Osteoarthritis of the knee: causes, signs and symptoms

Joint pathologies are among the most common among all disorders of the musculoskeletal system. Both inflammatory and non-inflammatory diseases significantly worsen the quality of human life, and in many cases lead to disability. Osteoarthritis of the knee joint is one of the most common diseases. Symptoms of pathology are more often acute and require qualified assistance.

Causes of disease

In medicine, the disease is also called osteoarthritis, gonarthrosis, deforming arthrosis (DOA). Arthrosis is a generalized name for all degenerative-dystrophic diseases of the articular and intervertebral joints. Violation in the region of the knee joint is called gonarthrosis.

It is characterized by damage to the cartilage of the knee joint.

The pathology consists of degenerative-dystrophic changes in bone and cartilage tissue, characterized by a gradual thinning of the cartilage in the articular joint and the parallel formation of bone growths.

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:

• Traumatic injuries of mild and severe forms with reduced mobility of the articular joint for a long time. Rupture of ligaments or severe bruising often provokes the development of an inflammatory process, which consequently provokes the appearance of symptoms of gonarthrosis.
• Surgical intervention on the knee joint in order to eliminate any defect or foreign body.
• Prolonged and excessive physical activity on a continuous basis. This may be due to the professional sport or the specialty. Constant tension in the connection area leads to 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 conservatively, so doctors resort to minor surgical intervention, which negatively affects the cartilage tissue.
• Arthritis of various 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 joint junction deformity.
• Weakened immunity, which causes a gradual resolution of bone and cartilage tissue due to the body's inability to cope with pathology.
• Bad habits - alcohol abuse, smoking - quite often become a predisposing factor for the appearance of signs of pathology.
• Serious autoimmune diseases.
• Frequent viral and catarrhal pathologies that provoke an inflammatory process and the development of degenerative-dystrophic changes.
• Excess weight and severe obesity also lead to a violation, since each additional kilogram increases the load on the articular joints by 10 times, which will certainly affect the cartilage tissue.

It should be noted that all these reasons most often provoke a secondary type of violation. There is also a primary disease, which differs in that the disease becomes a consequence of the body's natural aging process. Bone and cartilage tissues wear down, which increases friction and stress. The result is gonarthrosis.

Varieties of pathology

There are several types of disease states, each with its own characteristics. Depending on how the joint is affected, the following types of disorders are distinguished:

1. 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.
2. Signs of gonarthrosis on the left side of the knee joint by the nature of the clinical picture do not differ from the right side. But it is worth noting that this type often develops in overweight patients.
3. Bilateral refers to severe forms, affects the entire cartilage and is characterized by severe pain.

It should be noted that the latter type is more often observed in elderly patients with primary tissue damage. According to the course of the pathological process, acute and chronic types are distinguished. The first is characterized by rapid progression and the development of complications, the second progresses slowly, may not bother the patient for several years.

clinical picture

The signs of gonarthrosis of the knee joint and its symptoms 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:

1. The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets tired more than usual, but sees it as overwork or increased workload. He becomes lethargic, drowsy and his performance is greatly reduced. Some patients have mild stiffness in the diseased joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If at this stage an X-ray of the joint is taken, one can notice a narrowing of the joint space, which causes a violation.
2. At 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 at night, but reappears during the day. Since the pressure on the cartilage tissue increases due to its exhaustion, the patient often hears a characteristic crunch when moving. Flexion function is also impaired, as the patient is unable to fully bend the limb. At this point, patients usually turn to a specialist.
3. 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 aggravates his condition. Puffiness at this stage is constantly observed. In the joint bag, the amount of synovial fluid is sharply reduced, which increases the load and increases friction in the joint.

4. The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets tired more than usual, but sees it as overwork or increased workload. He becomes lethargic, drowsy and his performance is greatly reduced. Some patients have mild stiffness in the diseased joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If at this stage an X-ray of the joint is taken, one can notice a narrowing of the joint space, which causes a violation.
5. At 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 at night, but reappears during the day. Since the pressure on the cartilage tissue increases due to its exhaustion, the patient often hears a characteristic crunch when moving. Flexion function is also impaired, as the patient is unable to fully bend the limb. At this point, patients usually turn to a specialist.
6. 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 aggravates his condition. Puffiness at this stage is constantly observed. In the joint bag, the amount of synovial fluid is sharply reduced, which increases the load and increases friction in the joint.

