All about osteoarthritis of the knee joint: what it is, symptoms, causes, treatment, prevention

Arthrosis, gonarthrosis, arthrosis are synonymous terms that define the same disease: deforming changes in the cartilage tissue of the knee joint.

The human knee joint is made up of three bones: the femur, tibia and patella. At the point of contact with each other, these bones are covered with cartilage tissue, which ensures smooth sliding of the surfaces between them.

Over time, these cartilages become thinner, losing flexibility and elasticity. The cartilage is nourished by the synovial fluid; the cushioning properties of the joint depend on the quantity and quality of this fluid.

Early symptoms and signs

• It most often appears in people between the ages of 45 and 50. This disease is typical for both men and women, but the "weaker sex" suffers from this ailment much more often.
• At the onset of the disease, the patient feels tolerable pain in the knee joint area, and over time, severe pain appears.
• The intensity of the pain changes: with movement, physical activity, it becomes stronger, at rest - the pain recedes.

If you don't pay attention to these symptoms of an approaching disease in time, the disease begins to progress and, in severe cases, leads to disability.

When contacting a doctor, the diagnosis of osteoarthritis is clarified using X-rays. The images show the narrowing of the joint space from inside or outside the joint. But over time, the pathological process captures the entire joint. And along the edges of the articular surface, osteophytes are visible - bone growths.

The main signs of osteoarthritis of the knee joint:

• During the day, the pain intensifies; during the night's rest, the pain subsides. But if venous insufficiency is present, the dull pains persist throughout the night.
• Muscle tension in the joint area
• When walking, a creak is heard in the knee joint

• In severe cases of the disease, deformation and swelling of the affected joint, an increase in its volume are observed
• On palpation, the joint is painful
• When trying to move the knee brace, the pain increases
• In the advanced stage of the disease, muscle shortening occurs and the patient cannot put the leg in the correct position
• If left untreated, joint mobility decreases or is completely lost

What is patellofemoral knee osteoarthritis?

Very often at the doctor you can hear the diagnosis "patellofemoral arthrosis" - what is it? Indeed, in the international classification of diseases, such arthrosis is absent. Few people know that osteoarthritis of the knee joint begins with the development of patellofemoral syndrome.

This syndrome occurs when a part of the body is subjected to regular overuse or repeated injury. That is, patellofemoral osteoarthritis is the same as in patellofemoral syndrome.

The main causes of the disease are:

• congenital and acquired deformities of the lower limbs;
• various anomalies in the development of the patella;
• regular overload of the knee joint (for example, in athletes).

Patellofemoral arthrosis of the knee joint has the following clinical manifestations: pain in the area of the anterior side of the knee joint, which increases significantly with physical exertion (running, jumping, climbing and descending stairs, various squats). The pain may also increase when the patient sits with his legs bent under him. The patient may feel a sensation of tension and stiffness in the knee, both inside and in the front of the knee.

Patellofemoral syndrome is diagnosed clinically, no further studies are usually needed.

This disease, as a rule, does not require special treatment. However, to reduce pain and develop undesirable consequences (patella instability, deformation of the knee joint, accumulation of inflammatory exudate), the following procedures are required:

• decrease in physical activity. This does not mean that the patient will have to lead a passive lifestyle, only the activity level should not be painful;
• using a special bandage that is worn on the knee joint area during exercise or stress, thereby supporting and fixing the patella;
• with a pronounced pain syndrome, glucocorticosteroids and anesthetics are injected into the painful areas of the joint by precise injection, which relieves pain and helps to avoid the use of anti-inflammatory drugs in the future.

If patellofemoral osteoarthritis has already led to complications or is accompanied by other degenerative-dystrophic pathologies in the knee joint, therapy is carried out according to the treatment regimen for osteoarthritis of the knee joint.

The reasons

• An occupational disease of athletes who experience increased stress on the knee joints. Athletes suffer from injuries and microtrauma of the joints, bruises and ruptures of the ligaments. After retiring from sports, the muscle structure weakens, which leads to the progression of the disease.
• Greater life expectancy and greater physical activity in middle-aged people
• Increased physical activity on the knee joint in people who spend the working day "standing"
• Genetic predisposition
• Congenital diseases of the joints and bones
• Lack of collagen
• Knee injury
• Excess weight which puts more stress on the knee joints
• Acquired joint diseases
• Knee surgery

To obtain positive treatment results, it is necessary to conduct a clinical and radiological examination, which reveals several stages of the disease:

