Arthrosis of the knee: causes, signs and symptoms

Joint pathologies are one of the most common among all disorders of the musculoskeletal system. Inflammatory and non-inflammatory diseases significantly worsen the quality of human life and in many cases lead to disability. One of the most common diseases is osteoarthritis of the knee joint. Symptoms of pathology are more often acute and require qualified assistance.

Causes of the disease

In medicine, the disease is also called osteoarthritis, gonarthrosis, deformed osteoarthritis (DOA). Arthrosis is a general name for all degenerative-dystrophic diseases of articular and intervertebral joints. A disorder in the knee joint is called gonarthrosis.

It is characterized by damage to the cartilage of the knee joint.

The pathology consists in degenerative-dystrophic changes of the bone and cartilage tissue, which is characterized by the gradual thinning of the cartilage of the articular joint and the parallel formation of bone formations.

This is the body's reaction to friction and increased pressure. The most likely causes of symptoms of gonarthrosis of the knee joint are the following:

• Traumatic injuries of mild and severe forms with impaired movement of the articular joint for a long period of time. Rupture of ligaments or heavy bruises often lead to the development of an inflammatory process, which results in symptoms of gonarthrosis.
• Surgery to remove any defect or foreign body in the knee joint.
• Prolonged and excessive physical activity on an ongoing basis. This may be due to a professional sport or specialty. Constant tension in the joint area leads to gradual thinning of the cartilage, which negatively affects the entire musculoskeletal system.
• Acute bursitis with the development of purulent inflammation in the joint cavity. As a rule, it is difficult to get rid of such a pathology in a conservative way, so doctors resort to minor surgical intervention, which negatively affects the cartilage tissue.
• Arthritis of different forms and severity. In this case, the inflammatory process is pronounced, proceeds with a sharp increase in temperature and leads to the development of arthrosis after a certain period of time.
• Gout also often causes cartilage pathology with severe clinical manifestations and joint deformity.
• Weakened immunity, which provokes the gradual removal of bone and cartilage tissue due to the inability of the body to cope with the pathology.
• Bad habits - alcohol abuse, smoking - quite often become a factor causing signs of pathology.
• Severe autoimmune diseases.
• Viral and catarrhal pathologies that cause the inflammatory process and the development of degenerative-dystrophic changes are common.
• Overweight and severe obesity also cause disorders, because each extra kilogram increases the load on the articular joints by 10 times, which will definitely affect the cartilage tissue.

It should be noted that all these reasons most often lead to secondary violations. There is also a primary one, which differs in that the disease occurs as a result of the body's natural aging process. Bone and cartilage wear away, increasing friction and stress. The result is gonarthrosis.

Varieties of pathology

There are several types of pathological conditions, each of which has its own characteristics. Depending on how the joint is damaged, the following types of disorders are distinguished:

1. The right side is characterized by the appearance of cartilage tissue changes on the right side. As a rule, this is the initial stage of the disease.
2. The signs of left-sided gonarthrosis of the knee joint do not differ from the right side in terms of the nature of the clinical picture. But it is noted that this type often develops in overweight patients.
3. Bilateral refers to severe forms, affects the entire cartilage and is characterized by severe pain.

It is noted that the latter type is more often observed in elderly patients with primary tissue damage. Depending on the course of the pathological process, acute and chronic types are distinguished. The first is characterized by rapid progression and the development of complications, the second is slow and may not bother the patient for several years.

Clinical picture

Signs and symptoms of gonarthrosis of the knee joint largely depend on the degree of damage to the joint. Currently, there are several stages of the pathological process, each of which has its own clinical manifestations:

1. The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets more tired than usual, but writes it down as overwork or increased workload. He becomes lethargic, drowsy, and performance is dramatically reduced. Some patients have mild stiffness in the affected joint when moving, especially in the morning. However, they often do not pay attention to this and do not refer to a specialist. If an X-ray of the joint is taken at this stage, a narrowing of the joint space is observed, which provokes the disorder.
2. In the next stage, discomfort and stiffness do not disappear, but only increase. With a small and short-term load, the patient develops severe pain in the knee area, which disappears only after a long rest. In some cases, the joint is swollen and this swelling disappears at night, but reappears during the day. As the pressure on the cartilage tissue increases due to its depletion, the patient often hears a characteristic cramp during movement. The flexion function is also impaired, since the patient cannot fully bend the limb. At this stage, patients usually refer to a specialist.
3. The third stage is the most severe and is characterized by a pronounced pain syndrome that accompanies the patient not only during exercise, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Swelling is constantly observed at this stage. The amount of synovial fluid in the joint bag is sharply reduced, which increases the load and increases the friction in the joint.

4. The initial stage is characterized by the absence of pronounced symptoms and the inability to visually recognize the pathology. The patient gets more tired than usual, but writes it down as overwork or increased workload. He becomes lethargic, drowsy, and performance is dramatically reduced. Some patients have mild stiffness in the affected joint when moving, especially in the morning. However, they often do not pay attention to this and do not refer to a specialist. If an X-ray of the joint is taken at this stage, a narrowing of the joint space is observed, which provokes the disorder.
5. In the next stage, discomfort and stiffness do not disappear, but only increase. With a small and short-term load, the patient develops severe pain in the knee area, which disappears only after a long rest. In some cases, the joint is swollen and this swelling disappears at night, but reappears during the day. As the pressure on the cartilage tissue increases due to its depletion, the patient often hears a characteristic cramp during movement. The flexion function is also impaired, since the patient cannot fully bend the limb. At this stage, patients usually refer to a specialist.
6. The third stage is the most severe and is characterized by a pronounced pain syndrome that accompanies the patient not only during exercise, but also at rest. In severe cases, the pain does not leave a person even at night, which significantly worsens his condition. Swelling is constantly observed at this stage. The amount of synovial fluid in the joint bag is sharply reduced, which increases the load and increases the friction in the joint.

