Osteoarthritis of the knee joint

All of the synovial joints exhibited degenerative-degenerative diseases – arthritis, but some in a greater, others to a lesser extent. Most often affects the osteoarthritis knee and hip finishing the joints because they are exposed to significant stress, and knee joints – yet and injury. If the osteoarthritis is localized at the knees, put a diagnosis of gonarthrosis (deforming arthrosis of the knee joint). Osteoarthritis of the knee joint – a disease that often sees a temporary loss of work ability, and disability. What is gonarthrosis of the knee completing the joints, the reasons why it develops and how it manifests itself, this disease, how to treat it – the topic of this article.

A bit of terminology

Osteoarthritis – non-inflammatory joint disease, which begins with the degenerative processes in the articular cartilage, then in the process engage the articular surfaces of the mating bones, the synovial sheath, the muscles that support the articulated arm. Another name for this disease – arthritis, in it is contained a link to it, that the pathological processes occur in bone tissue.

To refine the localization to the name of the disease sounds like the name of the authority: arthrosis of the knee, osteoarthritis of the ankle. Since in the subsequent stage of the peripheral outgrowths of the joint surfaces lead to a significant deformation of the body, osteoarthritis of the knee joint and other articular joints of the so-called deforming, abbreviated as DOA. The diagnosis of DOA means the same thing as osteoarthritis.

What is gonarthrosis and how is called? Quite often on the internet you can come across the phrase gonarthrosis of the knee, gonarthrosis of the hip joint. If the first definition is a tautology, then the second represents a mixture of the names of two different joint diseases. The fact is, that for the convenience of the designations of the most common types of arthritis used names, in which is contained an indication of the localization. So, the first part of the complex words "gonarthrosis" dates back to ancient word meaning "knee". It is gonarthrosis – is it osteoarthritis of the knee joint, may also be used the name of the DOA of the knee joint, the knee, osteoarthritis. And here is the name of gonarthrosis of the knee joint and the like are released.

Anatomy of the knee joint

In the literature you can also come across mentions of osteoarthritis of the femoro-patellar completion of the joints helena patellofemoral syndrome. If you want to understand what it is, it is necessary to familiarize yourself with the anatomy of the knee joint. This condylar articulated arm:

• the articular surface of the femur is convex head;
• lower leg – trench.

In addition to the large tubular bones in the education of the knee joint is involved in a small sesamoid bone known as the patella helena kneecaps. The rear surface of its upper edge articulates with the femur. Patella in Latin is called the patella and the femur – femora. This means that if you translate into English the word femoropatellar hits the femoral-patellar. It is not a separate hang of it, but part of a complex of the knee completing the joints. Of knee, holding in the correct position system of ligaments, but sometimes shifted as a result of injuries helena initially has the configuration, leading to instability.

Offset, the instability of the patella – the main factors that lead to the development of the so-called patellofemoral arthrosis. To his reasons also include traumatic damage to the cartilage of the patella in the bangs, crashes. Experts usually use the term patellofemoral painful, because the mechanism for the development and clinical picture of this disease vary from the classical, which are typical for arthrosis. This disease is treatable, because the thinning of the cartilage (chondromalacie) only occurs in 3 stages, the prognosis is quite favorable. But in the absence of proper treatment, this disease goes into gonarthrosis.

The causes of the disease

What is osteoarthritis of the knee joints and the what causes it cause? One we've already said – injury and instability of the patella, which was launched patellofemoral syndrome (physicians often perceive as periartroz).

Reasons of joint arthrosis of the knee joint include:

• a congenital weakness of the muscular-ligamentous apparatus, stabilizing the knee joint;
• vascular disease of the lower extremities (varicose veins, thrombophlebitis), which is disrupted blood flow to the knee joint;
• prolong inflammatory processes in the joint cavity and periarticular tissues;
• endocrine disorders, especially diabetes mellitus;
• injuries of the lower extremities.

