The knee joints are distinguished by a particularly thick and dense cartilage lining - after all, nature intended them to withstand the weight of our body and absorb shocks when walking, running and jumping. And although the average person runs much less than his wild ancestors, this does not make it easier for the joints: they suffer from excess body weight, monotonous loads and even the wrong selection of furniture, due to which the legs do not rest, even if we are sitting. Most sports injuries occur in the knee area.
Doctors warn: gonarthritis (or arthritis of the knee joint) increasingly begins at a young age - starting at 30 years old. What are the symptoms and treatment of knee arthritis? How to treat knee arthritis?
Causes
Primary gonarthritis develops more often after injuries, operations and infection of open wounds. Secondary - against the background of other diseases: gout, rheumatism, psoriasis.
Other factors influencing the development of the disease are:
- hypothermia, frostbite;
- excess weight;
- changes in joints due to tumors;
- disturbances in metabolic processes and the endocrine system;
- uncomfortable shoes.
People over 25 years of age are at risk, but 70% of cases of the disease are diagnosed in elderly patients. The negative impact of arthritis extends to other organs: kidneys, heart, liver.
Knee structure
The knee is a complex structural element of the musculoskeletal system, which provides flexion and extension movements of the lower limb in this section. The articulation is based on the following bone components:
- Distal part of the femur (internal, external condyle);
- Proximal part of the tibia (also internal, external condyle, tibial plateau);
- The patella is a flat bone, which is surrounded on all sides by connective tissue fibers of the tendon coming from the femoral muscles (easily palpable through the skin on the anterior surface of the joint).
The articular bony surfaces of the femur and tibia are not compatible; for normal sliding, a cartilaginous layer is located between them. The cartilage in the knee takes the form of paired formations - menisci. The menisci have a horseshoe shape (the convexity is directed outward), and they are anatomically distinguished:
- Body (the most massive part);
- Front horns;
- Hind horns.
An important role in the knee is played by the tendon-ligamentous apparatus, which ensures the stability of the articulation in the sagittal and frontal planes. The posterior and anterior cruciate ligaments prevent pathological mobility in the anteroposterior direction. When they rupture, a “drawer” symptom appears, when, with a fixed tibia, the femur can be moved back. To combat the disease, you need to know exactly the symptoms and treatment of knee arthritis.
The medial and lateral collateral ligaments provide immobility of the knee in relation to the outer and inner sides. When the internal or external collateral ligament is torn, a valgus (towards the midline) or varus (away from the midline) deformity of the lower extremity can occur.
Cost of arthritis treatment
| Services list | Price, rub |
| Initial consultation with ORTHOPEDIST | 1600 |
| Repeated consultation with ORTHOPEDIST | 1200 |
| Consultation with an ORTHOPEDIST in a cycle | for free |
| Therapeutic puncture of the joint and joint capsule | 5500 |
| Intra-articular administration of drugs, without consumables | 4400 |
| Plasmolifting (Orthoplasma) into the joint | 7000 |
| Intra-articular injection (diprospan) | 5500 |
| Complex taping (joints) 1 zone | 1600 |
| Complex taping (joints) 2 zones | 2200 |
| Intra-articular blockade | 5500 |
| Paravertebral plasma | 6500 |
| Initial consultation with a kinesiotherapist | 1600 |
| Interim consultation with a kinesiotherapist | for free |
| Session with a kinesiotherapist (1 patient) | 3900 |
| Individual lessons with a personal trainer | 2700 |
| Intra-Articular PRP Injection | 7000 |
| Manual therapy 1 department (15 min.) | 2700 |
| Soft manual techniques (30 min.) | 4500 |
| Osteopathic techniques (30-75 min.) | 7000 |
| Kinesio taping 1 zone | 1100 |
| UVT 1 procedure | 2000 |
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Diagnosis of the disease
If a patient has symptoms of knee damage, the traumatologist first of all conducts an objective examination. After examination, palpation and auscultation of the joint, the doctor makes a preliminary diagnosis and determines what additional research methods may be needed.
To exclude the presence of fluid or blood in the joint cavity, an ultrasound examination is prescribed. X-rays may be needed to assess the condition of the adjacent bones. In this case, a fracture, dislocation, narrowing of the intercartilaginous gap or the presence of osteophytes (bone outgrowths) may be detected. If a more thorough assessment of the condition of bone tissue is necessary, computed tomography is prescribed.
For differential diagnosis of damage to the meniscus and ligamentous apparatus, magnetic resonance imaging is prescribed, which allows for good visualization of soft tissue formations.
Sometimes doctors perform joint punctures (if there is exudate in its cavity). The extracted synovial fluid is sent for laboratory testing (microscopic, bacteriological, and biochemical studies are carried out). In addition, during manipulation it is possible to administer medications directly into the joint cavity. Without using all diagnostic methods, treatment of knee arthritis will be ineffective.
