Arthrosis of the joints ✔️: symptoms, causes, diagnosis and treatment

A person’s daily life is unthinkable without physical activity, and therefore diseases that lead to a decrease in it are perceived as especially painful at any age. Osteoarthritis of the knee joint, also called gonarthrosis, occupies a special place among such diseases. The knee joint is located lower than most others, and therefore experiences the greatest load. It can occur not only when walking, but also when sitting in an uncomfortable position.

Over 75% of elderly people complain of symptoms associated with gonarthrosis. In advanced cases, even moving around the apartment becomes difficult—to get to the kitchen, the patient needs crutches or the help of loved ones. Osteoarthritis of the knee joints is one of the 10 main causes of disability in Russia. However, the disease can be prevented at a young age - in the early stages its development can be significantly slowed down, the main thing is to learn in time how to treat osteoarthritis of the knee joint.

general information

Arthrosis is a chronic, long-term process that affects not only the joints. As it progresses, dystrophic and degenerative changes and auxiliary apparatus occur. In the process, the patient faces inflammation of the cartilage and bone tissue, joint capsule and periarticular bursa, as well as the muscles, ligaments and subcutaneous tissue in contact with them.

Regardless of the location, the pathological process follows a single pattern. First, in the thickness of the tissue, the balance between the processes of growth and destruction of cartilage is disturbed, and the balance shifts in favor of dystrophy and reverse development (degeneration). At this time, invisible changes occur in the microstructure of the cartilage, which leads to its thinning and cracking.

As the disease progresses, the joint loses its elasticity and becomes more dense. This reduces its ability to absorb shock; the rate of tissue damage is constantly increasing due to vibration and microtrauma during movements. The thinning of the cartilage layer provokes the active growth of bone structures, as a result of which spines and protrusions appear on the smooth surface of the joint - osteoarthritis develops. Movement becomes increasingly limited and painful. Spasms of the muscles surrounding the affected area develop, which aggravates the pain and deforms the limb.

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Traumatologist

A joint and ligament doctor who diagnoses and treats injuries is called a traumatologist. He represents a narrower orthopedic specialization, therefore, if necessary (mainly in small medical clinics), he can deal with the problems of inflammatory and degenerative-dystrophic pathology of the structures of the musculoskeletal system, with the exception of autoimmune rheumatoid diseases.

A specialized medical specialist treats injuries suffered on an outpatient basis or in a trauma hospital. Also, most public and private medical institutions have trauma centers where medical specialists provide urgent care. They work around the clock without holidays or weekends. In a trauma center, a primary diagnosis of the cause and nature of the injury is carried out using radiography, and first aid is provided.

In case of fractures or dislocations, it includes repositioning of fragments or reduction followed by immobilization (immobilization) of the limb. In case of severe injury requiring surgical treatment, the victim is hospitalized in a hospital.

Stages of the disease

Arthrosis of the joints develops gradually and in the process goes through three successive stages that determine the severity of the disease:

Stage 1: the pathology is not detected on X-ray or ultrasound, but the destruction processes have already started; the composition of the joint fluid changes, as a result of which the tissues receive fewer nutrients and become more sensitive; increased stress on the affected area causes inflammation (arthritis) and pain;
Stage 2 is characterized by active destruction of cartilage tissue, and bone spines and growths appear along the edges of the articular platform (the area of contact of surfaces); at this time, the pain becomes habitual, and the inflammatory processes become stronger and weaker; spasms of the muscles associated with the joint are periodically observed;
Stage 3: areas of destruction affect almost the entire surface of the cartilage, the articular area is deformed, the affected limb deviates from its axis; range of motion decreases and ligaments weaken and become short.

Some experts also distinguish stage IV of the development of arthrosis. It is characterized by almost complete immobility of the joint.

Classification of ACS

According to the Kosinski classification of ACS, three stages of the disease are distinguished according to radiological and clinical manifestations. They focus on the degree of narrowing and unevenness of the joint space, deformation of the articular surfaces, changes in the subchondral bone (osteosclerosis).

First stage of gonarthrosis

The changes are almost invisible. The joint space is normal or slightly narrowed, with isolated tiny osteophytes at the edge of the articular surfaces.

Clinically - mild short-term pain after significant fatigue, minimal impairment of knee function. Most do not perceive these symptoms as a pathology and do not seek medical help.

