How is arthritis of the knee diagnosed and treated?

Osteoarthritis of the knee is also known as degenerative or deformed knee disease. This disease can lead to serious consequences, including disability. At the first sign of gonarthrosis, you should consult your doctor for diagnosis and treatment. Therapy must be completed in strict compliance with the terms and other prescriptions.

General characteristics of the disease

Gonarthrosis is a progressive lesion of the cartilage lining the surface of a joint. As a result of such changes, the function of the joint is impaired and pain appears.

Osteoarthritis is chronic. In most cases, the disease progresses slowly, but certain factors can accelerate its progression. This is mainly related to the individual characteristics of the body, the patient's physical activity and performance, the concomitant diseases.

Two concepts that are often confused - arthritis and dry joints. These pathologies are similar in terms of certain features, but differ in the nature of the course. Only a specialist can make an accurate diagnosis and prescribe the appropriate treatment.

With gonarthrosis, the nutritional mechanism of cartilage is disrupted, as a result of which its function is gradually interrupted. Among various site joint diseases, knee joint disease occurs in every third patient.

Causes of primary knee fibrosis

This is the most common form of the disease. Women of advanced age are at risk of primary medical problems, especially overweight - grade 2 obesity, 3 degrees.

There is an opinion that primary gonarthrosis is associated with life expectancy. Compared to previous centuries, it has increased markedly and the joints only wear out over time.

Gonarthrosis associated with natural aging is considered normal. If the joint cartilage is destroyed earlier or the process is too intense, the condition is considered pathological.

Causes of secondary osteoarthritis of the knee

Secondary gonadal fibroids can be triggered by the following factors:

genetic predisposition
• , provided it can be clearly traced;
broken leg
• ;
• dislocation of the knee;
• menial cartilage injuries;
• congenital knee dysplasia;
• excessive physical activity (typical for athletes);
• constant static load;
• rheumatism;
• rheumatoid arthritis (not to be confused with rheumatism);
• ankylosing spondylitis;
• congenital malformation of the lower extremities - valgus or varus;
• short of an congenital limb;
metabolic syndrome
• ;
gout
• ;
• maximum;
osteomyelitis
• ;
• chondrocalcinosis;
• pathology associated with physical metabolism;
• increased joint movement - already weak ligament apparatus;
• hemoglobin disease;
• diabetes mellitus;
• pathology of the endocrine system.

There are many possible causes of degenerative joint deformity, so this pathology is called pluralism. Usually, the exact cause of the disease cannot be determined, so a diagnosis of primary (idiopathic) gonarthrosis is made.

Symptoms of gonarthrosis

In addition to pain (main symptom), pathology can be accompanied by the following symptoms:

• Bending and clicking.These symptoms often appear with exercise and are often ignored by the patient. A groaning of the knee may mean a groove, a bone tumor, or an ulcer on the joint surface is present.
• Limit movement.This symptom is very important during the diagnosis process, as it allows to distinguish gonarthrosis from a number of other diseases affecting the musculoskeletal system. Movement is usually stiff in the morning. When a person starts to walk, this symptom should go away within half an hour. If stiffness persists for an hour or longer, this may indicate an inflammatory or other pathological process.
• Reduces the range of motion.This indicates that the patient is unable to fully bend the knee. This is due to pain syndrome, which reduces the intensity at which a person tries to move their legs less. Over time, this leads to the shortening of the ligaments, known as contractures.
• The joint is stuck.Gonarthrosis can lead to an obstruction of the joint in a given position and an inability to move the joint due to severe pain. This usually occurs due to a change in the joint surface, when the inner ligaments of the knee are pulled, protruding from the pineal gland. In this case, only the backward movement of the ligament can help. Less commonly, the cause of joint jamming is the entry of an object into the joint cavity. The source of the trouble can be part of the meniscus or a piece of bone-forming substance.

Classification of diseases

Each stage has specific features:

1. The first stageis ​​initial, it is also called easy. The first signs of the pathology are considered its onset, and the transition to the next stage is characterized by the appearance of bone deformities. They can be detected by visual inspection or on x-rays. In the early stages of the disease, fluid accumulation in the joints has begun - a phenomenon called bursitis. It is he who causes the pain, which manifests itself only when moving. Their intensity can vary.
2. In the second stage (moderate)of gonarthrosis, pathological changes are visible to the naked eye. They are manifested by an increase in the size of the knee, its deformation. On the x-ray film, you can see that bone tissue at the edge of the joint has grown and that joint space has narrowed. At this stage, pain syndrome manifests itself from the moment of lightest load, and when walking or squatting, the knees begin to scratch.
3. Third stage (severe) deformed osteoarthritisis ​​diagnosed when there is practically no cartilage tissue in the joint. If the condition is difficult, the bones may grow together, making the affected limb completely immobile.

