Deforming arthrosis of the knee: etiology, clinic, diagnostics and treatment

If you have a crunch and pain in his knees, more than 40 years of age, a sedentary lifestyle and you have the extra weight then this article is for you. Based on the obtained information, you will be able to make certain conclusions and to change your lifestyle to avoid the onset and progression of osteoarthritis, or osteoarthrosis of the knee joint. But, first of all, you need to explain what is osteoarthritis and why you need to fear is the destruction of the tribes.

osteoarthritis of the knee

Definition

Osteoarthritis is called the whole group of diseases which affects different joints, mainly articular cartilage. They start to become thin, they will warp. In severe cases, the cartilage completely loses its function, is subject to exposure of the bone and the joint loses its function it may cause clogging its slits and cause ankylosis.

On the articular ends of the bones, arise with spikes and growths, which are designed to compensate for increased specific pressure on the cartilage by increasing the area. But it helps a little, and develop a characteristic clinical picture.

Therefore, we can assume osteoarthritis abnormal growth of bone near the joint, together with the destruction of its cartilage.

Why the knees?

It is natural to think that the greatest risk of development of osteoarthritis is in joints where there is a large range of motion, combined with a significant load. It is to such belongs the knee joints. Of course, the ankle still have a big load, but the characteristics of it are that powerful ligaments and biomechanics of movement prevent wider amplitude, and shape of the articular surfaces protects the cartilage.

The knee joint is in a very vulnerable position: when walking and especially when running it on the cartilage of the tibia and the femur have a high specific load. In addition, the configuration of the cartilage surfaces represent a "reference platform". This is the most disadvantageous form, and it is under the greatest pressure. For example, the shoulder joint and hip represented by spherical surfaces of the femur and humerus, but the load is still considerably less.

The knee joint has other features: it is a large amount of cartilage and the presence of menisci. The last "level" of error the primary cartilage that can lead to disease without symptoms, but the knees are often injured.

Thus, the knee joint is the first large moving joints of bones that are exposed to excessive precipitating factors. What are the reasons lead to osteoarthritis of the knee?

About the causes of osteoarthritis

the cause of osteoarthritis

Sometimes the process is, as they say, out of the blue. In this case, the diagnosis is idiopathic process. But most often there are causes and risk factors that bring the development of the disease.

Among the most common include:

  • old age;
  • menopause and estrogen deficiency leads to osteoporosis;
  • injury;
  • chronic inflammatory diseases (arthritis);
  • dystrophic and degenerative processes;
  • congenital Hyper mobility of the ligamentous apparatus;
  • specific infections;
  • endocrinopathy;
  • various autoimmune diseases (SLE, rheumatoid arthritis);
  • systemic diseases of blood – hemophilia. It leads to hemorrhages that destroy cartilage;
  • the effects of various operations on the joints.

But even if all this is not excessive body weight and increased load on the joint, such as training or incorrectly organized conditions of production, can cause start mechanism leading to the development of osteoarthritis.

The stage of osteoarthritis

Deforming arthrosis and destruction of the cartilage with subsequent involvement of the bone takes place in several steps or stages. Let's consider them in order:

Deforming arthrosis of the knee joint of 1 degree – the onset of the disease.

There are no visible changes neither in cartilage nor bone. Alone, and under normal load, any complaints the patient does not occur. But if the load was excessive, for example, had all day to stay on their feet or a long walk a few hours, there is not only fatigue in the legs, but the pain in my knees. Pain because the first to strengthen the load reacted synovial, inside the joint fluid, which normally nourishes the cartilage. Reduction of production caused a deterioration in nutrition of the cartilage plates.

Attention! The cartilage, along with the transparent optical media of the eye is the only tissue in the human body, which is not supplied with blood vessels. All meals are taken diffuse through the nutrient of the synovial fluid and contained substances. Destroyed, normal cartilage also develops in the synovial fluid.

Deforming arthrosis of the knee joint 2 degrees – is expressed clinic and the presence of a variety of complaints, but the function retain.

Already broken not only the formation and secretion of synovial fluid, the impact on the nutrition of cartilage – it begins gradually to decay, and is clearly visible under x-ray examination. Violated the congruence of the articular surfaces, bony osteophytes at the edges, the quality of the joint pads decreases, it becomes lumpy.

At the third stage occurs a pronounced dysfunction of the joint. Bad leg flexion and extension, there is marked limitation of range of motion. There are secondary tendon contracture, the affected leg is shortened. Osteoarthritis at this stage deforms the joint and surrounding tissue, and the sore knee is different from a healthy, although in most cases deforming arthrosis is a two – way process.

the clinical picture of osteoarthritis

The clinical picture of osteoarthritis

Arthritis is a process which occurs with severe inflammation. Thus, the rest improves the condition of the joint, reduced swelling, and arthritis in the morning the patient gets up pretty easy on the affected leg. After some time inflammatory exudation and pain increase, there is swelling, increased local temperature in the region of the knee. The patient is forced to sit to rest to ease their condition.

Proceeds otherwise deforming osteoarthritis. When getting out of bed in the morning on the patient immediately fall knee pain: literally "limping" to the toilet. Each movement is accompanied by the crunch, especially audible in complete silence. Then the pain gradually reduced, and by mid-day they do not bother the person if the load is not excessive. Night pain present, they start after a period of rest and in the morning it all starts again.

Its cause is tissue detritus, or the remains of the destroyed cartilage. This fabric "mush" in the morning, prevents movement, as it is located between the cartilage and then she goes under the influence of the movement in hand, and the cartilage is cleared.