Second stage of gonarthrosis

The joint space is unevenly narrowed by 2-3 times. Maximum narrowing in places of maximum load (usually the inside of the joint). Along the edges of the articular surfaces there are large osteophytes, sclerosis of the endplate, and subchonar bone cysts. Moderate deformation of the bone epiphyses, disruption of the congruence of the articular surfaces.

Clinically - dysfunction of the knee in the form of limited movements, crunching, limping. Often there is slight local swelling and atrophy of the periarticular soft tissues.

Third stage of gonarthrosis

The intraarticular gap is barely noticeable or has disappeared. Many sharp massive osteophytes completely surround the articular surfaces. Gross deformation of the articulating surfaces (expansion and flattening), osteosclerosis of the epiphyses of the bones forming the joint, the presence of cysts. The joint is deviated from the vertical axis.

Clinically - visual deformation of the knee (thickening), forced position, immobility. Atrophy of all muscles of the lower limb, especially the quadriceps. Lameness, movement with the help of crutches, canes, walkers, constant excruciating pain. Patient's disability.

Kinds

Depending on the cause of the disease, primary and secondary arthrosis are distinguished. In the first case, the pathology occurs independently against the background of the complex influence of predisposing factors. The secondary form is a consequence of other diseases and is divided into the following groups:

joint damage resulting from metabolic disorders or endocrine diseases (gout, diabetes mellitus, acromegaly, hyperparathyroidism);
destruction associated with congenital pathologies (Paget's disease, congenital hip dislocation, scoliosis, hemophilia, etc.);
post-traumatic arthrosis, which arose against the background of fractures, cracks, necrotic processes or surgical operations, as well as due to the characteristics of the profession.

The most popular classification of osteoarthritis is depending on the location of the pathological process:

gonarthrosis: damage to the knee, one of the varieties of which is palletofemoral arthrosis - destruction of the joint between the femur and the patella);
arthrosis of the ankle joint: occurs against the background of heavy load and frequent injuries;
arthrosis of the foot joints: the big toe most often suffers at the junction with the foot; the lesion develops against the background of gout or hallux valgus;
shoulder arthrosis is characterized by damage to the shoulder and often occurs at a young age against the background of increased physical activity (loaders, athletes, construction workers);
coxarthrosis: damage to the hip joint; can be both unilateral and bilateral and is one of the common causes of disability in people over 50 years of age;
vertebral arthrosis: destruction of the cartilage discs between the vertebrae, most often affecting the cervical and lumbar spine;
arthrosis of the joints of the hand: the joints of the fingers are most often affected; women in menopause are especially susceptible to pathology;
arthrosis of the temporomandibular joint: it is quite rare, most often against the background of chronic inflammation due to malocclusion or improper prosthetics;
Arthrosis of the elbow joint: a rare form of the disease, most often associated with injuries to this area.

Rheumatologist

A doctor who specializes in joints and the heart is called a rheumatologist. The peculiarity of the specialization is that the specialist deals with a wide group of pathological processes, the development mechanism of which is associated with a violation of the functional state of the immune system, they are called rheumatoid diseases.

Typically, the triggering factor is a previous streptococcal infection, prolonged systematic exposure to the sun, the use of certain medications, as well as a genetic hereditary predisposition. In this case, immunocompetent cells produce antibodies to the body’s own tissues. Rheumatoid diseases occur with primary damage to the connective tissue of the structures of the heart and joints. The inflammatory process often develops symmetrically in large joints, so a specialist is also defined as a doctor for elbow joints and knees.

Diagnosis of the pathological process is carried out using modern imaging techniques, ECG (electrocardiogram), as well as laboratory tests to identify rheumatoid factors. Treatment of autoimmune pathology affecting the structures of the musculoskeletal system is predominantly conservative. It involves long-term (sometimes lifelong) use of hormonal anti-inflammatory medications.

Reasons for development

The main factor in the development of arthrosis is the discrepancy between the load experienced and the ability of the joint to withstand this load. Acute or chronic, this process inevitably leads to tissue destruction.

