Osteoarthritis of the knee joint (deforming arthrosis, gonarthrosis) is a degenerative-dystrophic disease in which there is a gradual destruction of the knee cartilage..

Osteoarthritis is characterized by gradual destruction of the knee cartilage. Pathology occurs quite often, along with arthrosis of the intervertebral joints and coxarthrosis.. If signs of the disease are detected, it is necessary to seek advice from a traumatologist or rheumatologist.

Classification Distinguish between primary and secondary forms of the disease.

There are the following clinical stages of arthrosis:.

Severity.

Description.

Light.

The patient feels a crunch in the knee joints when moving, there is a feeling of stiffness in the morning and pain is observed when the leg is fully flexed at the knee.

Medium.

The patient has pain in the knees after exercise. Morning stiffness lasts no more than a quarter of an hour. Knee flexion range is reduced by 10-15 degrees.

heavy.

There is constant aching pain in the knees, which increases with movement. Morning stiffness lasts up to half an hour, and during an exacerbation it lasts longer. Joint mobility is impaired, and the range of passive and active movements is significantly narrowed..

Causes There are a lot of reasons for the development of the disease. If one of them cannot be identified, idiopathic (primary) arthrosis of unknown etiology is diagnosed..

Depending on the area in which the cartilage is damaged, the following types of pathology are distinguished:.

arthrosis of the femoral-patellar joint;

arthrosis of the lateral part of the tibiofemoral joint;

arthrosis of the medial part of the tibiofemoral joint.

Normally, aging of the whole organism leads to the destruction of articular cartilage.. If the process starts ahead of time, this is a pathology.. The first signs of degenerative changes (stiffness of the joints after sleep, slight pain during exercise) may appear after 40 years..

With deforming arthrosis, these symptoms occur in young people (16-18 years old), and in severe cases, the joints begin to suffer even earlier.

The mechanism of the formation of pathologyDaily, the cartilages in the knees experience the maximum load, since they are shock absorbers. The result of this is the appearance of microscopic cracks in the subcartilaginous layer.. Gradually, they are filled with synovial fluid and turn into cavity formations (microcysts). Nearby cavities coalesce and cysts enlarge.

With arthrosis, the process of restoring cartilage tissue is disrupted. Large cysts squeeze the blood capillaries that nourish the cartilage tissue and supply it with oxygen.. As a result, the synthesis of type 2 collagen is slowed down and the process of cartilage destruction is accelerated.. Instead of restoring its shape, after each load, the cartilage begins to compress until it becomes thinner..

Chondroblasts (young cells synthesizing cartilage tissue) are activated, but the bulk of the cartilage tissue is formed not in the place where the cartilage is most destroyed, but in areas where it does not experience special stress. The result of this is excessive and chaotic growth of cartilage tissue along the edges of the articular surfaces and the formation of chondrophytes (cone-shaped growths).

At the initial stage, chondrophytes do not manifest themselves in any way, but later the process of ossification occurs and they turn into osteophytes (thorns). This causes damage to the cartilage tissue and synovial membrane, resulting in an inflammatory process and pain.. The composition of the synovial fluid changes, the inflamed joint receives less nutrients, swelling appears.

Against the background of pathology, there is a high probability of dislocation of the patella. A person tries to reduce the load on the knee, which leads to the formation of new osteophytes and adhesions, which cause a decrease in the range of motion. Due to the increase in pressure in the cavity, the articular surfaces move away from each other, so there is a high risk of dislocation in case of unsuccessful movement.

Secondary osteoarthritis In secondary osteoarthritis, the cause of the development of the disease is known, but the mechanism of development of the pathology is the same as in the primary form.

Joints can be damaged in the following cases:.