Osteoarthritis of the knee joints threatening to people who are diagnosed with DOA ankle, coxarthrosis, flat feet. When defeat in the ankle helena of the hip joint, a violation of the support function of the feet increases the burden on the knee. With increasing age the frequency of cases of arthrosis of the knee joints increases. This is due to the slowing of metabolic processes and regeneration, disorders of blood circulation, natural wear and tear of the cartilage, changes in the hormonal background.

Gonarthrosis in young age is more often develops in persons with a hereditary predisposition, genetic defects of the connective tissue. He also exposed to athletes and people engaged in heavy physical work with the load on the feet. Heavily damaging knee joints overweight.

Symptoms

When arthritis of any localizing symptoms gradually builds up from stage to stage. At 1 stage gonartrózaa the patient is experiencing discomfort:

• feet quickly get tired;
• at the beginning of the movement creates short-term pain, feeling of pressure, stiffness, but in about half an hour these symptoms disappear;
• the pain may resume after a long load, but goes after the rest.

On the 2 stage so negligible load to cause pain, and needs a longer rest to get it passed. Because in this stage often inflammation of the synovial shell, the mechanical headaches with join inflammation that occur in the idle state. For synovitis is the typical increase in the knee due to the accumulation of inflammatory exudate in the joint cavity, the skin often turns red, becomes hot to the touch.

If in the early stage of contractures (limitation of motion of the joint), most often are associated with painful sensations while moving, then depending on how disease of the knee completing the joints progresses, contractures are persistent. The growth of osteophytes, which prevents movements, shortened and lose their elasticity of the ligaments, weak muscles, reduces the private intra-articular lubrication – synovial fluid. On the 3rd phase of the amplitude of the movements decreases strongly, some patients may only perform rocking motion in the knee. Finally, at the late stage of the joint deformed due to bone growths, the leg at the knee twisted (X-shaped helena O-shape deformation).

What is osteoarthritis of the knee joints and what are the signs allow you to distinguish from patellofemoral syndrome? For the last are characteristic of:

• pain that is localized in the front of the knee, manifested usually in Jogging, are amplified in squats, lifting from the chair, walking up stairs;
• swelling in the area of the kneecap;
• limping walking;
• clicks during the movement, whereby clicking and pain, which arise at the same time.

Swelling of the knee, change in gait, pain syndrome are characteristic and for gonarthrosis, but the pain is manifested in the depth of the joint, most often suffer from its inner side. Movements often accompanied by pain and crepitus. To accurately determine the localization of the process, it is necessary function tests and x-rays.

Methods of diagnosis

The diagnosis of DOA put after a comprehensive examination of the patient. First, the doctor listens to the complaints, examines the medical history, checks the feet, palpate the joints, carried out passive movements, and asks the patient to perform a series of active. Gonarthrosis is one-way and two-way. In the one-sided defeat of the healthy limb compared with the sick. Assesses range of motion, muscle strength, measured by the loop of the hips and lower limbs, the length of the legs. Because of gonarthrosis accompanied by atrophy of the muscles and ligaments, the affected leg is reduced in volume, and is shortened.

After the physical survey prescribe the hardware and laboratory:

• the main method of diagnosis of arthrosis – an x-ray image is performed at least in 2 planes;
• CT – variety x-ray studies, which is extracted layer-by-layer image of the joint;
• assess the condition of the cartilage, soft tissue, the volume of intra-articular fluids allows ULTRASOUND;
• a highly informative method of diagnosis – MRI;
• tests are appointed, in order to distinguish arthritis from arthritis and other inflammatory diseases.

In establishing the diagnosis and determining the degree of gonarthrosis in the knee joints rely on the data of the x-ray.