The list of reasons that increase the risk of developing arthrosis of any localization includes:

heredity;
endocrine pathology (diabetes mellitus);
injuries of the articular apparatus: bruises, dislocations, fractures or cracks of bones inside the joint capsule, complete or partial ruptures of ligaments, penetrating wounds;
regular increased load on the joints associated with the profession);
obesity;
hypothermia;
previous inflammatory diseases of the joints: acute arthritis, tuberculosis, etc.;
blood diseases in which bleeding into the joint often occurs (hemophilia);
sudden changes in hormonal levels (pregnancy, menopause);
local circulatory disorders due to atherosclerosis, varicose veins, thrombophlebitis, etc.;
autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, etc.);
connective tissue dysplasia (congenital pathology, accompanied, among other things, by excessive joint mobility);
congenital pathologies of the musculoskeletal system (flat feet, dysplasia or congenital dislocation of the hip joint, etc.);
age over 45-50 years (increased risks are associated with a decrease in collagen synthesis);
osteoporosis (bone loss);
chronic intoxication of the body (including salts of heavy metals, drugs, alcohol);
surgical interventions on joints.

Consequences and complications

Osteoarthritis of the knee joints develops very slowly, but if left untreated, this disease becomes the cause of serious and unpleasant complications:

severe deformation of the joint and leg in general (associated with changes in the configuration of the knee, as well as restructuring of the muscle frame and curvature of the bones);
shortening of the limb by grinding down the heads of the bones;
ankylosis: complete lack of movement in the affected knee;
damage to other parts of the musculoskeletal system due to improper load distribution (heel spur, arthrosis of the hip joint, pain in the spine).

To prevent these problems, it is important to undergo a timely examination by an orthopedist and follow his recommendations. Self-medication and addiction to folk remedies can cause a serious aggravation of the situation.

Symptoms

Symptoms of arthrosis practically do not depend on its cause and location, since changes in the joints follow the same scenario. The disease develops gradually and begins to manifest itself when the cartilage is quite seriously damaged.

One of the first signs of trouble is a crunching sound in the problem area when moving. It most often occurs when the knee or shoulder is affected. At the same time, a person may feel a slight decrease in mobility after prolonged inactivity, for example, in the morning.

When asked what symptoms appear with arthrosis, most patients name pain first. At first insignificant and weak, it gradually gains strength, preventing normal movement. Depending on the stage and location of the pathology, a person may feel:

starting pain: occurs during the first movements after prolonged inactivity of the joint and is associated with the formation of a thin film of destroyed tissue on the surface of the cartilage; after starting work, the film moves and the discomfort disappears;
pain during prolonged physical activity (standing, walking, running, etc.): appears due to a decrease in the shock-absorbing properties of the joint;
weather pain: provoked by low temperature, humidity, changes in atmospheric pressure;
night pain: associated with venous stagnation and increased blood pressure inside the bones;
joint blockade: sharp, severe pain associated with pinching of a piece of cartilage or bone located in the joint cavity.

As arthrosis develops, the symptoms become more noticeable, the patient notes the following signs:

increase in morning stiffness;
intensification and increase in duration of pain;
decreased mobility;
joint deformation due to bone growths;
deformation of bones and surrounding tissues: the process is clearly visible on the limbs and fingers, which become noticeably curved.

When inflammation occurs, the affected area swells, turns red and becomes hot to the touch. Pressing on it causes a sharp increase in pain.

Early symptoms

Try to be attentive to the signals that your body sends you, indicating a clear disorder in the knee joint. And the first of these alarm bells is a nagging, aching pain in this area of any intensity. If you experience such a symptom, go to the hospital immediately! Pain is a common sign of impaired metabolism in osteochondral tissues, deficiency of cartilage nutrition and its incipient destruction.

The first symptom is pain.

What other signs may most likely indicate the onset of development of degenerative-dystrophic processes in one of the main movable bone joints of the lower limb? So, the early manifestations of gonarthrosis of the knee joints include:

a feeling of slight stiffness and/or pain in the joint after a long walk, long physical activity, and after rest the disappearance of these symptoms;
stiffness of the knee (it can be combined with pain) after a long stay in a stationary state, for example, after sleep or a long stay in a sitting position, which is felt from the first steps and goes away on its own as soon as you move away;
mild or moderate crepitus of the joint, characterized by any sounds that the patient hears in the knee region during movement (crunching, creaking, clicking, crackling), however, this symptom is mainly common in the middle stage.