Surgically
In cases of severe arthrosis, which is accompanied by rapid destruction of cartilage tissue, surgical intervention (arthroplasty) is used. The most common procedures are hip or knee replacements. Previously, most of the operations were performed on elderly people, whose age was 60 years or older. However, with the development of technology, artificially produced implants have become much better, and therefore young patients also undergo similar operations. However, another procedure in the form of revision surgery has been prepared for them in the future. Therefore, it is important to understand this before undergoing surgery.
Prospects for recovery after surgery
Endoprosthesis replacement is the most effective method of treating pathological changes in the knee joint. It allows you to get rid of chronic pain, completely restore the mobility of the knee and return the person to the ability to move. In the absence of complications and a favorable course of the recovery period, a person can return to a full life within a few months.
However, no prosthesis can completely replace the “native” joint. Therefore, after the operation you will have to take some precautions. You will not be allowed to kneel, engage in certain sports, jump, fall, make sudden movements, etc.
As for patients with rheumatoid arthritis, after surgery they will have to continue to take basic anti-inflammatory and genetically engineered drugs. Drug therapy is necessary to reduce the activity of the disease, avoid further destruction of large joints and another operation.
Physiotherapy
Phonation
Vibroacoustic therapy involves the transmission of sound microvibration using a special medical device. It creates microvibrations that, with their physical characteristics, are identical to those created by muscle tissue under maximum static physical tension. In short, this therapy is a direct alternative to exercise.
Vitafon.
Phoning Effects:
- Improving lymph flow in the area of influence, which promotes accelerated tissue cleansing, has an anti-inflammatory effect.
- Improves blood flow and, accordingly, nutrition of the treated area.
- Has a beneficial effect on nerve pathways with prolonged exposure.
- Promotes the release of joint lubrication.
Galvanization and electrophoresis
The essence of the procedure is to activate the blood supply to joint tissues in chronic arthritis. Vasodilation occurs in the area of influence, increasing blood supply and improving recovery processes.
Electrophoresis.
UHF therapy
The affected joint is exposed to a continuous or pulsed electric field. For the knees, low-thermal doses are used at a current power of 20-30 W.
The procedure is aimed at reducing swelling, activating regenerative processes in the joint, improving nutrition and blood supply. The method allows you to achieve long-term remission.
Infrared laser therapy
Using a laser applicator, they act on biologically active points located along the lateral surfaces of the joint. The procedure activates blood flow, reduces pain sensitivity, and stimulates healing processes.
Ultrasound therapy
The method optimizes and accelerates the biochemical processes occurring in joint tissues, accelerates healing processes, and reduces swelling.
Hydrogen sulfide and radon baths, peloid therapy, massage, and manual therapy have also proven themselves well.
Glucosamine
It acts as an amino sugar, which gives a “start” to the biochemical synthesis of glycosylated proteins. It is also a structural component of cartilage tissue. Thanks to glucosamine, the body receives “natural” materials for the development, repair and support of tendons, ligaments and other tissues. With age, the body produces less of this substance, which leads to deterioration of the musculoskeletal system.
Rheumatologists say that taking a glucosamine supplement can reduce pain and the destruction of cartilage tissue. More than 18 studies that served as the basis for the 2005 review clinically supported the substance's effectiveness and beneficial effects on osteoarthritis.
The norm for patients is 700 mg/day. If necessary, the dosage can be increased to 1500 mg.
Prevention
- The most important factor in favorable disease control is control of BMI (body mass index), which reduces the axial load on the joints. You should avoid foods rich in starch and sugar (potatoes, sweets, sweet flour products). 2. It is worth adding more vegetables and fruits: apples, sea buckthorn, rowan, black currants, plums.
- Include fatty fish in your diet: tuna, salmon, cod, sardines, trout, herring.
- Rejection of bad habits.
- Taking vitamins.
- Hardening.
- Maintaining a healthy lifestyle.
- Strengthening the immune system.
- Maintain an active lifestyle (preferably including regular exercise).
Alternative medicine
Alternative treatment will not replace medication. However, many patients tend to claim that, for example, acupuncture or reflexology helps reduce symptoms and side effects while taking medications.
It is important to note that treatment is most successful when the course begins early. Its goal is to reduce pain, support and improve skeletal functionality.
It is worth noting that you should not self-medicate. Contact a specialist, he will select the necessary medications for you according to your condition. He may also refer you to physical therapy.
Please note that walking for an hour or two in the fresh air will help prevent the disease. This is especially important with a sedentary lifestyle and low mobility. Do exercises in the morning; this will not only reduce the risk of illness, but also improve your well-being and give you strength for the whole day.