• Osteoarthritis of the knee joint 1 degree. . . There is a slight narrowing of the joint space, the edges of the surface are slightly sharp, a slight restriction of movement. During the arthroscopic examination, the doctor probes the softening of the cartilage.
• 2nd degree knee joint arthrosischaracterized by a significant limitation in the movement of the knee joint, a strong crunch. The images clearly show osteophytes and a 2-3 fold narrowing of the joint space. Small cracks are observed on the surface of the joint.
• Grade 3 of osteoarthritis of the knee- this is already a complete restriction in movement, when deformation of the joint has occurred, deformation and compaction, osteophytes and cysts are observed on the surface of the joint. There were changes in the cartilage tissue throughout its thickness.
• Grade 4 of knee osteoarthritis- arthroscopy shows the complete absence of cartilage tissue.

Pharmacological treatment

In the complex treatment of arthrosis of the knee joint, drug therapy occupies an important place. Combining it with physiotherapy procedures, therapeutic exercises and manual therapy, excellent results can be obtained, up to the restoration of limb functionality.

When osteoarthritis of the knee joint is diagnosed, drug treatment helps to eliminate pain, normalizes blood circulation in the problem area, improves metabolism and nutrition of cartilage, activates recovery processes and increases joint mobility.

Since it is impossible to apply other therapeutic methods against the background of acute pain sensations, therefore, first of all, the patient is prescribed painkillers and anti-inflammatory drugs. However, it is not recommended to use such funds for a long time, because, in addition to side effects (most often this is a negative effect on the digestive system), they can contribute to dehydration and further destruction of cartilage tissue.

Chondroprotectors are used to restore cartilage nutrition, regenerate the cartilage plate and improve the quality of synovial fluid.. . . Drugs of this group are injected directly into the aching joint and are the safest for the patient. Immediately falling into the affected area, chondroprotectors save the joint from destruction and help restore its functions. One of the disadvantages of this method is the long wait for the result: the patient can notice an improvement only after a few months. Also, it is not recommended to take chondroprotectors if the disease is in the third stage and the joint is almost completely destroyed.

Various ointments and creams are used to reduce pain, relieve swelling and somewhat improve joint mobility.Various heating agents are useful for relaxing ligaments and muscles, improving blood circulation and speeding up the metabolism of the joint. But they cannot be used in the presence of inflammation, in which case it is proven that they use non-steroidal anti-inflammatory gels and ointments.

Tablets should not be neglected: they have penetrating abilities, improve blood circulation, have anesthetic and anti-inflammatory effects and accelerate metabolic processes in the cartilage.

Therefore, a visit to the doctor should not be delayed for people who suspect the presence of a disease or arthrosis of the knee joint is found: drug treatment, started in a timely and correctly selected manner, can save thejoint and help avoid surgery.

Medicines for the treatment of osteoarthritis of the knee joint

Treatment of osteoarthritis of the knee is never complete without the use of drugs.

Drug therapy is mainly aimed at eliminating inflammation and pain, improving local blood circulation and nutrition of joint cartilage, activating metabolic processes and restoring joint mobility.

What drugs are prescribed for osteoarthritis of the knee joint?

1. For the successful treatment of the disease, you should initially relieve pain and eliminate the inflammatory process. Non-steroidal anti-inflammatory drugs are used for this. However, you should not get carried away with these funds: with prolonged use, they tend to mask the true clinical picture of the disease.
2. To restore the cartilage surface of the joints, restore their structure, nourish the cartilage and improve the production of intra-articular fluid, chondroprotectors are used. The action of these drugs is very slow, therefore, before the patient notices a real improvement, he will need to undergo 2-3 courses of treatment with chondroprotectors, which will take about a year.
3. To improve the general condition of the patient and relieve pain, in combination with other drugs, gels and ointments can be used. If the course of arthrosis is accompanied by synovitis, preference is given to ointments based on non-steroidal anti-inflammatory substances.
4. Intra-articular injections are used to provide emergency care for osteoarthritis. The most commonly injected corticosteroids or hyaluronic acid.
5. For local treatment, tablets with drugs are prescribed: dimethyl sulfoxide, bischofite and medical bile. Dimethyl sulfoxide has the ability to penetrate skin barriers, that is, its action is directed directly to the site of inflammation. This substance has analgesic, anti-inflammatory, absorbent properties and improves metabolism in the area of its application. Bischofite - a derivative of oil - also has an anti-inflammatory effect on the affected joint, gives a warming effect. Medical bile has the same properties as dimethyl sulfoxide with bischofite, but its use is limited by some contraindications. Medical bile should not be taken by patients with pustular skin diseases, elevated body temperature and inflammation of the lymph nodes.