As a rule, the pain disturbs the patient's sleep, there is irritation and a feeling of constant fatigue. Appetite weakens or completely disappears, which leads to the deterioration of the work of the digestive and cardiovascular systems.

Lack of normal sleep often leads to nervous disorders, especially in elderly patients or young people who are engaged in intensive physical work. Decreased memory and decreased concentration of attention are also the result of insufficient rest of the patient.

Usually, the pathology proceeds without temperature, but in the advanced stages, when the cartilage is completely destroyed, the friction of the bones and the pressure between them increases, which leads to the inflammatory process.

The body tries to restore balance and reduce the load on the joint. It is for this reason that osteophytes or bony growths develop in the joint. They become the cause of deformation in the advanced stages of the pathological process.

The most dangerous complication of such disorders will be complete immobilization and disability of the patient. As a rule, this happens in case of lack of proper treatment or ignoring the symptoms of osteoarthritis of the knee for a long time.

Diagnostic methods

To determine the exact diagnosis, the doctor advises the patient to undergo a complete examination. This is necessary not only to determine the cause, but also for the correct selection of drugs necessary for therapy. The first step would be to interview the patient and determine the probable causes. Lifestyle, professional activities and habits play a special role. The next step will be to examine the affected limb and determine the degree of damage.

If there are no visible signs of pathology, the disease is at an early stage. The next step will be to collect anamnesis and identify chronic pathologies that can become a predisposing factor. After that, the patient donates blood for laboratory examination. The detection of traces of inflammation in the form of an increased level of leukocytes suggests that some process has led to the development of the disorder.

A mandatory moment of diagnosis will be an X-ray examination to accurately determine the degree of gonarthrosis. The image usually shows areas of complete cartilage destruction, as well as the number of osteophytes and their location. This helps to clarify the probable diagnosis and prescribe the appropriate treatment.

Sometimes it is impossible to show the exact picture and degree of joint damage on X-ray. In this case, it is recommended to conduct an ultrasound examination of the joint.

In extreme cases, the patient is prescribed a CT scan. This is usually enough to get a complete picture of the disease.

Medical therapy

Conservative treatment of the pathological condition is possible only in the 1st and 2nd stages, when the formation of osteophytes has not yet begun. Therapy is mainly aimed at slowing cartilage destruction and restoring it. The classic scheme includes the use of the following drugs:

1. Means from the group of painkillers that help relieve pain. Allow the patient to feel better, improve the night's sleep. In the hospital, injections are effective, which are given 1 to 3 times a day under the supervision of a specialist. It is not recommended to use the joints for a long time, because they do not affect the course of the pathological process, but only relieve acute pain.
2. Nonsteroidal anti-inflammatory drugs. Funds are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of the pathology, remove local fever and swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active components of the drug is observed in the patient's blood, which ensures a long-term effect. It is not recommended to take medicines for a long time, because they often have a negative effect on the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
3. Chondroprotectors help restore cartilage in the affected joint and increase the amount of synovial fluid. As a rule, such preparations contain glucosamine and chondroitin. It is recommended to take them for a long time. As a rule, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. Longer reception is possible with a clear indication.
4. Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. Helps with swelling and reduces pain. It is allowed to be used only in the hospital as intramuscular or intravenous injections.
5. Nonsteroidal anti-inflammatory drugs. Funds are available in the form of tablets and injections, they can not only eliminate acute pain, but also slow down the progression of the pathology, remove local fever and swelling, and improve motor function. With regular intake for 7-10 days, a constant concentration of the active components of the drug is observed in the patient's blood, which ensures a long-term effect. It is not recommended to take medicines for a long time, because they often have a negative effect on the digestive system. For this reason, they should not be taken by patients with severe peptic ulcers or other disorders.
6. Chondroprotectors help restore cartilage in the affected joint and increase the amount of synovial fluid. As a rule, such preparations contain glucosamine and chondroitin. It is recommended to take them for a long time. As a rule, a course of 8-12 weeks is prescribed with regular visits to a specialist to detect improvement. Longer reception is possible with a clear indication.
7. Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. Helps with swelling and reduces pain. It is allowed to be used only in the hospital as intramuscular or intravenous injections.

In addition to such funds, the patient is prescribed a course using an external agent in the form of an ointment, cream or gel. The latter option is the most preferred because it quickly penetrates into the joint cavity and has a therapeutic effect. Their use is allowed for 14 days. It is not recommended to continue the course independently, as the risk of complications increases.

In the most severe cases, the patient is injected directly into the joint cavity. You can administer conventional analgesics, but the best therapeutic effect is achieved with the introduction of hyaluronic acid preparations. Injections are made 1 time in 7 days. 3-5 injections are enough to completely eliminate the pain. After such therapy, the effect lasts for 6 months. The patient has normal mobility and the pain syndrome disappears almost completely.

If none of the methods bring the expected result and the patient's condition worsens, a surgical operation is performed to replace the joint with a prosthesis. Replace the entire joint or its individual parts. It is usually indicated for arthrosis, which is provoked by a severe injury to the knee. The operation is performed under general anesthesia, and the recovery period is quite long and difficult.

Gonarthrosis is a severe degenerative-dystrophic pathology, which in the absence of proper treatment causes disability of the patient. At the first signs of a disorder, it is recommended to consult a doctor immediately.