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

8 April 2021

Osteoarthritis, gonarthrosis, osteoarthritis are synonymous terms that define the same disease: deforming changes in the cartilage of the knee joint.

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

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

First symptoms and signs

They most often occur in people aged 45-50 years. This disease is common in both men and women, but the "weaker sex" suffers from this disease much more often.
At the beginning of the disease, the patient experiences tolerable pain in the knee joint and over time severe pain occurs.
The intensity of pain changes: with movement, physical activity it becomes stronger, at rest - the pain subsides.

If you do not pay attention to these symptoms of an impending illness in time, the disease begins to progress and in severe cases leads to damage.

Upon contact with a doctor, the diagnosis of osteoarthritis is clarified with the help of X-rays. The pictures show a narrowing of the joint space on the inside or outside of the joint. But over time, the pathological process captures the entire joint. Osteophytes - bone growths - can also be seen at the edges of the joint surface.

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 there is venous insufficiency, then the dull pain continues at night.
Muscle tension in the joint area
When walking, a crunch is heard in the knee joint

In severe cases of the disease there is deformation and swelling of the affected joint, an increase in its volume
On palpation, the joint is painful
When you try to move the knee pad, the pain increases
In the late stage of the disease, the muscles shorten and the patient cannot put his legs in the correct position.
If left untreated, joint mobility is reduced or completely lost

What is patellofemoral osteoarthritis of the knee?

Very often you can hear from the doctor the diagnosis "patellofemoral arthrosis" - what is it? In fact, 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 recurrent injuries. That is, patellofemoral osteoarthritis is the same as patellofemoral syndrome.

The main causes of the disease are:

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

Patelofemoral osteoarthritis of the knee joint has the following clinical manifestations: pain in the front of the knee joint, which increases significantly with exercise (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 experience a feeling of tension and stiffness in the knee, both inside and in front.

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

This disease, as a rule, does not require special treatment. In order to reduce pain and develop side effects (patellar instability, knee deformity, accumulation of inflammatory exudate), the following procedures are required:

reduction of physical activity. This does not mean that the patient will have to lead a passive lifestyle, just that the level of activity should not be painful;
use of a special bandage that is worn on the knee joint during exercise or stress, thus supporting and fixing the patella;
with a pronounced pain syndrome, glucocorticosteroids and anesthetics are injected into painful areas of the joint by precise injection, which will relieve pain and help 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, then the therapy is carried out according to the treatment regimen for osteoarthritis of the knee joint.

The reasons

Occupational disease of athletes who experience increased stress on the knee joints. Athletes receive injuries and microtraumas to the joints, bruises and tears of the tendons. After withdrawal from sports, the muscular framework weakens, leading to disease progression.
Increased life expectancy and increased physical activity in middle-aged people
Increased physical activity of the knee joint in people who spend their working day "on their feet"
Genetic predisposition
Congenital diseases of the joints and bones
Lack of collagen
Knee injury
Overweight, which puts more stress on the knee joints
Acquired joint diseases
Knee surgery

To achieve positive results from the treatment 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 pointed, a slight restriction in movement. During an arthroscopic examination, the doctor examines the softening of the cartilage.
Osteoarthritis of the knee joint of 2nd degreecharacterized by a significant restriction in the movement of the knee joint, strong crunch. The images clearly show osteophytes and narrowing of the joint space by 2-3 times. Small cracks are observed on the surface of the joint.
Osteoarthritis of the knee 3 degree- 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 are changes in the cartilage tissue throughout its thickness.
Osteoarthritis of the knee 4 degree- Arthroscopy shows the complete absence of cartilage tissue.

Medication treatment

In the complex treatment of osteoarthritis of the knee joint, drug therapy occupies an important place. Combining it with physiotherapy procedures, therapeutic exercises and manual therapy, you can achieve very good results, up to the restoration of limb function.