It is not recommended to prescribe medication for yourself, since treatment and preventive measures should be carried out by a highly qualified specialist based on diagnostic data, the etiology of the disease and the individual characteristics of the patient’s body. In addition, it is not enough to “extinguish” pain with common non-steroidal anti-inflammatory drugs; in treatment, it is extremely important to correctly develop the most effective treatment program. It involves a multi-complex individual approach, including a combination of exercise therapy with physiotherapeutic, medicinal, nutritional and massage techniques.

If your knee hurts, this does not always mean that the problem is there, so do not rush to apply ointments and take pills, but see a good doctor.

Without adequate comprehensive therapy, which is strongly recommended to begin as early as possible (ideally at stage 1), the disease will simply turn you into a frail and disabled person.

Tests and diagnostics

An orthopedic surgeon diagnoses arthrosis. He conducts a detailed interview with the patient to identify complaints and medical history. The doctor asks in detail about the time of the first signs and the speed of their development, previous injuries and illnesses, and the presence of similar problems in relatives.

A general blood test can reveal the inflammatory process that often accompanies arthrosis.

The main diagnostic method is radiography. The following signs are clearly visualized in the image:

narrowing of the joint space;
change in the contours of contacting bones;
impaired bone structure in the affected area;
bone growths (osteophytes);
curvature of the axis of a limb or finger;
subluxation of the joint.

For a more detailed diagnosis, the following may be prescribed:

computed tomography (CT);
magnetic resonance imaging (MRI);
Ultrasound of the joint;
arthroscopy (internal examination of the joint cavity using a camera inserted through a small puncture);
scintigraphy (assessment of the condition of bones and metabolism in them using the introduction of radiopharmaceuticals).

If a secondary nature of the disease is suspected, appropriate tests and consultations with specialists are prescribed.

What are the dangers of lack of treatment?

If treatment is ignored, the pathology will gradually destroy the hyaline cartilage covering the ends of the articular bones, which will cause compaction of the subcartilaginous areas, the formation of rough bone spines (osteophytes), narrowing of the joint space and pathological friction of bone surfaces against each other. Thus, the knee will undergo severe deformations, which will make moving excruciatingly painful and very difficult, since there will be a pronounced curvature of the bone axis and failure of flexion/extension functions. You can no longer do without a cane or crutches.

What's next? And then the pain syndrome will only intensify, in addition, it will become constant, even at rest. The muscle structures that should move the joint will undergo atrophy due to limited mobility of the leg. The neglected pathology will eventually lead to the fusion of the curved epiphyses of the articular bones and the complete ossification of the once mobile joint, that is, to its absolute blocking.

No non-invasive or minimally invasive methods, including all medications, even stem technologies, are completely ineffective in severe gonarthrosis, and sometimes even in its second stage. It’s better not to mention cellular technologies at all, because to date they have not proven their effectiveness in relation to osteochondral anatomical structures. The only remedy that is reliably capable of radically solving a complex medical problem is knee replacement, that is, replacing a dysfunctional one with an artificial implant.

Early diagnosis and timely prevention are the two best ways to combat the disease. There is no need to wait for anything if your knee is bothering you; it is better to quickly stop gonarthrosis than to allow it to destroy and bend your knee joints to such an extent that you cannot simply walk without assistance or crutches.

Yes, you will have meetings with a rheumatologist, orthopedist-traumatologist or neurologist with periodic regularity; you will be required to strictly adhere to each course of special therapy prescribed by a specialist, but this is the only way to prevent the progression of a dangerous disease and maintain freedom of movement for many years.

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Treatment of joint arthrosis

The choice of treatment for joint arthrosis depends on the cause of the disease, its stage and symptoms. In the arsenal of doctors there are:

medications;
non-drug treatment;
surgical techniques.

In addition, the patient is required to strictly follow a diet and adjust their lifestyle to minimize further damage to the joints.

Drug treatment

Prescribing medications for arthrosis has two main goals:

relieving pain and inflammation;
restoration of cartilage tissue or, at least, stopping further degeneration.

To alleviate the patient's condition, various types of drugs are used:

non-steroidal anti-inflammatory drugs: ibuprofen, ketorolac, diclofenac and their analogues in the form of tablets, injections, ointments or suppositories; they relieve pain and inflammation well;
hormones (corticosteroids): indicated for severe pain and, most often, injected directly into the joint cavity;
other analgesics, for example, antispasmodic (mydocalm): help reduce pain by relaxing muscles;

It is important to remember: all types of painkillers are used only to alleviate the patient’s condition. They do not affect the condition of cartilage, but when taken for a long time, they accelerate its destruction and cause serious side effects.

