Articular pathology is one of 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. Pathological symptoms are more often acute and require qualified help.
Cause of disease
In medicine, this disease is also called osteoarthritis, gonarthrosis, deforming osteoarthritis (DOA). Arthrosis is a general 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.
Pathology consists of degenerative-dystrophic changes in bone tissue and cartilage, characterized by gradual thinning of cartilage in articular joints and parallel formation of bone growth.
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:
- Mild and severe traumatic injuries with impaired movement of articular joints for a long period of time. Ligament ruptures or severe bruises often lead to the development of an inflammatory process, which in turn causes symptoms of gonarthrosis.
- Surgical intervention on the knee joint to remove any deformity or foreign body.
- Prolonged and excessive physical activity continuously. This may be due to professional sports or expertise. Constant tension in the joint area leads to a gradual thinning of the cartilage, which has a negative effect on the entire musculoskeletal system.
- Acute bursitis with the development of purulent inflammation in the articular cavity. As a rule, it is difficult to get rid of such pathologies in a conservative way, so doctors use minor surgical interventions, which adversely affect the cartilage tissue.
- Arthritis of various forms and severity. In this case, the inflammatory process is pronounced, continues with a sudden 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 articular junction defects.
- Weak immunity, which causes the gradual resolution of bone and cartilage tissue due to the inability of the body to overcome pathology.
- Bad habits - alcohol abuse, smoking - are quite often predisposing factors for the appearance of pathological signs.
- Severe autoimmune disease.
- Frequent viral and catarrhal pathologies that trigger the inflammatory process and the development of degenerative-dystrophic changes.
- Overweight and severe obesity also cause violations, because each additional kilogram increases the load on the articular joints by 10 times, which will certainly affect the cartilage tissue.
It should be remembered that all these reasons most often give rise to a type of secondary violation. There is also the main one, which is different because the disease is a consequence of the body's natural aging process. Bone and cartilage tissue wears down, which increases friction and stress. The result is gonarthrosis.
Pathological varieties
There are several types of pathological conditions, each with its own characteristics. Depending on how the joints are 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.
- The signs of gonarthrosis of the left side of the knee joint with the nature of the clinical picture do not differ from the right side. But it is noted that this type often develops in patients who are overweight.
- Bilateral refers to the severe form, affecting the entire cartilage and characterized by severe pain.
It is noted that the latter type is more often observed 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 development and the development of complications, the second is slow, may not bother the patient for several years.
Clinical picture
The signs and symptoms of gonarthrosis of the knee joint 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:
- The initial stage is characterized by the absence of obvious symptoms and the inability to visually recognize the pathology. The patient becomes more tired than usual, but perceives it as overwork or increased workload. He became lethargic, drowsy and performance decreased dramatically. Some patients experience 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 specialists. If at this stage an X-ray of the joint is taken, one can see the narrowing of the joint space, which causes a violation.
- In the next stage, discomfort and stiffness do not disappear, but only increase. With a small and short load, the patient experiences severe pain in the knee, which disappears only after a long rest. In some cases, these swollen and swollen joints disappear at night, but reappear during the day. As the pressure on the cartilaginous tissue increases due to its thinning, the patient often hears characteristic crunch during movement. Flexion function is also affected, as the patient cannot fully bend the limb. At this stage, patients usually turn to specialists.
- The third stage is the most severe and is characterized by a clear pain syndrome that accompanies the patient not only during exercise, but also during rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Swelling at this stage is always observed. In the joint bag, the amount of synovial fluid decreases dramatically, which increases the load and increases friction on the joint.
- The initial stage is characterized by the absence of obvious symptoms and the inability to visually recognize the pathology. The patient becomes more tired than usual, but perceives it as overwork or increased workload. He became lethargic, drowsy and performance decreased dramatically. Some patients experience 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 specialists. If at this stage an X-ray of the joint is taken, one can see the narrowing of the joint space, which causes a violation.