Before starting any drug for osteoarthritis of the knee joint, it is necessary to consult a doctor, discuss the dosage, features of administration and the duration of the course of treatment.

Injections in the knee joint for osteoarthritis

Intra-articular injections are one of the highly effective methods for treating osteoarthritis of the knee joint. This rather expensive procedure significantly reduces pain and inflammation, and new modern drugs not only improve the general condition of the patient, but also treat the affected cartilage tissue.

Injections into the knee joint for osteoarthritis are a rather difficult procedure, therefore, you should consult a doctor, even if the patient knows which drugs need to be injected and in what quantity.

For intra-articular injections, the following drugs are often prescribed:

1. Corticosteroid hormones. These are the most common remedies, since the effect after their introduction is achieved in a few minutes. However, by relieving inflammation and pain, corticosteroids negatively affect the joint itself: cartilage tissue remains degenerative, in addition, drugs in this group cause blood vessels to narrow, which further destroys joint tissues. Therefore, the use of corticosteroid hormones is justified only in the case of unbearable pain in the last stages of arthrosis. The injection can be repeated no more than once every two weeks.
2. Chondroprotectors and enzymes. Unlike hormones, they do not reduce inflammation, so administration is meaningless in the presence of joint swelling. But they have a regenerative effect, partially restore cartilage tissue. The use of such drugs is particularly effective in the initial stages of osteoarthritis. The course of treatment is 5-10 injections.
3. Hyaluronic acid. A very effective, but at the same time expensive drug. Its effectiveness lies in the fact that the acid itself is similar in composition to the natural lubrication of the joint. After the introduction of drugs with hyaluronic acid into the knee, the friction of the affected joint surfaces decreases and the mobility of the knee improves. Such injections are very effective in the initial stage of arthrosis, a slightly lower effect is observed in the second stage, and with arthrosis of the third knee joint, such drugs only briefly relieve the patient's condition. The course of treatment usually includes three to four injections once a year.

Injections into the knee joint for osteoarthritis are strictly contraindicated in the following cases:

• infection of the skin or subcutaneous tissue in the intended injection area;
• sepsis;
• infectious arthritis;
• haemophilia;
• the presence of a viral infection;
• lack of result from previous injections;
• individual intolerance to the drug.

It is also unacceptable to carry out intra-articular injections for prophylactic purposes.

Orthopedic knee pads for osteoarthritis of the knee joint

When treating arthrosis of the knee joint, to prevent various injuries, as well as to support damaged tissues and relieve stress from the joint, knee pads are used.

An orthopedic knee brace is essentially the same as an elastic bandage. However, compared to the latter, the knee brace has its advantages: it does not need to be bandaged several times a day, it will not slip or dangle, a properly fitted knee brace will not squeeze the leg and cause swelling and other unpleasant consequences of prolonged squeezing.

Orthopedic knee pads for osteoarthritis of the knee joint perform the following functions:

• reduce inflammation and pain;
• relieve swelling;
• relieve stiffness and tension;
• normalize blood circulation;
• facilitate the free movement of the joint.

When choosing an orthopedic knee brace, you need to pay attention to the following features:

1. Knee brace type - is selected based on the severity of pain. There are these types of knee pads:
   • closed - used when it is impossible to determine the localization of pain;
   • open with adjustable tension - used during rehabilitation and for minor pain;
   • open with spiral stiffening ribs - for pain when climbing stairs, etc. ;
   • articulated - for different types of pain;
   • to support the tendons - used if pain is localized under the kneecap.
2. The material from which the toggle is made is of great importance, since not only the degree of fastening, but also the intensity of the heating effect depends on it. Modern knee pads are made from cotton, lycra, nylon, neoprene, spandex, camel and dog hair.
3. The size of the knee brace, which is calculated individually for each patient.

The doctor will help determine the parameters of the future purchase: he will not only select the optimal size and type of knee brace for the patient, but also advise which material will be the most effective.

Orthopedic knee pads for osteoarthritis can be purchased at a pharmacy or in a specialized medical equipment store, its price is quite acceptable. You should be careful with such purchases at non-specialized outlets or from dubious firms, since you can easily buy a fake, which, if it does not harm, will certainly not help.

Proper nutrition

Nutritionists have been studying the nutritional characteristics of different peoples for many years. By comparing national cuisines, scientists are trying to understand the influence of people's culinary preferences on the onset of certain diseases. This type of research has been conducted many times in relation to such a common disease as osteoarthritis of the knee joint.