As a rule, pain disturbs the patient's sleep, he becomes irritable and feels constant fatigue. Appetite is weakened or disappears completely, which leads to a deterioration in the work of the digestive and cardiovascular systems.

Lack of normal sleep often leads to nervous breakdown, especially in elderly or young patients who are engaged in heavy physical labor. Memory impairment and a decrease in concentration of attention also become the result of insufficient rest of the patient.

Usually the pathology proceeds without temperature, but in advanced stages, when the cartilage is completely destroyed, the friction of the bones and the pressure between them increase, 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 bony growths develop in the joint. They become the cause of deformities in the advanced stages of the pathological process.

The most dangerous complication of such violations will be the complete immobilization of the patient and his disability. As a rule, this occurs in the absence of proper treatment or ignoring the symptoms of osteoarthritis of the knee for a long time.

Diagnostic methods

In order to accurately diagnose, the doctor suggests that the patient undergo a comprehensive examination. This is necessary not only to identify the cause, but also for the correct selection of drugs necessary for treatment. The first step will be to interview the patient and identify the probable 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 at an early stage. The next step will be to collect an anamnesis and identify chronic pathologies that could become a predisposing factor. After that, the patient donates blood for laboratory tests. The detection of traces of inflammation in the form of an increase in the level of leukocytes suggests that a process caused the development of the disease.

An obligatory moment in the diagnosis will be an X-ray examination in order to accurately determine the degree of gonarthrosis. The image usually shows areas of complete cartilage destruction, 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 degree of joint damage on an x-ray. In this case, it is recommended to undergo an ultrasound of the joint.

In extreme cases, the patient is prescribed to undergo a CT scan. This is usually enough to get a full picture of the disease.

medical therapy

Conservative treatment of the pathological condition is possible only in the 1st and 2nd stages, when the formation of osteophytes has not yet begun. Therapy is primarily aimed at slowing the destruction of cartilage and its restoration. The classical scheme involves the use of the following drugs:

1. Means from the group of analgesics that help relieve pain. Allow the patient to feel better, improve their night's sleep. In a hospital, injections are effective, which are done 1-3 times a day under the supervision of a specialist. It is not recommended to use the funds for a long time, since they do not affect the course of the pathological process, but only relieve acute pain.
2. Nonsteroidal anti-inflammatory drugs. Funds are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow the progression of pathology, relieve local fever and swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active components of the drug is observed in the patient's blood, which guarantees a prolonged action. It is not recommended to take drugs for a long time, as they often have adverse effects on the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
3. Chondroprotectors help restore cartilage in the affected joint and increase the amount of synovial fluid. As a rule, these drugs contain glucosamine and chondroitin. It is recommended to take them for a long time. As a rule, a course of 8-12 weeks is prescribed with regular visits to a specialist in order to detect improvement. Longer reception is possible with clear directions.
4. 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 use only in a hospital in the form of intramuscular or intravenous injections.
5. Nonsteroidal anti-inflammatory drugs. Funds are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow the progression of pathology, relieve local fever and swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active components of the drug is observed in the patient's blood, which guarantees a prolonged action. It is not recommended to take drugs for a long time, as they often have adverse effects on the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
6. Chondroprotectors help restore cartilage in the affected joint and increase the amount of synovial fluid. As a rule, these drugs contain glucosamine and chondroitin. It is recommended to take them for a long time. As a rule, a course of 8-12 weeks is prescribed with regular visits to a specialist in order to detect improvement. Longer reception is possible with clear directions.
7. 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 use only in a hospital in the form of intramuscular or intravenous injections.

In addition to these funds, the patient is prescribed treatment using an external agent in the form of an ointment, cream or gel. The latter option is the most preferable, since 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 prolong the course on your own, as the risk of complications increases.

In the most severe cases, the patient is injected directly into the joint cavity. You can conduct conventional painkillers, 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 persists 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, surgery is performed to replace the joint with a prosthesis. Replace the entire gasket or its individual parts. This is usually indicated for osteoarthritis, caused 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 properly treated, leads to disability of the patient. It is recommended to immediately consult a doctor at the first signs of a violation.