The main drugs for joint restoration today are chondroprotectors. They help saturate the cartilage with nutrients, stop degeneration and initiate cell growth processes. The most common remedy in this group is glucosamine and its analogues. They have an effect only at the early and middle stages of the disease and with regular long-term use.

Drugs that improve microcirculation in tissues and antienzyme agents help enhance the effect of chondroprotectors. The former provide a good supply of oxygen and nutrients to the affected area, while the latter slow down the processes of tissue destruction.

The doctor selects specific medications, their dosage and regimen.

Non-drug treatment

Non-drug treatment includes the following methods:

physiotherapy: shock wave therapy: destroys bone growths and stimulates blood circulation due to ultrasound;
automated electromyostimulation: exposure to electrical impulses to stimulate muscle contraction;
ultraphonophoresis: exposure to ultrasound combined with the use of medications;
ozone therapy: introduction of a special gas mixture into the joint capsule;

physiotherapy;

mechanotherapy: exercise therapy using exercise machines;

traction of joints to reduce stress;

massage.

Surgery

Most often, the help of a surgeon is required in severe stages of the disease. Depending on the localization of the pathological process and the degree of damage, the following may be prescribed:

puncture: puncture of the joint with removal of part of the fluid and, according to indications, administration of drugs;
corrective osteotomy: removal of part of the bone followed by fixation at a different angle to relieve the load on the joint;
endoprosthetics: replacement of a damaged joint with a prosthesis; used in extremely advanced cases.

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Features of the development of osteoarthritis of the knee joint

Osteoarthritis of the knee joint

is a common pathology that belongs to the category of the most common diseases that have an extremely negative impact on a person’s quality of life.

Degenerative-dystrophic processes most clearly manifest themselves in the form of physical dysfunction of the legs, accompanied by severe pain. Depending on how much the pathological process progresses, further forecasts for the course of the disease are made.

One of the disappointing forecasts is paralysis of the lower limbs. The seriousness of the consequences of pathological processes necessitates seeking qualified medical help.

Arthrosis in children

Arthrosis is considered a disease of older people, but it can also occur in children. The most common causes of pathology are:

congenital pathology of connective tissue;
severe injuries;
heredity;
metabolic disorders and functioning of the endocrine glands;
orthopedic disorders (flat feet, scoliosis, etc.);
overweight.

Children's arthrosis is rarely accompanied by severe symptoms: the pain is aching, and there is virtually no stiffness or limitation of function. Degenerative changes are detected on x-rays, MRI and ultrasound. The treatment process uses the same means as for adults. Maximum attention is paid to exercise therapy and physiotherapy, since they are especially effective at a young age. Without treatment, the disease sooner or later goes into an advanced stage with complete loss of mobility.

Manifestations of pathology

The main manifestation of the pathology is pain. It can be localized in large or small structures. If large joints (knees) hurt, the doctor may suspect the development of arthrosis or rheumatism. The doctor regards damage to small (inflammation) joints as rheumatoid arthritis.

Infectious pathology is often accompanied by a deterioration in the patient’s general condition with the development of intoxication of the body. The injuries suffered are characterized by acute symptoms with intense pain and dysfunction of the damaged structure. Since the manifestations can be different, the doctor determines joint diseases using additional objective research methods.

Diet

Diet is one of the most important factors in the treatment of arthrosis. If you are overweight, you need to reduce it to reduce the stress on your joints. In this case, a balanced diet with a calorie deficit is prescribed. Regardless of body mass index, doctors recommend completely avoiding:

fast carbohydrates (sugar, desserts, flour);
alcoholic drinks;
spices;
legumes;
strong tea and coffee;
excessively fatty and spicy foods.

Canned food and offal are not excluded, but are significantly limited, as is salt. An ideal diet for osteoarthritis includes:

lean meats;
fish and seafood;
eggs;
dairy products;
flaxseed and olive vegetable oils;
vegetables and fruits, a large amount of greens;
cereals in moderation, durum wheat pasta;
products with a high content of collagen (jellied meat, jellied meat, jelly).