The exact stage of gonarthrosis is determined by a specialist. In this case, you don't need to focus on the symptoms of the disease, but on the x-rays received. The pathology does not always follow the standard pattern.

Diagnosis

Only diagnose with a new tool to determine osteoarthritis deformation:

• x-ray;
ultrasound scanning
• ;
• tomography - computer or magnetic resonance imaging;
• arthroscopy;
• thermometer;
Rendering
• .

Usually one x-ray is enough to detect gonadal pathology. It is performed in two projections. If only one knee is affected, an image of the healthy limb is still taken to compare the results.

What doctor should I find for help?

In the case of osteoarthritis, different specialists may be involved. In a regular clinic, they often consult a surgeon.

Joint doctors, rheumatologists, and orthopedists often deal with the problems of gonarthrosis. In addition, the participation of an orthopedist or arthroscopist may be required. A physiotherapist, a physiotherapist, and a massage therapist with expertise in the field are often involved in the treatment process.

Treatment of gonarthrosis

Treatment for osteoarthritis of the knee takes quite a while. In most cases, outpatient treatment is sufficient. It covers a wide range of measures. Treatment is based on medication, physical therapy, and exercise therapy. In some cases, surgery is required. With genital warts is also allowed to use folk recipes but must combine with traditional remedies.

Drug treatment

The use of different drugs is the main ingredient in the treatment of gonarthrosis disease. With such a disease, it is necessary to have an integrated approach, implying the possibility of using the following drugs:

• Nonsteroidal anti-inflammatory drugs.These drugs are produced in many different forms, but for osteoarthritis, pills for oral administration, solution for injection, topical medications in the form of creams, ointments, gels are preferred. Nonsteroidal anti-inflammatory drugs are not only anti-inflammatory but also analgesic.
• Corticosteroids.These drugs are often used until severe illness or nonsteroidal anti-inflammatory drugs are ineffective. Most often they are used in the form of injections, injecting drugs into the joint follicles. Corticosteroids are used as symptomatic therapy to eliminate inflammation and severe pain.
• Pain reliever.When prescribing these drugs, the severity of the pain syndrome is taken into account. If the pain syndrome is intense, then they must resort to strong opioids.
• Chondroprotectors.Thanks to these drugs, the cartilage tissues are saturated with nutrients that stimulate cell growth. The effects of chondroprotectors manifest for a long time, so they are used for long course of treatment. These medications are suitable for a category 1 or 2 illness.
• Antispasmodic and muscle relaxants.These drugs are necessary when the condition is accompanied by muscle spasticity.
• Vasodilators.Such drugs improve blood flow, reduce constriction of small vessels. The combination of vasodilators and chondroprotectors is effective because the cartilage tissue in this case is better saturated with nutrients.
• Warming ointmentto improve blood circulation. Such funds are suitable in the absence of synovitis.

Medicine prescribed by a doctor. Only he can determine which drugs are needed in a particular case, according to the plan they need to take and how long the course of treatment should be for each prescribed medication.

Physiotherapy

In osteoarthritis, different physiotherapy methods are actively used. They are used for different purposes: relieve pain, reduce inflammation, activate blood supply, and accelerate the recovery process.

The following physical treatments are effective for knee arthritis:

• Electrophoresis.This technique is an ultrasound therapy combined with drug effects. Due to the high frequency vibration, the tissues of the knee joint are warmed, ensuring that the medicinal substances penetrate deeper into them.
• Shock wave therapy. A process that uses a special device that generates radial sound waves. Under their action, the blood supply in the area around the joint is activated, stimulating the restoration of cartilage and bone structure.
• Ozone therapy.This procedure involves the use of activated oxygen. It provides analgesic and anti-inflammatory effects on tissues.
• Electromechanical stimulation.This technique is often used during rehabilitation, as well as when there are exercise contraindications. Under the action of electrical impulses, increases muscle tone and improves blood circulation.
• Foreign object.This technique deals with electrotherapy and involves the use of high-intensity high-frequency currents for deep heating.
• Cryotherapy.This technique is also known as cold treatment. The affected skin is exposed to low heat for a short time. This method restores metabolism, increases blood circulation, reduces the severity of inflammation, eliminates pain, reduces muscle spasm.
• Inheritance therapy.This technique is considered an alternative. The leeches are placed around the affected joint. Therapy for pain, swelling and stimulation of regeneration.
• Laser therapy.This technique is often used in the early stages of the pathology. It provides anti-inflammatory, analgesic and irritating effects.
• Plasma therapy.This process is also known as concatenation. It involves intra-articular injection. For them, the patient's plasma is used, which is saturated with platelets. This procedure reduces inflammation, promotes cartilage tissue regeneration.
• Healing Bath- resin, radon, hydrogen sulfide.
• Acupuncture.Such a procedure is usually used in the early stages of the pathology. This technique helps reduce swelling, eliminate pain and restore joint mobility.

