assessment of the condition of cartilage, ligaments, tendons, blood vessels;
- arthroscopy with simultaneous collection of material for further morphological study.
The results of general clinical and biochemical tests allow differentiation of osteoarthritis from arthritis. To exclude inflammatory lesions of the knee, the levels of ESR, C-reactive protein, rheumatoid factor, sialic acids, antinuclear antibodies, and uric acid are determined.
Treatment of arthrosis of the knee joint
Therapy includes a set of procedures, medication, and recommendations for lifestyle changes. It is important not to try to treat arthrosis on your own. Often, patients in the first stages of the disease use painkillers and consult a doctor when the joint is already destroyed. The earlier treatment is started, the more effective it is.
Drug treatment
The doctor prescribes medications to relieve inflammation, swelling, reduce pain, activate metabolic processes and tissue regeneration. Medicines are selected individually.
The following medications can be taken:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) in the form of tablets, ointments, injections. The drugs relieve pain and swelling well, and improve the patient’s well-being.
- Glucocorticosteroids in the form of injections directly into the knee joint. Injections are indicated for severe cases of the disease, when the limb is practically immobilized.
- Painkiller blockades. They help cope with symptoms and alleviate the course of the disease.
- Chondroprotectors. The drugs help restore cartilage tissue and slow down the destruction of the joint.
Conservative treatment
Shock wave therapy
The method is non-invasive, helps remove salt deposits and improve the trophism of connective tissue. Physiotherapy improves blood circulation and has a beneficial effect on the elasticity of ligaments. Shock wave therapy is carried out in courses of 4-10 procedures.
Plasmolifting (PRP therapy)
The patient's own platelet-rich plasma is injected into the joint. A course of plasma lifting accelerates tissue regeneration.
Phonophoresis
The method combines the effects of ultrasound and medicinal ointments. Physiotherapy products, as a rule, have a complex composition and are prepared in a pharmacy according to a prescription. Ultrasound increases the penetrating ability of the active substance.
Massage
The procedure is contraindicated in the acute stage of arthrosis. When the inflammation is relieved and the pain is reduced, you can begin a massage course. Lymphatic drainage technique helps prevent the accumulation of synovial fluid. Massage also improves blood circulation in the knee and relieves muscle spasm. The procedure is most effective after performing special exercises for arthrosis of the knee joint.
Taking a bath
You can conduct the course at home as prescribed by a doctor or as part of a spa treatment. For arthrosis, radon, turpentine, and hydrogen sulfide baths are indicated. The procedures have a beneficial effect not only on the knees, but also on the hip and ankle joints.
Hirudotherapy
Medical leeches are placed around the deformed joint. The saliva of these creatures contains active substances that promote the restoration of cartilage. Hirudotherapy is usually prescribed for grade 1 and 2 arthrosis to relieve swelling and reduce pain.
Physiotherapy
Gymnastics for arthrosis of the knee joint is an essential part of complex treatment. Special exercises help maintain muscle tone in the sore limb and prevent congestion. They begin to do gymnastics in the morning, without getting out of bed. Then during the day, perform another 3-4 sets of exercises for several minutes. It is useful to supplement therapeutic exercises for arthrosis of the knee joint with swimming.
Surgery
Surgery is indicated for grade 2 and 3 arthrosis:
- Puncture. Using a syringe, the accumulated fluid is pumped out of the joint cavity. Internal pressure decreases, swelling and inflammation decrease, and mobility improves. The procedure is carried out on an outpatient basis, at the surgeon's appointment.
- Arthroscopy. The method is used for rehabilitation of the knee joint. Arthroscopy is performed through small punctures, so the operation is quite easy to tolerate and the recovery period is short.
- Corrective osteotomy. A classic method of treating deforming arthrosis, which consists of correcting the deformed anatomical axis of the lower limb, followed by fixation of the wedge-shaped resection of the bone with a titanium plate. After osteotomy, the patient requires rehabilitation for several months.
- Endoprosthetics. Installation of an artificial joint is performed in extreme cases of deforming arthrosis of the knee joint and allows the knee to return to its previous range of motion without pain. After total endoprosthetics, the patient requires long-term (about 2-3 months) rehabilitation.
Kinesitherapy
Reducing the progression of osteoarthritis can be achieved with an integrated approach to treatment, including medications, physiotherapy and rehabilitation methods, as well as exercise therapy.
One of the most modern types of physical therapy is kinesitherapy - movement treatment in which the patient actively participates in the healing process.
This helps to increase the patient’s motivation for regular exercise, strengthens self-confidence, and accelerates the cessation of the inflammatory process.
The course of treatment is best completed at the specialized Kinesitherapy Center “Doctor Osteochondrosis”. The advantages of treatment at the Center are obvious:
- The set of exercises is carried out under the guidance of an experienced physician-instructor, who adjusts the training program depending on the well-being and individual characteristics of the patient.
- The lesson plan is developed in consultation with the patient at a time convenient for him, which will allow him to combine them with study, work and other usual activities.
- The most modern technologies, equipment and simulators are used during treatment.
- Since 02/11/2020, the Center has been running a program of free classes “Moscow Longevity” for residents of the capital over 55 years of age.
- Before starting classes, you can get a free online consultation from a leading specialist at the Center.
Our Kinesitherapy Center operates in Zelenograd and the cities of Tver, Dubna and Klin. You can sign up for an in-person consultation by phone or through the online services of the Doctor Osteochondrosis Center for Kinesitherapy.