- In the next stage, discomfort and stiffness do not disappear, but only increase. With a small and short load, the patient experiences severe pain in the knee, which disappears only after a long rest. In some cases, these swollen and swollen joints disappear at night, but reappear during the day. As the pressure on the cartilaginous tissue increases due to its thinning, the patient often hears characteristic crunch during movement. Flexion function is also affected, as the patient cannot fully bend the limb. At this stage, patients usually turn to specialists.
- The third stage is the most severe and is characterized by a clear pain syndrome that accompanies the patient not only during exercise, but also during rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Swelling at this stage is always observed. In the joint bag, the amount of synovial fluid decreases dramatically, 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 becomes weak or disappears completely, which causes a deterioration in the work of the digestive and cardiovascular systems.
Lack of normal sleep often leads to nervous disorders, especially in elderly patients or young people engaged in intense physical labor. Memory impairment and decreased concentration of attention are also a consequence of insufficient patient rest.
Usually, the pathology proceeds without temperature, but in the 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 joints. It is for this reason that osteophytes or bony growths develop in the joints. They become the cause of deformation at an advanced stage of the pathological process.
The most dangerous complication of such violations is complete immobilization of the patient and disability. As a rule, this happens if there is no proper treatment or ignoring the symptoms of knee osteoarthritis for a long time.
Diagnostic method
In order to make an accurate diagnosis, the doctor recommends that the patient undergo a complete examination. This is necessary not only to identify the cause, but also to select the correct drug needed for therapy. The first step is to interview the patient and identify possible causes. Lifestyle, professional activities and habits play a special role. The next step is to examine the diseased member and determine the extent of the damage.
If there are no visible signs of pathology, the disease is in its early stages. The next step is to collect anamnesis and identify chronic pathologies that can be predisposing factors. After that, the patient donates blood for laboratory tests. The detection of inflammatory effects in it in the form of an increase in the level of leukocytes indicates that some process causes the development of the disorder.
A mandatory moment in the diagnosis is an X-ray examination to accurately determine the degree of gonarthrosis. The picture usually shows the area of complete destruction of the cartilage, 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 picture and extent of damage to the joint on 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 pathological conditions 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 its recovery. The classic scheme involves the use of the following drugs:
- Means from the group of pain relievers that help relieve pain. Allow the patient to feel better, improve night sleep. In the hospital, effective injections, which are made 1 to 3 times a day under the supervision of a specialist. It is not recommended to use the funds for a long time, because it does not affect the course of the pathological process, but only relieves acute pain.
- Nonsteroidal anti-inflammatory drugs. The funds are available in the form of tablets and injections, they can not only relieve acute pain, but also delay the development of pathology, relieve fever and local swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active component of the drug is observed in the patient's blood, which ensures a prolonged action. It is not recommended to take the medicine for a long time, because it often affects 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 affected joints and increase the amount of synovial fluid. As a rule, the drug contains glucosamine and chondroitin. It is recommended to take it for a long time. Usually, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. Longer reception is possible with clear indications.
- 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 hospitals in the form of intramuscular or intravenous injections.
- Nonsteroidal anti-inflammatory drugs. The funds are available in the form of tablets and injections, they can not only relieve acute pain, but also delay the development of pathology, relieve fever and local swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active component of the drug is observed in the patient's blood, which ensures a prolonged action. It is not recommended to take the medicine for a long time, because it often affects 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 affected joints and increase the amount of synovial fluid. As a rule, the drug contains glucosamine and chondroitin. It is recommended to take it for a long time. Usually, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. Longer reception is possible with clear indications.
- 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 hospitals in the form of intramuscular or intravenous injections.
In addition to the funds, the patient is prescribed a course of using external agents in the form of ointments, creams or gels. The last option is the most preferred because it quickly penetrates 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 on your own, as the risk of complications increases.
In the worst cases, the patient is injected directly into the joint cavity. You can drive conventional analgesics, but the best therapeutic effect is achieved with the introduction of hyaluronic acid preparations. Injections are made 1 time in 7 days. For 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 is almost completely gone.
If none of the methods bring the expected results, 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, which is 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 severe degenerative-dystrophic pathology, which, if not treated properly, leads to the disability of the patient. It is recommended that you immediately see a doctor when the first signs of a violation appear.