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

As it is impossible to apply other therapeutic methods against the background of acute pain, in the first place, 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 it 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 cartilage plate and improve the quality of synovial fluid.. . . Drugs from this group are injected directly into the diseased 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 may notice improvement only after a few months. In addition, 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 to some extent improve joint mobility.Various warming agents are good for relaxing ligaments and muscles, improving blood circulation and speeding up metabolism in the joint. However, they cannot be used in the presence of inflammation, in which case non-steroidal anti-inflammatory gels and ointments have been shown to be used.

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

Therefore, you should not delay a visit to the doctor for people who suspect the presence of disease or osteoarthritis of the knee joint - drug treatment, started in a timely manner and properly selected, can save the joint and help avoid surgery.

Drugs for the treatment of osteoarthritis of the knee joint

Treatment for osteoarthritis of the knee is never complete without medication.

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

What drugs are prescribed for osteoarthritis of the knee?

For successful treatment of the disease, you must first relieve the 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.
Chondroprotectors are used to restore the cartilaginous surface of the joints, restore its structure, nourish the cartilage and improve the production of intra-articular fluid. The effect of these drugs is very slow, therefore, before the patient notices a real improvement, you will have to undergo 2-3 courses of treatment with chondroprotectors, which will take about a year.
Gels and ointments can be used in combination with other medications to improve the patient's general condition and relieve pain. If the course of osteoarthritis is accompanied by synovitis, then ointments based on non-steroidal anti-inflammatory substances are preferred.
Intra-articular injections are used to provide emergency care for osteoarthritis. The most commonly injected are corticosteroids or hyaluronic acid.
For local treatment, compresses with drugs are prescribed - dimethyl sulfoxide, bischofite and medical bile. Dimethyl sulfoxide has the ability to penetrate skin barriers, ie its action is directed directly to the site of inflammation. This substance has analgesic, anti-inflammatory, absorbent properties and improves metabolism in its application. Bischofite - a derivative of the oil - also has an anti-inflammatory effect on the affected joint, gives a warming effect. Medicinal bile has the same properties as dimethyl sulfoxide with bischofite, but its use is limited by some contraindications. Medicinal bile should not be taken by patients with purulent skin diseases, fever and inflammation of the lymph nodes.

Before starting any medication for osteoarthritis of the knee, it is necessary to consult a doctor, discuss the dosage, the peculiarities of application and the duration of treatment.

Injections into 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 quite a difficult procedure, so you should consult a doctor, even if the patient knows what drugs should be injected and in what amount.

The following drugs are most commonly prescribed for intra-articular injections:

Corticosteroid hormones. These are the most common drugs, as the effect after their introduction is achieved in minutes. However, by relieving inflammation and pain, corticosteroids have a negative effect on the joint itself - cartilage tissue remains degenerative, in addition, drugs from this group cause narrowing of blood vessels, which further destroys joint tissue. Therefore, the use of corticosteroid hormones is justified only in case of unbearable pain in the last stages of osteoarthritis. The injection can be repeated no more than once every two weeks.
Chondroprotectors and enzymes. Unlike hormones, they do not reduce inflammation, so the application is pointless in the presence of swelling of the joints. But they have a regenerating effect, partially restore cartilage tissue. The use of such drugs is especially effective in the early stages of osteoarthritis. The course of treatment is 5-10 injections.
Hyaluronic acid. Very effective, but at the same time expensive medicine. 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 in 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 osteoarthritis, a slightly smaller effect is observed in the second stage, and in osteoarthritis of the third knee joint such drugs only briefly alleviate 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 area of injection;
sepsis;
infectious arthritis;
hemophilia;
the presence of a viral infection;
lack of result from previous injections;
individual intolerance to the drug.

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

Orthopedic knee pads for osteoarthritis of the knee joint

During the treatment of osteoarthritis of the knee joint, knee pads are used to prevent various injuries, as well as to support damaged tissues and relieve stress from the joint.

The orthopedic knee pad is essentially the same as the elastic bandage. However, compared to the latter, the knee brace has its advantages: it is not necessary to bandage several times a day, it will not slip or hang, a properly mounted knee will not squeeze the legs and provoke swelling and other unpleasant consequences of prolongedsqueezing.

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

reduction of inflammation and pain;
relief of puffiness;
relief of stiffness and tension;
normalizes blood circulation;
facilitate the free movement of the joint.