limb injuries. With leg fractures, an acute form of the disease most often develops, while with frequent and minor joint injuries, a chronic form of osteoarthritis occurs.;

congenital valgus deformities. In this case, there is a load on the lateral or inner sides of the joint and premature wear of the joint occurs, which is accompanied by an inflammatory process.;

congenital shortening of one leg. In this case, the normal limb takes on an additional load, and the cartilaginous tissue of the healthy leg changes.;

knee dysplasia. Structural changes in the bones lead to joint instability and the development of post-traumatic arthrosis.;

rheumatoid arthritis. This is a systemic disease in which the immune system attacks the body's own structures, which leads to the development of an inflammatory process.;

diabetes. Due to the fragility of the capillaries, the nutrition of the cartilage tissue is disrupted, resulting in the development of osteoarthritis.;

osteomyelitis. This is a purulent-necrotic process caused by pathogenic microorganisms.. If it develops in the bone near the knee, then its fistula opens directly into the joint cavity, which leads to the appearance of purulent arthritis;

acromegaly. An excess of somatotropin hormone in the body leads to a pronounced growth of bone and cartilage tissue, as a result of which the shape of the joints changes, and the condition of the cartilage worsens;

obesity. An increase in body weight contributes to an increase in the load on the knee joints, which further leads to compression and abrasion of cartilage tissue and disruption of its nutrition.. Since the knee joints are quite massive and complex, they suffer in the first place.;

frostbite. Prolonged exposure to low temperatures causes damage to germ cells. Externally, the joint is restored, while internally the process is irreversible and leads to gradual tissue destruction..

Symptoms The disease develops gradually, its symptoms depend on the stage of the disease..

CrackingInitially, the patient has a crunching and clicking of the joint with certain movements. Usually a person does not pay attention to it for a long period, considering it insignificant.

The crunch indicates damage to the articular surfaces and the appearance of furrows and osteophytes. You can identify cartilage damage using a simple method - just put your hand on the patella and slowly unbend and bend the leg.

Stiffness of movementAnother symptom of osteoarthritis is stiffness of movement.. This symptom can be observed within half an hour after waking up in the morning.. If after this period the stiffness does not disappear, this indicates inflammatory processes..

During inactivity of the joint, fibrin films are formed that envelop the exposed nerve fibers.. Until they are partially erased, a person feels stiffness of movements. The inflammatory process is an aggravating factor, as the synovial fluid becomes cloudy and the internal ligaments swell and shorten..

Pain The main symptom of osteoarthritis of the knee is pain.. Initially, it is unexpressed and occurs after physical exertion or weight lifting.. The appearance of this symptom is based on the erasure of the upper layer of cartilage and the exposure of nerve endings..

Pain is the main symptom of the disease. If a person rests for several hours, the exposed nerve endings are covered with a thin layer of fibrin, which makes it possible to reduce irritation and dull pain..

Over time, the disease progresses and the cartilage wears off more, so in order for the pain to decrease, the patient needs to rest for a longer period.. In addition, inflammation appears, which leads to the development of edema and compression of nerve fibers..

Usually, pain in osteoarthritis is observed only with movements of the limb.. If there are pains at rest, this indicates the addition of an inflammatory process..

Other signs As the disease progresses, the patient develops other signs of osteoarthritis, which include:.

decreased range of motion. In order to reduce pain, a person tries to reduce the load on the knee as much as possible.. After some time, the ligamentous apparatus adjusts to a minimum of movements, and the ligaments themselves shorten.. In order to develop them, it will take a long time to do special exercises.;

jamming. In some cases, the knee may lock in one position and an attempt to bend or straighten the leg leads to severe pain.. This symptom occurs when the internal ligaments go beyond the protrusions of the epiphyses and are strongly stretched.. You can return the joint to its place only if they move back;

increase in knee size. The reason for this may be swelling of the tissues or the growth of osteophytes, which can reach large sizes and form arrays..

Treatment of osteoarthritis of the knee joint Therapy of the disease should be complex, the patient is prescribed drugs that eliminate the inflammatory process, reduce pain and restore cartilage tissue. In addition to the main treatment, the patient should take vitamin complexes, which include calcium, vitamin D3, B vitamins..

Non-steroidal anti-inflammatory drugs Drugs of this group can reduce pain and eliminate the inflammatory process.. For the treatment of the disease, drugs based on ibuprofen, diclofenac, meloxicam, nimesulide are prescribed.. They are produced in the form of tablets, powders, ointments, suppositories or injections.. The course of treatment usually lasts from 5 to 14 days.

Non-steroidal anti-inflammatory drugs are used to relieve pain and inflammation. Non-steroidal anti-inflammatory drugs can adversely affect the digestive system.. Therefore, they are often prescribed in combination with proton pump inhibitors (omeprazole, pantoprazole, lansoprazole).

Preparations for external use do not create a high concentration of the active substance in the blood, so they can be used for a long time.

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