Diet and general nutritional recommendations for arthrosis of the knee joint

A diet for arthrosis of the knee joint is necessary for patients with excess body weight. A low calorie diet and a wealth of nutrients will ensure weight loss and accelerate the recovery process of affected joints.

Nutrition for arthrosis of the knee joint should first of all be balanced. The daily diet should contain dishes enriched with beneficial vitamins and microelements necessary for the regeneration of joint tissues and maintaining the balance of the entire body.

It is recommended to give up not only bad habits (alcohol abuse and smoking), but also such dishes as:

store-bought semi-finished products;
fatty, spicy and overly salty foods;
sweet carbonated drinks.

For convenience and competent planning of the diet, when treating knee arthrosis, it is recommended to keep a food diary, which disciplines and helps facilitate the process of restructuring the usual lifestyle.

Prevention

Arthrosis is easier to prevent than to treat. To maintain healthy joints for many years, it is recommended:

to live an active lifestyle;
do exercises regularly and visit the pool;
eat right, consume enough omega-3 and collagen;
do not exceed the BMI norm;
wear comfortable shoes.

If the disease is diagnosed at an early stage, it is recommended to undergo regular spa treatment, as well as to exclude occupational risk factors: prolonged standing, heavy lifting, vibration.

General clinical recommendations

For osteoarthritis you can and should:

move more, alternating loads with rest;
regularly engage in exercise therapy; Swimming is a particular priority;
eat properly regularly;
avoid physical injury and prolonged stress - this reduces the risk of disease progression;
follow all doctor's orders.

It is forbidden:

lift weights, do hard physical work;
perform physical exercises when pain occurs;
be in a forced position for a long time, especially in a standing position;
allow excess weight to appear;
smoke a lot and drink alcohol too much.

Prevention

To prevent age-related degenerative-dystrophic disorders, you need to lead a healthy, active lifestyle. To prevent secondary osteoarthritis, all joint diseases and injuries must be carefully treated.

Treatment at the Energy of Health clinic

Medical orthopedists invite everyone to check the condition of the joints and, if necessary, begin treatment. We use modern effective techniques:

full-fledged drug therapy in accordance with indications;
physiotherapy, exercise therapy and massage;
diagnostic and therapeutic punctures of the joint with the introduction of a synovial fluid substitute or medications;
drug blockades for complete pain relief and other techniques.

You can view the full list of services on the website or by phone.

What does joint pain tell you?

During the initial diagnosis, the therapist will determine the nature and location of the pain. Of interest is the severity of pain at its peak. The specialist will ask what kind of pain you feel - superficial or deep, sharp or dull, burning or another nature. You will be asked to remember under what conditions the pain intensifies, how often it bothers you, and at what time of day it reminds you of itself.

Analyzing these and other factors will help the therapist determine which doctor to refer the patient to. After all, joint pain can be inflammatory or non-inflammatory. It can hinder movement in different ways and produce different accompanying symptoms.

Advantages of the clinic

“Health Energy” is a multidisciplinary medical center equipped in accordance with modern standards. We offer patients:

consultations with experienced doctors;
examination using high-quality diagnostic equipment;
individual approach to treatment selection;
regular monitoring and performance monitoring.

The joints of our body can withstand enormous loads, but there are situations when they need help. Don’t let arthrosis change your life, sign up for a consultation at Health Energy.

At-risk groups

Many people are susceptible to osteoarthritis of the knee, because no one can predict a knee injury in advance. This most often happens among professional athletes leading an active lifestyle: the likelihood of injury is very high, but since this category of people is accustomed to bruises and injuries, at first they do not pay attention to the pain until it becomes unbearable, due to why treatment of the joint is delayed.

In addition, elderly people are at risk of developing osteoarthritis. Any organ and any tissue in the body wears out over time. This happens with the cartilage of the knee joint; it thins out and becomes fragile, susceptible to damage from any blows or falls. Therefore, it is quite easy to develop this disease in old age. The main percentage of people suffering from arthrosis are women over 50 years old: the disease is often inherited, along the maternal line.

Get a consultation on MRI diagnostics. Consultation on the service does not oblige you to anything.

People over 40 years of age who are overweight and workers whose task is to carry heavy loads are also at risk. Since each knee bears half of the body's weight and load every day, excessive stress can damage the joint.