Osteoarthritis of the knee joint

All synovial joints are exposed degenerate-degenerative diseases of the arthritis, but some more, others less. Most often affects the osteoarthritis of the knees and the hip joint, because they are exposed to considerable stress, and the joints of the knee and injuries. If the osteoarthritis is localized at the level of the knees, diagnosed the knee (deforming osteoarthritis of the knee). Osteoarthritis of the knee joint is a disease that often leads to a temporary disability and disability. What is gonarthrosis of the knee-joint, for what reasons develops and how it manifests this disease, how to treat it – the subject of this article.

A bit of terminology

Osteoarthritis – non-inflammatory joint disease, which begins with the degenerative process in the articular cartilage, iup in the process involved joint site of the mating bone, synovial sheath, the muscles that support the joint. Another name of this disease of osteoarthritis, it indicates that the pathological processes occurring in bone tissue.

To refine the location in the title of the disease, it adds the name of the body: osteoarthritis of the knee, osteoarthritis of the ankle. As an advanced stage of the limit expansion joint sites lead to severe deformation of the authority, of osteoarthritis of the knee and other articular joints called deforming, in abstract of the DOA. The diagnosis of DOA means the same thing as osteoarthritis.

What is the knee and, as it's called again? Very often, on the internet, you can meet the phrases of the knee of the tribe, the the knee hip. If the first definition is a tautology, the second is a mixture of names, two joint diseases. The fact that for the convenience to designate the most common types of oa use the names, and which contains an indication on the location. Thus, the first part of a compound word, "the knee" goes back to the ancient Greek word, which means "the knee". It is the knee – is it osteoarthritis of the knee, can also be used in the name of DOA of the knee joint, the knee osteoarthritis. And here is the name of gonarthrosis of the knee joint, and others are redundant.

The anatomy of the knee joint

In the literature, one can encounter a mention of the osteoarthritis of the femoro-patellar joint or patellofemoral caudal. To understand what it is, you need to be familiar with the anatomy of the knee joint. This is joint condylar:

• the articular surface of the thigh is a convex crown;
• tibia – cavity.

Outside of the large bone in the formation of the knee joint is part of a small sesamoid bone known as the patella or of the patella. The back surface of its upper edge, it is mated to the thigh. The ball joint on the latin is called the patella and the femur – femurs. If the translation of the word femoropatellar, you get a femoral-patellar. This is not independent of the joint, and the complex part of the knee joint. The ball remains in the correct position, the system of ligaments, but sometimes, it moves because of injury or first configuration, leading to instability.

The offset, the instability of the patella – the main factors of the development of the so-called patellofemoral of osteoarthritis. His reasons apply also to traumatic lesions of the cartilage of the patella during shocks, falls. The experts generally use the term patellofemoral pain syndrome, because the mechanism of development and the clinical picture of this pathology differ from traditional, typical of osteoarthritis. This disease is difficult to treat, because the thinning of the cartilage (chondromalacia) occurs only on 3 stage, the prognosis is quite good. But in the absence of treatment, the disease passes into the knee.

The causes of the disease

What is osteoarthritis of the knee and the causes of its cause? A we have already named – injury and instability of the patella, launched patellofemoral caudal (doctors often consider as periartroz).

The causes of osteoarthritis of the knee joint are:

• congenital weakness of the muscular-ligamentous apparatus, stabilization of the knee joint;
• vascular pathology of the lower limbs (varicose veins, thrombosis), for which the supply of blood to the tribe;
• long inflammatory processes in the joint cavity and the tissue periarticular;
• diseases of the endocrine system, particularly diabetes mellitus;
• injuries of the lower limb.

Osteoarthritis of the knee threat of people diagnosed DOA of the ankle, osteoarthritis of the hip, feet flat. When the defeat of the ankle or hip joints, and the violation of a reference function of the foot increases the load on the knees. With age, the frequency of cases of osteoarthritis of the knee increases. This is due to a slowdown of metabolic processes and the process of regeneration, circulatory disorders, the consequences of the wear and tear of the cartilage, changes in hormone levels.

The knee at a young age often develops in people with a hereditary predisposition, genetic defects of the connective tissue. It has also exposed the athletes and people engaged in physical labor heavy, with the load on the feet. Serious damage to knee joints of the excess weight.

The symptoms

When arthritis of any localizing symptoms gradually accumulated over the course of the stages. In step 1 of the knee the patient is experiencing discomfort:

• the legs get tired quickly;
• at the beginning of the movement occurs on a short-term pain, a feeling of tightness, stiffness, but about a half hour, these symptoms disappear;
• the pain may be renewed after a long load, but goes after the rest.

On 2 the stage low enough load, to cause pain, and requires a longer stay than he has spent. Because at this stage, often-inflamed synovial sheath, the mechanical pain join inflammatory, all of which occur in a state of rest. For synovitis characteristic to increase the tribe due to the accumulation of inflammatory effusion in the joint cavity, reddened skin often is hot to the touch.

If the early phase of the contracture (restriction of the mobility of the joint) is mostly related to painful sensations with the movements as the disease of the knee joint progresses, the contracture economic resistant. The proliferation of osteophytes, which prevent movements, shortened and lose their elasticity of the ligaments, weakening the muscles, decreases the production of intra-articular fat – synovial fluid. 3-the phase of the amplitude of the movements is strongly reduced, some patients can not do that rocking motion at the knee. Finally, at an advanced stage, the joint is deformed due to bony growths on the foot in the knee bent (X-shape or the shape of the deformation).