When choosing an orthopedic knee pad, you should pay attention to the following features:

Knee pad type - selected depending on the severity of the pain. There are these types of knee pads:
- closed - used when it is impossible to determine the location of pain;
- open with adjustable tension - used during rehabilitation and for mild pain;
- open with spiral ribs for hardening - for pain during ascent and descent of stairs, etc. ;
- articulated - for different types of pain;
- for tendon maintenance - used if the pain is localized under the patella.
The material from which the knee pad is made is of great importance, as it depends not only on the degree of fixation, but also the intensity of the warming effect. Modern knee pads are made of cotton, lycra, nylon, neoprene, elastane, camel and dog hair.
Knee size, which is calculated individually for each patient.

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

Orthopedic knee pads for osteoarthritis can be purchased at a pharmacy or specialty store for medical equipment, the price is quite reasonable. You should beware of such purchases in non-specialized stores or from dubious companies, as you can easily buy a counterfeit, which, if not harmful, will certainly not help.

Proper nutrition

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

Many theories have been proposed, many different assumptions have been made. For example, at one time it was thought that the use of tomatoes contributed to the development of the disease, then it was assumed that table salt was "to blame" for the appearance of osteoarthritis.

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

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. From the diet, the consumption of meat products belonging to the fast food segment should be minimized. These products are:

semi-finished products from meat production waste: sausages, sausages, all kinds of sausages, etc.
smoked meats sold in stores (most often this type of product is prepared using chemicals, not in smokers).
ready-to-eat meat - ham, bacon (producers in this case do not hesitate to use flavor enhancers and colors).
fast food.

Of course, not everyone is able to give up the above foods. Many over the years have developed the habit of indulging in smoked sausage sandwiches or cooked 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 spices, cut it and then use it as a base for sandwiches. This type of "fast food" will not harm the body.

So, we realized that it is best to give up semi-finished products, smoked meats and fast food. But what about meat if it's 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 that as many harmful chemicals as possible are destroyed. Sometimes the use of only this factor makes it possible to achieve an excellent effect in the fight against osteoarthritis.

How to properly cook food for osteoarthritis of the knee

It should be remembered that nutrition in 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 birds. It is in fats that the greatest amount of harmful substances is concentrated.

Cooking, stewing, baking in foil and steaming are the healthiest ways to prepare food.

In osteoarthritis of the knee, jelly and jelly should not be eaten. There is an opinion from the series "Grandma in the yard" said that these dishes are good for the joints, but this is 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 fat in the second. Better to get used to vegetable soups, which are so popular in Western countries. Mushroom soups are also useful.

Trying to replace meat for soup with dry 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 is therefore harmful to osteoarthritis of the knee. That's why you should buy live fish whenever possible. It is clear that not everyone has enough money for this. The above methods will help to properly cook frozen fish.

Prevention of osteoarthritis of the knee joint

It is impossible to allow the deterioration of life due to the disease, so the causes that lead to osteoarthritis must be ruled out. It is much easier to prevent the disease than to deal with expensive and 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 physical activity also leads to disease. Alternate the loads on the joints with appropriate rest.
Osteoarthritis develops due to knee injuries. Padded knee pads should be worn when skiing, skating, cycling or rollerblading. There is a sufficient selection of both fixing knee pads and sheep wool heating on sale.
Do not neglect the help of another person if the weight is beyond your strength.
Eat more vegetables and fruits. It is noted that vegetarians practically do not suffer from osteoarthritis. Replace mayonnaise with olive oil or mustard oil. Especially useful are plums, dried apricots, apricots, apples, raspberries, blueberries with honey.
Strong tea and coffee wash away calcium in large quantities.
Homemade cottage cheese and cheese will help strengthen bones.
Walking with a cane will save you from overloading your knee joints.
Shoes should be comfortable, on small heels.
Swimming and water aerobics will relieve stress from the whole body and fatigue from the knee joints.
Of the 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 than vitamin D deficiency.
Calcium helps keep your bones healthy. High content of calcium in sesame and celery.

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