exercise therapy

Physiotherapy is required for gonarthrosis disease. Various exercises should be supervised by a qualified specialist. The main goal of exercise therapy is to restore joint mobility and achieve a certain range of motion. It is also needed to increase muscle strength and endurance.

Exercise therapy is not to be used in worsening periods of illness. At this point, the joint needs to rest and minimize pain. Positional activity is allowed when the inflammation and pain subside, at least 5 days from this point will pass.

A therapeutic exercise program should be developed individually for each patient. It is necessary to take into account the characteristics of the course of the disease, its severity, the individual characteristics of the patient.

Gymnastics

At home, a patient with gonarthrosis can do a number of exercises independently. You need to work in stages - first warm up, then do strength exercises and finish with tension.

The warming is done as follows:

• Place your legs shoulder-width apart and lower your arms along your body or lean against the back of a chair. Slowly lift your toes, hold on to the extreme point for 3 seconds, then gently transfer weight to your heels, lifting your toes as high as you can. Perform 10 repetitions without any sudden movements.
• The starting position remains the same. The leg lifts bent at the knee level with the waist, then lowered. Perform 15 alternate repetitions for each leg. Movements should be slow and flexible.
• Lie on your back, raise bent knees and simulate the rotation of the bicycle pedal. Rotate half a minute in one direction, then rotate in the other direction. Move slowly.
• Keep feet shoulder-width apart, back straight, and elbows bent. Simulate running in place, alternating weight transfer from leg to foot. The movements should be done on the toes, not against the heels. Do the exercise for about 5 minutes.

Surgery

Deformed osteoarthritis may need surgical treatment. They use the following options:

• Puncture.This intervention is minimally invasive. It is not only used to study fluid in joints, but also to remove its excess. As a result of such manipulations, inflammation decreases and restores joint mobility, but sometimes only partially.
• Arthroscopy.This process can be performed as a stand-alone activity or in one of its phases. This technique is laparoscopic and does not require dissection of the joint cavity. For operation, exceptionally thin and flexible tools are used, and all operations are controlled by micro video cameras. If arthroscopy is used as a stand-alone operation, then during this process the joint surface is cleaned of fragments of affected cartilage tissue.
• Osteoarthritis surgery.This kind of surgery is quite painful. It is used to redistribute the load on the knee, so the pain syndrome decreases and the joint becomes more mobile. During operation, the bone, which is involved in the formation of the knee joint, is sawed and then fixed in a different location. Such surgical interventions are suitable for grade 1 or 2 osteoarthritis.
• Endocrine drugs.Such surgery is performed when tertiary genital fibroids are diagnosed. During surgery, the knee joint is replaced with a biocompatible structure. It is necessary to restore the patient's previous range of motion and normal quality of life. Endoscopy is a rather complicated surgery and therefore requires a long time to recover from function.

Diet and general recommendations

Despite the fact that the pathology affects the knee joint, its treatment includes adherence to diet. It must adhere to the following rules:

• If necessary, normalize the body weight. The BMI should not exceed 20. It is advisable to lose weight slowly - 2-3 kg per month.
• Cut down on carbohydrates and animal fats.
• Most of the fat you eat should be of vegetable origin.
• You need to eat fish at least 1-2 times a week.
• You should eat split. Servings should be small, but should have 5-6 meals a day.
• End each meal with a vegetable or fruit.
• For cooking, you should choose a cooking method, including steaming, stewing, and baking.
• Adhere to the drinking regimen. On average, a person needs 2 liters of fluids per day, and most of it should be clean water without gas.
• Drink water before eating. One cup is enough for half an hour before meals.
• Reduces salt intake.
• Avoid alcohol, carbonated and sugary drinks.
• Should exclude beef, pork, semi-finished products, hot peppers, white cabbage, and sour fruit.
• Very useful when eating jelly meat, gelatin jelly, cheese, fresh cheese, chicken, legumes.

Traditional medicine

In the treatment of osteoarthritis, unique methods are also suitable. In this case, you should consult a specialist, since even the use of natural remedies has contraindications.