In addition, you need to remember the following characteristics of the development of osteoarthritis:

  • the cartilage is completely devoid not only of blood vessels, and nerves. This means that the process is limited by cartilage, no pain is not determined. Their appearance suggests that in the process of destruction and destruction is now involved bone;
  • those elements of the joint (capsule, synovial membrane, ligaments and muscles) that can hurt, affected at different times and to different degrees. This leads to the fact that the pain may be minor and occur in different parts of the joint at different times.
  • this disease (e.g. arthrosis deformans of the knee joint 2) evolving in many times slower than an inflammatory process of arthritis. Therefore, while the expressed will develop osteoarthritis, the body has time to adapt to it and employ all of the compensatory options, and that's why in many cases, the process proceeds without any symptoms.

The main symptoms

To articular, the classical signs of the disease include the following symptoms and complaints:

  • the pain is intermittent, dull in nature, increases in wet and cold weather, occurs in the evening after a severe load, and in the morning, in view of the above-described "starting" morning paroxysms, which are then damped. Elderly patients may be aching in the legs or a feeling of heaviness.;
  • stiffness and fatigue. These symptoms are associated with the violation of the congruence of the articular surfaces;
  • deformation of the knee joints;
  • a distinct crunch when driving. It is associated with phenomena such as the irregularity of the cartilage, abundant deposits of lime, sclerosis (hardening) of soft tissues. For osteoarthritis of the crunch is rough and audible even to strangers;
  • the alternation of exacerbations and remissions.

In addition to clinical manifestations, there are certain diagnostic criteria.

diagnosis of osteoarthritis

Diagnosis

In order to make a diagnosis, it is necessary to relate the severity of clinical manifestations with the data of radiological research, which still plays a major role.

So, clinical and radiological picture of deforming osteoarthritis of the knee joints allows you to perfectly determine the stage of the disease:

  • the diagnosis of knee joints of 1 degree is characterized by a very small, barely noticeable narrowing of the joint space, and place the greatest load from the medial side (inside). The edges of the depression, you may notice small bony growths – osteophytes;
  • diagnosis of the knee 2nd degree involves already visible gross changes: the joint space is significantly narrowed, and the phenomena of adjustment surfaces. The epiphyses of the femur and tibia become uneven and dense, and articular ends of the bones are deformed, as the osteophytes grow significantly;
  • third degree accompanied by a pronounced sclerosis of subchondral tissue, there is a hole in the bone and the cyst – a radiological picture begins to resemble a tuberculosis of bones. Sometimes inside the articular cavity can be seen the wreckage of the cartilage.

Quite a long time of x-ray examination was the only diagnostic method. Currently, the widely used MRI and arthroscopy.

Principles of treatment

Therapeutic measures in various degrees or stages of osteoarthritis are often the same. So, the treatment of deforming arthrosis of the knee joint of 1 degree as more severe stages, is primarily in the events, preventing further destruction of the cartilage. Consider the principles of therapy that are applied in the initial stages of the disease and further progression.

First degree

Treatment of osteoarthritis of the knee joint of 1 degree involves the optimization of the load on the knees and prevention. The most important of them can be called rational motive regime and normalization of body weight. In addition, it is important to keep drinking regime and drink at least 1.5 liters of fluid per day.

Under the rational regime of motion refers to the exception of prolonged standing on his feet, long walks and at the same time – long immobility. Office operation does not create any load on the joint, but contributes to congestion and poor circulation. One of the most important strongholds in the treatment are physical therapy and swimming lessons. Swimming – a unique way to increase the range of motion in the knee joint and improve its blood circulation with virtually zero load, because the water in our body weighs nothing. The use of drugs is not shown here.

Second degree

Treatment of deforming arthrosis of the knee joint 2 degree – long process, which uses both pathogenetic and symptomatic agents and drugs. The main ones:

  • NSAIDs, or nonsteroidal anti-inflammatory drugs. Apply in exacerbations, administered intramuscularly and orally;
  • GKS. Injected into the joint cavity once every few months, providing analgesic effects, help to prevent secondary inflammation;
  • the use of muscle relaxants of Central action. They help to reduce muscle tone, which prevents the formation of contractures and reflex spasm of the muscles;
  • artificial synovial fluid. Used as a symptomatic and pathogenetic means, which is inserted into the joint. It reduces pain, facilitates movement and prevents the cartilage from excessive abrasion.

An important means of treatment without medicines, you can call the security of the rest of the limb.

Treatment of osteoarthritis of the knee 2nd degree must include physiotherapy as an application of therapeutic mud, bischofite, ozokerite. Shown bathing in salt lakes. A good therapeutic effect have a compress on the knees, dry heat. As symptomatic therapy has also shown applications of paraffin wax, hot baths for your joints. Sometimes you need a blockade local anesthetics – in other words, having joint novocaine.

deforming arthrosis of the knee treatment

In conclusion, I must say, to what doctor should be treated at the first symptoms of osteoarthritis. It just so happens that the disease is at the crossroads of many disciplines, and no one seriously does. Gerontologists are concerned about the heart attack and dementia, trauma and fractures. A rheumatologist may begin to treat you, but then it turns out that autoimmune pathology is not, and you non-core patient. Specialist joints you would be unlikely to find, so it's easier to choose the right therapist. But to deforming arthrosis has progressed, it is necessary to abandon bad habits, to normalize the body weight and to establish the optimal motor mode. And then osteoarthritis will not be afraid of you, and you will gain freedom of movement.

28.03.2019