Many theories have been advanced, many different hypotheses have been made. For example, it was once thought that the use of tomatoes contributed to the development of the disease, then it was suggested that table salt was "to blame" for the onset of arthrosis.

In the twentieth century, the situation with the development of the disease has noticeably deteriorated.

Proper nutrition is the key to joint health.

To prevent the development of the disease, it is necessary to understand that nutrition plays a key role in osteoarthritis of the knee joint. From the diet, the consumption of meat products belonging to the fast food segment should be minimized. These products are:

• semi-finished products based on meat processing waste: sausages, sausages, sausages of all kinds, etc.
• smoked meats sold in stores (most often this type of product is prepared using chemistry and not in smoked products).
• ready-made meat - ham, bacon (manufacturers in this case do not hesitate to use flavor enhancers and dyes).
• Fast food.

Of course, not all people are able to give up the aforementioned food items. Many over the years have developed the habit of indulging in smoked sausage sandwiches or boiled sausages in the morning. In this case we advise you to buy a piece of meat on the market, bake it in the oven with the spices, cut it and then use it as a base for sandwiches. This type of "fast food" will not harm the body.

Thus, we found that it is better to refuse semi-finished products, smoked meats and fast food. But what about meat if it is syringed?

The ideal option, of course, is to buy meat from trusted suppliers, but in urban conditions this advice is impractical.

In this regard, it is necessary to use such cooking methods so as to destroy as many harmful chemical compounds as possible. Sometimes the use of only this factor made it possible to achieve an excellent effect in the fight against osteoarthritis.

How to properly cook food for osteoarthritis of the knee joint

It should be remembered that nutrition for osteoarthritis of the knee joint should not be saturated with fat.

Therefore, when preparing food, it is necessary to cut the visible fat from the meat and remove the skin from the poultry. It is in the fat that the greatest amount of harmful substances is concentrated.

Boiling, stewing, baking and steaming are the healthiest ways to prepare food.

With osteoarthritis of the knee joint, jellied and jellied meat should not be eaten. There is an opinion from the "grandma in the yard said" series that these dishes are good for the joints, but that's not the case. A person with osteoarthritis will only get worse from high cholesterol levels.

Meat broths and soups should be consumed as little as possible. Even if you drain the first broth, there will still be a lot of unhealthy fats in the second. Better get used to vegetable soups, so popular in Western countries. Mushroom soups are also useful.

An attempt to replace meat for soup with dried broths and cubes will not lead to anything good - these products contain an incredible amount of chemical components.

Alas, the fish sold in our markets is also diligently injected with dyes and preservatives and therefore is harmful to osteoarthritis of the knee joint. Therefore, you should buy live fish whenever possible. It is clear that not everyone has enough money for this. The above methods will help to cook frozen fish correctly.

Prevention of osteoarthritis of the knee joint

It is impossible to allow the conditions of life to worsen due to the disease, therefore, the causes leading to osteoarthritis must be excluded. It is much easier to prevent disease than to go through expensive, long-term treatment.

• You need to lose weight.
• The joints need constant physical activity: jumping rope, squats, small runs. But everything should be in moderation. Excessive exercise also leads to illness. Joint loads alternating with adequate rest.
• Due to knee injuries, osteoarthritis develops. When skiing, skating, cycling or roller-skating, you must wear padded knee pads. On sale there is a sufficient selection of both fixing and warming knee pads made of sheep's wool.
• Don't ignore another person's help if the weight is beyond your strength.
• Eat more fruits and vegetables. Note that vegetarians practically do not suffer from osteoarthritis. Replace mayonnaise with olive oil or mustard. Especially useful are plums, dried apricots, apricots, apples, raspberries, cranberries with honey.
• Strong tea and coffee eliminate calcium in large quantities.
• Homemade cottage cheese and cheese will help strengthen the bones.
• Walking with a cane will prevent you from overloading the knee joints.
• Shoes should be comfortable, with small heels.
• Swimming and aqua aerobics relieve whole body stress and fatigue in the knee joints.
• Among vitamins, vitamin E is especially useful, which prevents the destruction of cartilage tissue.
• Vitamin C is involved in the synthesis of cartilage tissue.
• The disease progresses faster from a lack of vitamin D.
• Calcium helps keep bones strong. High calcium content in sesame and celery seeds.

By observing these simple rules of a healthy lifestyle, you can avoid a serious illness. And in case of the manifestation of the disease, they will slow down the development of pathological processes.