Make good use of the following folk formulas:

• Lubricate the back of burdock leaves with honey, apply to the affected area, fix with a cellophane film and insulate. Hold for up to 4 hours.
• You can use cabbage leaves instead of burdock. You can knead or prick a few places with your hand. Honey is optional.
• For internal use, you can use burdock root tincture. Ingredients must be shredded, steamed through boiling water and simmered. Drink one tablespoon 5 times a day.
• Rinse the potato sprouts, put in a glass container and cover with alcohol. Stand in the dark for 3 weeks, stretch and use three times a day to rub the affected area.
• Heat honey in a pot of water to a liquid state and massage into the sore knee, massage. Cover the treated area with a gauze or bandage and insulate it. This procedure is repeated daily for a week and a half.
• Steam 5 tablespoons. l. Roll the oats and cook for 5-8 minutes over low heat. Wrap the cooled mixture in a natural cloth, apply to the blemished area and fix with polyethylene. Every time you need to prepare a fresh mixture.
• Mix the iodine well with honey and glycerin, leave on for 3 hours. Dip a cotton pad into the forming component and treat the knee and vicinity with bottom-up movements.
• Mince one end of garlic and add a glass of vegetable oil. Press for a week in the dark, stretch and dab on the affected areas before going to bed.
• Grind school white powder and mix with yogurt or sour cream to create a paste. Wrap it with natural cloth and compress for 2, 5 hours, insulated with polyethylene. Repeat this process every day.
• Boil two large onions with peels in one liter of distilled water, filter the water. Take the infusion results three times a day before meals.

Treatment of gonarthrosis should not be limited to traditional medicine. The disease requires an integrated approach, necessarily with medication and exercise.

Prognosis, possible complications

The general prognosis of osteoarthritis is unfavorable due to the progressive nature of the disease. Tissue degeneration and joint deformation are irreversible, but can be stopped or significantly slowed down.

The following factors influence the prognosis of gonarthrosis:

• Age of patient.The younger the baby, the less favorable the prognosis is. The pathological process develops gradually, so with joint damage in young people, the disease can transition to the late stage in old age and cause many different complications.
• Type of joint disease.In primary pathology, with only the joint affected, the disease usually progresses slowly. With secondary illness, there are other disorders that can either speed up the process or cause complications.
• Follow your doctor's instructions.This involves taking necessary medications, undergoing physical therapy procedures, exercising therapy, ensuring joint removal. It is important to follow the length of drug therapy, as most medications need to be taken regularly within a certain number of courses.
• Body mass.If the patient is more severe, the joint strain will increase, negatively affecting the course of the disease.
• Occupation.This factor is very important to the prognosis of the disease. Professional athletes, who are stressed frequently or regularly standing on their feet, suffer more. The inactivity, when the joint is in one position for a long time can also adversely affect the course of the disease.

Osteoarthritis progresses slowly, but without proper treatment it can cause a number of complications:

• Joint deformation.This happens in the late stages of the disease. The leg can be bent at an unnatural angle, which not only causes aesthetic discomfort, but can also cause complete loss of joint function.
• Infections.A micro injury, for example, a crack in the cartilage tissue, can cause such complications. The pathogen can enter the joint with an electrical current or lymphatic flow from the point of infection. Surgical intervention - arthroscopy, diagnostic puncture can also cause infection. Infection of the joint can cause aseptic necrosis.
• Dislocations, fractures.Such complications occur on the basis of a violation of the function of the knee joint, in which the load is not distributed correctly and excessively can lead to injury.
• Teething.In this case, the bones at the missing joint site grow together. This is one of the most serious disorders, and due to the immobilization of the leg in one position, motor function is lost.

In most cases, complications arise at the fault of a patient who has either ignored his or her illness or ignored a doctor's order.

Precautions

To avoid osteoarthritis of the knee, it is necessary to take some precautions:

• maintain a normal body weight;
• avoids heavy bearing and heavy pressure on the knee;
• ensures regular and adequate physical activity;
• avoids joint injury;
• if an injury is received, prompt, competent and complete treatment is required;
• Strengthens peristalsis.

Secondary precautions should also be highlighted. They are needed once gonarthrosis has been diagnosed and its rate of development should be reduced. In this case, you need to take the following measures:

• uses one chondroprotectors course every six months or a year;
• promptly, quickly and effectively treat arthritis.

Osteoarthritis is a serious medical condition that has a poor prognosis and can cause a number of complications. Treatment should be carried out as soon as possible to slow down the pathological process. Therapy should be comprehensive, several techniques should become part of the lifestyle: diet, exercise, certain medications.