What is osteoarthritis of the knee and symptoms that help distinguish it from patellofemoral syndrome? The last is characterized by:

• the pain, which are located at the front of the knee, felt mostly when jogging, as transposed accented when gliding down, rising from the chair, walking to the stairs;
• the swelling in the area of the patella;
• the lameness of the approach;
• the clicks with the movements and clicks and pain do not occur at the same time.

The swelling of the knee, the modification of the process, the pain syndrome characterized by and for the knee, but the pain felt in the depth of the joint, the more often prey to its inner side. The movements are often accompanied and pain, and crepitus. In order to determine precisely the location of the process requires function tests and x-rays.

The methods of diagnosis

The diagnosis of DOA is placed after the complete study of the patient. First, a doctor is listening to the complaint, study the history, look at the feet, palpating the joints, performs passive movements and asks the patient to perform a number of assets. The knee is unilateral and bilateral. When unilaterally defeat healthy member compare with the patient. Assess the amount of motion, muscle strength, measure of the loops of the shoulder, the thighs and the shins, the length of the leg. Because the knee is accompanied by an atrophy of the muscles and ligaments, a shock to the leg decreases volume and shortens.

After physical survey prescribed and the laboratory equipment:

• the main method of diagnosing osteoarthritis, x-rays, photo is at least 2 projections;
• CT – shape of the x-ray examination, which is layer-by-layer image of the joint;
• assess the state of cartilage, soft tissue, the amount of fluid intra-articular allows the ULTRASOUND;
• very informative method of diagnosis – MRI;
• the analyses are named, to distinguish it from osteoarthritis, arthritis, and other inflammatory diseases.

The diagnosis and determining the severity of gonarthrosis of the knee is based on the data from the x-ray.

1. Light, usually uneven narrowing of the joint space, spurs in the form of a small tapering on the edges of the joint land.
2. The shrinkage level of 50% and more of the large multiple osteophytes, joint of bone tissue (osteosclerosis) in the places of greatest load. On the background of foci of osteosclerosis may be observed in the illumination – testopodobnymi of the cavity.
3. The almost complete absence of the vehicle, expressed osteosclerosis, of osteophytes, deformation of the articular surfaces of the bones, the smoothing of their relief, a deviation of the axis of the member.

Treatment

Next Question: what is osteoarthritis of the knee and how to fight it? The methods of treatment of this disease are various, it is crucial that an integrated approach, combining drug and non-pharmacological therapy. Treatment should begin with the limit load on the knees. To do this, it is necessary to abandon the race, jumps, weight lifting, patients with an excess weight you need to lose weight.

Those whose muscles are weakened due to inactivity, the need for more to move, but not to overload the knee joints. The shoes should be comfortable when walking, it is recommended to use a cane, also orthopedic doctors can choose from knee pads, orthez and other accessories for the unloading and stabilization of the joint. Not necessarily need to follow a diet.

The drug treatment

How to treat osteoarthritis, if it is accompanied by pain? Most often, cropped to the help of nonsteroidal anti-inflammatory drugs, which is taken orally and use it in the form of ointments, gels. Rogue prescribe irritants the ointment. In case of inflammatory process can be displayed by the injection into the joint of the hormonal drugs combined with local anaesthetics. But this treatment only relieves the symptoms, his conduct brief exchange, according to the testimony.

1-2 stages of symptomatic treatment necessarily needs to be combined with a long reception chondroprotectors. These drugs slow down the destruction of cartilage and early onset of the same to contribute to its restoration. Well relieve pain and restore mobility intra-injection of hyaluronic acid.

Drugs with osteoarthritis may also be appointed as vasodilators and drugs to improve the microcirculation, their receipt is posted at the violation of the blood supply of the joint. Relieve muscle spasms help muscle relaxants. A specific means for the treatment of arthrosis with the protective cartilage is a drug neutralizing the activity of the protein, which destroys the cartilage tissue.

Non-drug treatment

Shows patients the knee joints of the knee and non-drug treatment. Methods non-pharmacological therapy are:

• physical therapy – electrophoresis, ultrasound, magnetotherapy, laser therapy, UHT, UV and other;
• application of paraffin, ozokerite;
• compresses with dimexide, medical, bile, bichofite;
• massage to impact mainly on the joint and muscles;
• manual therapy – stretching or an open reduction of the joint;
• PHYSIOTHERAPY, physiotherapy. Master the exercises, a training video, complex descriptions with the photo, but it is best to start the course, under the supervision of an instructor.

In a number of clinics pass the test of an innovative method of treatment of stem cell therapy. It allows you to recover the cartilage, the tissue, without the need for surgical intervention.

On step 1 of the knee shows only conservative treatment, starting 2 may be a surgical intervention. The more progressive of the transaction with osteoarthritis:

• arthroscopic debridment – removal of osteophytes, dead pieces of cartilage through a small incision;
• arthroscopic arthroplasty of the knee – the "difficulty" of the articular cartilage;
• stent – replacement of the artificial joint.

The first two operations usually take place on 2 phase, give a temporary effect, 1 to 2 years. Arthroplasty of the shows on the 3 stages of osteoarthritis of the knee, it is the only way to avoid the disability. Stents are used of 15-20 years, after a new operation.

Gonarthrosis or osteoarthritis of the knee is one of the three most common types of osteoarthritis. The pain in the knee may indicate not only the progression of osteoarthritis, but an injury to the ligaments or menisci, arthritis and other diseases. Therefore, at the onset of the symptoms of anxiety it is necessary to consult a doctor for an examination.

Often osteoarthritis of the knee is progressing slowly, since the onset of the first symptoms until the complete loss of the functions of the joint can pass the past two decades. Heal completely and the knee can not, but if you start treatment early, the greater the chances to slow development and delay the final step leading to disability.