General clinical recommendations
Patients suffering from gonarthritis are recommended:
- avoid heavy physical activity and heavy lifting;
- lead a healthy lifestyle;
- do therapeutic exercises, swim;
- eat properly regularly;
- do not smoke, do not abuse alcohol;
- regularly carry out anti-relapse treatment courses recommended by your attending physician;
- promptly treat any acute and chronic diseases, foci of infection.
Prevention of knee arthritis
It is especially important for people at risk to follow preventive measures:
- athletes - avoid knee injuries, wear special knee pads;
- persons who have relatives suffering from rheumatoid, reactive, psoriatic, gouty arthritis should be attentive to their health and, if knee pain occurs, immediately seek medical help;
- promptly identify and treat all foci of infection - carious teeth, tonsillitis, sinusitis, etc.
Physiotherapy
Physiotherapy is an integral part of complex treatment for arthritis (ICD-10 code M05–M99) of the joints. Some of them are used during the acute period of the disease. Procedures that are done for inflamed joints:
- electrophoresis with glucocorticoids;
- ultraviolet radiation.
They relieve inflammation and pain.
At other stages of the disease the following is prescribed:
- magnetic therapy;
- laser irradiation;
- phototherapy using lamps;
- massage and self-massage;
- mud baths;
- hydrotherapy.
Therapeutic gymnastics is very important for damaged joints. It helps improve their mobility and prevents the formation of adhesions. The patient should perform exercises daily from the very beginning of the diagnosis, excluding the time of exacerbation of the disease. In addition, patients with autoimmune arthritis should receive an annual course of sanatorium-resort treatment, and the use of essential medications is not canceled.
Therapy methods
The most important tasks in the treatment of arthritis are:
- Reducing the inflammatory process in the synovial area to maintain and normalize the dynamic ability of the joints.
- Preventing the development of a destructive process.
Treatment methods for autoimmune arthritis include a whole range of different measures:
- Relieving symptoms – most often you have to deal with painful sensations. They can be easily treated with NSAIDs.
- Basic therapy - it begins immediately after the disease is detected. With the correct prescription of drugs, it is possible to relieve inflammation and achieve remission for a long period. First-line drugs, for example, Methotrexate, are especially effective; second-line drugs are less effective and are used if the first are intolerant.
- Local treatment - rubbing with ointments and other means are used, for example, compresses for joints with Dimexide.
- Physiotherapeutic procedures eliminate inflammation and reduce pain. Used at various stages of the disease.
- Surgical intervention is used extremely rarely if there is no effect from conservative treatment.
- Folk remedies - used only after consultation with a doctor. Very often, traditional healers recommend burdock and bay leaves.
- Dietary nutrition is an invariable condition for the successful fight against arthritis.
Stages of gonarthritis
There are three stages of the disease in total:
- Initial. Characterized by inflammation of the inner surface of the synovial membrane. The initial stage does not last long, since the inflammatory process quickly spreads to other structures.
- Early gonarthritis. Inflammation affects the synovial membrane and cartilage tissue. The joint capsule thickens and becomes swollen. If the disease is infectious, purulent exudate may accumulate in the joint cavity; if it is reactive, transudate may accumulate.
- Advanced gonarthritis. At the third stage, destructive changes appear in the synovium and cartilage. Later, the pathological process spreads to bone and periarticular tissues. The patient has impaired mobility of the knee and, as a result, of the entire lower limb.
Stages of knee arthritis on x-ray.
The development of some types of arthritis can be stopped if treatment is started in time. Often the disease can be completely cured without allowing the second stage to progress to the third. Most infectious, reactive and early post-traumatic gonarthritis respond well to treatment, provided that the therapy is timely and adequate. As for rheumatoid, psoriatic and advanced post-traumatic arthritis, they have a chronic progressive course. This means that even effective and timely treatment cannot stop their development. Therefore, a large number of patients sooner or later have to undergo surgery. According to statistics, every eighth patient with rheumatoid arthritis and every fifth patient with severe knee injuries require knee replacement.
Methylsulfonylmethane
Methylsulfonylmethane (MSM) is an organosulfur compound. Also known as methylsulfone or dimethylsulfone. Sulfur plays an important role in the formation of connective tissue. This substance is a mild analgesic that reduces pain.
According to a pilot study that involved 50 people with knee osteoarthritis, it was found that when taken at 6000 mg per day, the drug reduced severe symptoms of the disease with minimal side effects. The study was conducted in 2006. Future trials have been conducted numerous times, all of which have shown a reduction in oxidative stress and inflammation through MSM supplementation. It turned out that it protects muscles from various mechanical damage that arise from an active lifestyle.
