Articular 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 often acute and require qualified help.
Causes of the disease
In medicine, the disease is also called osteoarthritis, gonarthrosis, deforming osteoarthritis (DOA). Arthrosis is a general name for all degenerative-dystrophic diseases of the 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 bones and cartilage tissues, characterized by a gradual thinning of the cartilage in the articular articulation and the parallel formation of bone growths.
This becomes the body's response to increased friction and pressure. The most likely causes of the symptoms of gonarthrosis of the knee joint are as follows:
- Traumatic injuries of mild and severe forms with impaired mobility of the articular joint for a long period. Ligament rupture or severe bruising often provokes the development of an inflammatory process, which as a result provokes the appearance of gonarthrosis symptoms.
- Surgical intervention in the knee joint to eliminate any defect or foreign body.
- Prolonged and persistently excessive physical activity. This may be due to professional sport or specialty. Constant tension in the connection 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 in a conservative way, so doctors use minor surgical interventions, which negatively affects the cartilage tissue.
- Arthritis of different 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 deformation of the articular junction.
- Weakened immunity, which provokes 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.
- Severe autoimmune diseases.
- Frequent viral and catarrhal pathologies that provoke an inflammatory process and the development of degenerative-dystrophic changes.
- Excess weight and severe overweight also cause violations, since each extra kilogram increases the load on the articular joints by 10 times, which will certainly affect the cartilage tissue.
It is worth noting that all these reasons most often provoke some kind of secondary 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 wears away, which increases friction and stress. The result is gonarthrosis.
Types 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:
- 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.
- Signs of gonarthrosis of the left side of the knee joint by the nature of the clinical appearance do not differ from the right. But it is noted that this type often develops in overweight patients.
- Bilateral refers to severe forms, affects the entire cartilage and is characterized by severe pain.
It is noted that the last type is observed more often 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 progress and the development of complications, the second proceeds slowly, may not bother the patient for several years.
Clinical picture
The signs of gonarthrosis of the knee joint and its symptoms depend mainly 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:
- The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets more tired than usual, but writes it off as overwork or increased workload. He becomes lethargic, sleepy, and performance decreases significantly. Some patients have mild stiffness in the affected joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If an x-ray of the joint is taken at this stage, a narrowing of the joint space can be observed, which provokes a violation.
- In the next stage, discomfort and stiffness do not disappear, 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 disappears during the night, but reappears during the day. Since the pressure on the cartilage tissue increases due to its depletion, the patient often hears a characteristic crackle during movements. Flexion function is also impaired, as the patient is unable to fully flex the limb. At this stage, patients are usually referred to a specialist.
- 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 his condition. Bloating at this stage is constantly observed. In the joint bag, the amount of synovial fluid is significantly reduced, which increases the load and increases friction in the joint.
- The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets more tired than usual, but writes it off as overwork or increased workload. He becomes lethargic, sleepy, and performance decreases significantly. Some patients have mild stiffness in the affected joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If an x-ray of the joint is taken at this stage, a narrowing of the joint space can be observed, which provokes a violation.
- In the next stage, discomfort and stiffness do not disappear, 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 disappears during the night, but reappears during the day. Since the pressure on the cartilage tissue increases due to its depletion, the patient often hears a characteristic crackle during movements. Flexion function is also impaired, as the patient is unable to fully flex the limb. At this stage, patients are usually referred to a specialist.
- 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 his condition. Bloating at this stage is constantly observed. In the joint bag, the amount of synovial fluid is significantly reduced, which increases the load and increases friction in the joint.
As a rule, the pain disturbs the patient's sleep, he becomes nervous and feels constant fatigue. The appetite weakens or disappears completely, which causes a deterioration in the work of the digestive and cardiovascular systems.
Lack of normal sleep often leads to a nervous breakdown, especially in elderly patients or young people who are engaged in intensive physical work. Memory impairment and decreased concentration of attention are also the result of the patient's insufficient rest.
Usually, the pathology continues without fever, 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 bone growths develop in joints. They become the cause of deformation in the advanced stages of the pathological process.
The most dangerous complication of such violations will be the patient's complete immobilization and disability. As a rule, this happens in the absence of proper treatment or in the absence of symptoms of osteoarthritis of the knee for a long period.
Diagnostic methods
To make an accurate diagnosis, the doctor suggests that the patient undergo a complete examination. This is necessary not only to identify the cause, but also for the correct choice of drugs needed for therapy. The first step will be to interview the patient and identify possible 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 in 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 analysis. The discovery of traces of inflammation in him in the form of an increased level of leukocytes suggests that a process caused the development of the disorder.
A mandatory moment in the diagnosis will be an X-ray examination to accurately determine the degree of gonarthrosis. The photograph usually shows areas of complete cartilage destruction, as well as the number of osteophytes and their location. This helps to clarify the presumed diagnosis and to prescribe the appropriate treatment.
Sometimes it is impossible to see the exact picture and extent 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 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 in stages 1 and 2, when the formation of osteophytes has not yet begun. Therapy is mainly aimed at slowing the destruction of cartilage and restoring it. The classic scheme includes the use of the following drugs:
- Means from the group of sedatives that help relieve pain. Allow the patient to feel better, improve night sleep. In the hospital, injections are effective, which are given 1 to 3 times a day under the supervision of a specialist. It is not recommended to use funds for a long time, as they do not affect the course of the pathological process, but only relieve acute pain.
- Non-steroidal anti-inflammatory drugs. Funds are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of the pathology, relieve fever and local swelling and improve motor function. With regular intake for 7-10 days, a constant concentration of the active ingredients of the drug is observed in the patient's blood, which ensures a prolonged action. It is not recommended to take medicines for a long time, as they often negatively affect the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
- Chondroprotectors help restore cartilage in 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. Typically, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. A longer wait is possible with clear indications.
- Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. It helps relieve swelling and reduce pain. It is allowed to be used only in the hospital in the form of intramuscular or intravenous injections.
- Non-steroidal anti-inflammatory drugs. Funds are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of the pathology, relieve fever and local swelling and improve motor function. With regular intake for 7-10 days, a constant concentration of the active ingredients of the drug is observed in the patient's blood, which ensures a prolonged action. It is not recommended to take medicines for a long time, as they often negatively affect the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
- Chondroprotectors help restore cartilage in 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. Typically, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. A longer wait is possible with clear indications.
- Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. It helps relieve swelling and reduce pain. It is allowed to be used only in the hospital in the form of intramuscular or intravenous injections.
In addition to such funds, the patient is prescribed a course using an external agent in the form of an oil, cream or gel. The last option is the most preferred because it quickly penetrates into the joint cavity and has a therapeutic effect. They are allowed to be used within 14 days. It is not recommended to extend the course yourself, as the risk of complications increases.
In the most severe cases, the patient is injected directly into the joint cavity. You can use conventional analgesics, but the best therapeutic effect is achieved with the introduction of hyaluronic acid preparations. Injections are given once every 7 days. For the complete elimination of pain, 3-5 injections are enough. After such therapy, the effect continues for 6 months. The patient has the ability to move normally, and the pain syndrome almost completely disappears.
If none of the methods bring the expected result and the patient's condition worsens, a surgical operation is performed to replace the joint with a prosthesis. Replace the entire joint or its individual parts. This is usually indicated for arthrosis, provoked by a severe knee injury. The operation is performed under general anesthesia, and the recovery period is quite long and difficult.
Gonarthrosis is a serious degenerative-dystrophic pathology, which, if not treated properly, leads to disability of the patient. It is recommended to immediately consult a doctor when the first signs of a violation appear.