1. A small, usually asymmetric joint space narrowing, beginning with osteophytes in the form of a small tapering on the edges of the joint surfaces.
2. Narrowing of the articular lumen to 50% and more, big more osteophytes, seal of bone tissue (osteosclerosis) in the places of greatest load. In the background the chimneys of the osteosklerózya could occur to enlightenment – testopodobnymi cavity.
3. The almost complete absence of articular lumen, expressed osteosclerosis, coarse osteophytes, deformation of the articular surfaces of the bones, the smoothing of the relief, the curvature of the axis of the limb.

Treatment

Another question: what is osteoarthritis of the knee joints and how to fight it? Methods of treatment of this disease are diverse, a very important is a comprehensive approach, a combination of medication and non-drug therapy. Treatment should start with limiting the load on the knees. For it is necessary to refrain from running, jumping, lifting weights, overweight patients should lose weight.

For those whose muscles are weakened due to a sedentary lifestyle, it is necessary to move more, but not to overload the knee joints. Shoes should be comfortable, when walking it is recommended to use a walking stick, also an orthopedist can pick up a knee pad, brace and other accessories for relief and stabilization of the joint. Definitely need to stick to a diet.

Treatment treatment

How to treat arthritis, if it is accompanied by pain? Most often their cropped using a non-steroidal anti-inflammatory drugs that are taken orally and is used in the form of ointments, gels. Additionally prescribe irritating ointments. During intense inflammatory process can be displayed injection into the joint of the hormonal drugs in combination with local a local anesthetic. But such treatment only relieves the symptoms, it spends a brief courses, on the testimony.

On the 1-2 stages of symptomatic treatment necessarily need to be combined with the prolonged enjoyment of chondroprotectors. These drugs slow down the destruction of cartilage, and in the early stage even support her recovery. Perfectly removes pain and restores the mobility of the intra-articular injection of hyaluronic acid.

Of drugs in osteoarthritis can also set apart a vasodilator, and drugs to improve the microcirculation, their income is indicated by the in violation of blood supply to the joint. Relieve muscle spasms help muscle relaxants. The specific means for the treatment of arthritis along with cartilage pads is the remedy, the neutralizing activity of the protein, which destroys the cartilage of the fabric.

Non-drug treatment

Is indicated when gonartrózae the knee joints and non-drug treatment. To the methods of non-drug therapy include:

• physiotherapy – electrophoresis, ultrasound, magnetic therapy, laser therapy, durable goat, a UFO and more;
• the application of paraffin, ozokerite;
• compresses with dimexide, medical bile, a mineral;
• massage with an influence mainly on the joint and surrounding muscles;
• manual therapy – traction helena soft reduction of the joint;
• Exercise therapy, physiotherapy. Handle the exercises can be on the training video, the description of the complexes with the photo, but it is better to start lessons under the supervision of an instructor.

In a number of clinics currently underway to test an innovative method of treatment – stem cell therapy. It allows you to restore cartilage tissue, without resorting to surgical intervention.

On 1 stage of gonarthrosis is given only conservative treatment begins with 2 may be surgery. The most progressive operations in osteoarthritis:

• arthroscopic debridment – removal of osteophytes, dead land of the cartilage through a small incision;
• arthroscopic chondroplasty – "mending" of the articular cartilage;
• the knuckle – joint of the artificial.

The first two operations are carried out usually in 2 stages, to give temporary effect for 1-2 years. The joint is shown in 3 stages of arthrosis of the knee, it's the only way to avoid disability. Implants serve 15-20 years, after which it is necessary to re-operation.

Gonarthrosis or arthrosis of knee joints is included in the first three most common types of arthritis. Knee pain may signal not only on the development of the arthrosis, but also on the damage to the ligaments helena meniscus, arthritis and a number of other diseases. Therefore, when the occurrence of anxiety symptoms need to see a doctor and undergo examination.

Often osteoarthritis in the knee joints progresses slowly, from the emergence of the first symptoms until the complete loss of function of a joint can go through a couple of decades. Completely cure gonarthrosis can't, but if you start treatment at an early stage, is more likely to hinder his development and delay the last phase, leading to disability.