Osteoarthritis of the knee: causes, signs and symptoms

Joint pathologies are among the most common diseases of the musculoskeletal system. Inflammatory and non-inflammatory diseases significantly reduce people's quality of life and, in many cases, lead to disabilities. One of the most common diseases is osteoarthritis of the knee joint. The symptoms of the pathology are more often acute and require qualified help.

causes of the disease

In medicine, the disease is also called arthrosis, gonarthrosis, deforming osteoarthritis (DOA). Osteoarthritis is a collective term for all degenerative-dystrophic diseases of the joint and intervertebral joints. An injury in the area of the knee joint is referred to as gonarthrosis.

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

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

This becomes the body's response to friction and increased pressure. The most likely causes of symptoms of gonarthrosis of the knee joint are the following:

• Traumatic injuries of light and severe forms with prolonged restriction of movement of the joint. Torn ligaments or severe bruising often provoke the development of an inflammatory process, which as a result provokes the appearance of symptoms of gonarthrosis.
• Surgical intervention on the knee joint to remove a defect or foreign body.
• Persistent and excessive physical activity. This may be due to professional sports or specializations. Constant tension in the junction 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 resort to minor surgical interventions that affect the cartilage tissue.
• Arthritis of various forms and degrees of severity. In this case, the inflammatory process is pronounced, proceeds with a sharp increase in temperature and after a certain time leads to the development of arthrosis.
• Gout also often leads to cartilage pathology with severe clinical manifestations and joint deformity.
• Weakened immunity, which, due to the body's inability to cope with the pathology, provokes a gradual dissolution of bone and cartilage tissue.
• Bad habits - alcohol abuse, smoking - often become a predisposing factor for the appearance of signs of pathology.
• Severe autoimmune diseases.
• Common viral and catarrhal pathologies that provoke an inflammatory process and the development of degenerative-dystrophic changes.
• Overweight and severe obesity also cause injury, since each extra kilogram increases the load on the articular joints tenfold, which certainly affects cartilage tissue.

It is worth noting that all these reasons most often provoke a secondary type of 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 wear away, increasing friction and stress. The result is gonarthrosis.

Varieties 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 diseases 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 left-sided gonarthrosis of the knee joint do not differ from the right side by the nature of the clinical picture. However, it is noted that this type often develops in patients who are overweight.
3. Bilateral refers to severe forms, affects the entire cartilage and is characterized by severe pain.

It is noted that the latter 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 progression and the development of complications, the second proceeds slowly and can not bother the patient for several years.

clinical picture

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 identify the pathology. The patient becomes more tired than usual but writes it off as overwork or increased workload. He becomes lethargic, sleepy, and his ability to perform decreases sharply. Some patients have a slight 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 an X-ray of the joint is taken at this stage, narrowing of the joint space causing injury can be seen.
2. At the next stage, discomfort and stiffness do not go away, but only increase. With a light and short load, the patient develops severe pain in the knee, which only disappears after a long rest. In some cases, the joint swells and this swelling goes away 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 crunching sound when moving. Flexion function is also impaired as the patient is unable to fully flex the limb. At this stage, 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 with loads, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Swelling at this stage is constantly observed. In the joint pocket, the amount of synovial fluid is greatly 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 identify the pathology. The patient becomes more tired than usual but writes it off as overwork or increased workload. He becomes lethargic, sleepy, and his ability to perform decreases sharply. Some patients have a slight 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 an X-ray of the joint is taken at this stage, narrowing of the joint space causing injury can be seen.
5. At the next stage, discomfort and stiffness do not go away, but only increase. With a light and short load, the patient develops severe pain in the knee, which only disappears after a long rest. In some cases, the joint swells and this swelling goes away 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 crunching sound when moving. Flexion function is also impaired as the patient is unable to fully flex the limb. At this stage, 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 with loads, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Swelling at this stage is constantly observed. In the joint pocket, the amount of synovial fluid is greatly reduced, which increases the load and increases friction in the joint.

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

The lack of normal sleep often leads to a nervous breakdown, especially in elderly patients or young people engaged in intense physical work. Impaired memory and a decrease in the concentration of attention are also the result of insufficient rest on the part 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 increases, which provokes the inflammatory process.

The body tries to restore balance and reduce stress on the joint. Because of this, osteophytes, or bone growths, form in the joint. They become the cause of deformations in the advanced stages of the pathological process.

The most dangerous complication of such violations will be the complete immobilization of the patient and disability. This usually happens without proper treatment or when the symptoms of knee osteoarthritis are ignored for an extended period of time.

diagnostic methods

In order to make an accurate diagnosis, the doctor suggests that the patient undergo a full examination. This is necessary not only to identify the cause, but also for the correct selection of drugs necessary 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 extremity and determine the degree of damage.

If there are no visible signs of pathology, then the disease is at an early stage. The next step is to take a medical history 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 increased level of leukocytes suggests that some process caused the development of the disorder.

An obligatory moment in the diagnosis will be an X-ray examination to accurately determine the degree of gonarthrosis. The picture usually shows areas of complete destruction of the cartilage, as well as the number of osteophytes and their location. This will help clarify the suspected diagnosis and prescribe the appropriate treatment.

Sometimes it is impossible to see the exact picture and degree of damage to the joint on an X-ray. In this case, an ultrasound examination of the joint is recommended.

In extreme cases, the patient is prescribed a CT scan. This is usually sufficient to obtain a complete clinical picture.

Medical therapy

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

1. Means from the group of painkillers that help relieve pain. Make the patient feel better, improve night sleep. In a hospital, injections are effective, which are made 1 to 3 times a day under the supervision of a specialist. It is not recommended to use funds for a long time, since they do not affect the course of the pathological process, but only relieve acute pain.
2. Non-steroidal anti-inflammatory drugs. The funds are available in tablet and injection form, they can not only eliminate acute pain, but also slow down the progression of pathology, relieve local fever and swelling, and improve motor skills. With regular intake for 7-10 days, a constant concentration of the active substances of the drug is observed in the patient's blood, which ensures a prolonged effect. It is not recommended to take drugs for a long time, as they often adversely affect the digestive system. For this reason, they should not be taken by patients with severe stomach ulcers or other medical conditions.
3. 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 period of time. Typically, a course of 8-12 weeks is prescribed with regular visits to a specialist to see improvement. With clear indications, longer reception is possible.
4. glucocorticoids. They are used to treat advanced cases where the pain syndrome cannot be eliminated by conventional means. Helps reduce swelling and reduce pain. It is allowed to be used only in a hospital in the form of intramuscular or intravenous injections.
5. Non-steroidal anti-inflammatory drugs. The funds are available in tablet and injection form, they can not only eliminate acute pain, but also slow down the progression of pathology, relieve local fever and swelling, and improve motor skills. With regular intake for 7-10 days, a constant concentration of the active substances of the drug is observed in the patient's blood, which ensures a prolonged effect. It is not recommended to take drugs for a long time, as they often adversely affect the digestive system. For this reason, they should not be taken by patients with severe stomach ulcers or other medical conditions.
6. 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 period of time. Typically, a course of 8-12 weeks is prescribed with regular visits to a specialist to see improvement. With clear indications, longer reception is possible.
7. glucocorticoids. They are used to treat advanced cases where the pain syndrome cannot be eliminated by conventional means. Helps reduce swelling and reduce pain. It is allowed to be used only in a hospital in the form of intramuscular or intravenous injections.

In addition to these funds, the patient is prescribed a course with an external agent in the form of an ointment, cream or gel. The latter option is most preferable, since it quickly penetrates the joint cavity and has a therapeutic effect. They may be used within 14 days. Prolonging the course on your own is not recommended, as the risk of complications increases.

In the most severe cases, the patient is injected directly into the joint cavity. You can drive out conventional analgesics, but the best therapeutic effect will be obtained with the introduction of hyaluronic acid preparations. Injections are carried out 1 time in 7 days. For complete pain relief, 3-5 injections are enough. After such therapy, the effect lasts for 6 months. The patient can move normally, and the pain syndrome almost completely disappears.

If none of the methods bring the expected result, and the patient's condition worsens, surgical intervention is performed to replace the joint with a prosthesis. Replace the entire joint or its individual parts. This is usually indicated for osteoarthritis caused by a serious 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 the patient's disability. It is recommended to consult a doctor immediately at the first sign of a violation.