Knee osteoarthritis: causes, signs and symptoms

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

Causes of disease

In medicine, the disease is also called osteoarthritis, gonarthrosis, osteoarthritis deformans (DOA). Osteoarthritis is a generalized name for all degenerative-dystrophic diseases of the articular and intervertebral joints. Violation in the area of the knee joint is called gonarthrosis.

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

The pathology consists of degenerative-dystrophic changes in bone and cartilaginous tissue, characterized by a gradual thinning of the cartilage in the joint joint and the parallel formation of bone growths.

This becomes the body's response to friction and increased pressure. The most likely causes of knee joint gonarthrosis symptoms are as follows:

• Traumatic injuries of mild and severe forms with impairment of joint mobility for a long period. Ligament rupture or severe bruising often provokes the development of an inflammatory process, which, as a result, causes the appearance of symptoms of gonarthrosis.
• Surgical intervention in the knee joint to eliminate any defect or foreign body.
• Prolonged and excessive physical activity on a continuous basis. This could be due to professional or specialty sports. Constant tension in the connecting area leads to a 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 conservatively, so doctors resort to a minor surgical intervention, which negatively affects the cartilage tissue.
• Arthritis of various 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 frequently leads to cartilage pathology with severe clinical manifestations and joint junction deformity.
• Weakened immunity, which causes a gradual resolution of bone and cartilage tissue due to the body's inability to cope with the pathology.
• Bad habits - alcohol abuse, smoking - often become a predisposing factor to the appearance of signs of pathology.
• Serious autoimmune diseases.
• Frequent viral and catarrhal pathologies that provoke an inflammatory process and the development of degenerative-dystrophic changes.
• Overweight and severe obesity also cause a violation, as each extra kilo increases the load on the joint joints by 10 times, which will certainly affect the cartilage tissue.

It is worth noting that all of these reasons often trigger a secondary type of violation. There is also a primary one, which differs in that the disease becomes a consequence of the body's natural aging process. Bone and cartilage tissue wear out, which increases friction and stress. The result is gonarthrosis.

Varieties of pathology

There are several types of pathological condition, each with its own characteristics. Depending on how the joint is affected, the following types of disorders are distinguished:

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

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

Clinical condition

The signs of knee joint gonarthrosis and its symptoms largely depend on the degree of damage to the joint. Currently, there are several stages of the pathological process, each with 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 tired more than usual, but considers this as overwork or increased workload. He becomes lethargic, sleepy and performance is drastically reduced. Some patients experience mild stiffness in the diseased joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If at this stage an X-ray of the joint is taken, a narrowing of the joint space can be noted, which causes a violation.
2. In the next stage, the discomfort and stiffness do not go away, but only increase. With a light and short load, the patient develops severe pain in the knee, which disappears only after a long rest. In some cases, the joint swells and this swelling goes away at night but reappears during the day. As the pressure on the cartilaginous tissue increases due to its depletion, the patient usually hears a characteristic noise during movements. Flexion function is also impaired as the patient is unable to fully bend the limb. At this stage, patients usually turn to a specialist.
3. The third stage is the most serious 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 at this stage is constantly observed. In the joint bursa, the amount of synovial fluid is drastically reduced, which increases the load and increases 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 tired more than usual, but considers this as overwork or increased workload. He becomes lethargic, sleepy and performance is drastically reduced. Some patients experience mild stiffness in the diseased joint when moving, especially in the morning. However, they often do not pay attention to this and do not turn to a specialist. If at this stage an X-ray of the joint is taken, a narrowing of the joint space can be noted, which causes a violation.
5. In the next stage, the discomfort and stiffness do not go away, but only increase. With a light and short load, the patient develops severe pain in the knee, which disappears only after a long rest. In some cases, the joint swells and this swelling goes away at night but reappears during the day. As the pressure on the cartilaginous tissue increases due to its depletion, the patient usually hears a characteristic noise during movements. Flexion function is also impaired as the patient is unable to fully bend the limb. At this stage, patients usually turn to a specialist.
6. The third stage is the most serious 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 at this stage is constantly observed. In the joint bursa, the amount of synovial fluid is drastically reduced, which increases the load and increases friction in the joint.

As a rule, pain disturbs the patient's sleep, becomes irritable and feels constant fatigue. The appetite is weakened or disappears completely, which causes a deterioration in the work of the digestive and cardiovascular systems.

Lack of normal sleep often leads to a nervous breakdown, especially in elderly or young patients who are involved in intense physical work. Memory impairment and decreased concentration of attention also become the result of the patient's insufficient rest.

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

The body tries to restore balance and reduce the load on the connection. 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 violations will be complete immobilization of the patient and deficiency. As a rule, this happens in the absence of proper treatment or ignoring the symptoms of knee osteoarthritis for a long time.

diagnostic methods

To diagnose accurately, the doctor suggests that the patient undergo a thorough examination. This is necessary not only to identify the cause, but also for the correct selection of drugs needed for therapy. The first step will be to interview the patient and identify the probable causes. Lifestyle, professional activities and habits play a special role. The next step will be to examine the diseased 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 could become a predisposing factor. After that, the patient donates blood for laboratory tests. The detection of traces of inflammation in the form of an increased level of leukocytes suggests that some process caused the disorder to develop.

A mandatory moment in the 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 clarify the presumptive diagnosis and prescribe appropriate treatment.

It is sometimes impossible to see the exact image and degree of joint damage on an x-ray. In this case, an ultrasound examination of the joint is recommended.

In extreme cases, the patient is prescribed to undergo a CT scan. This is usually enough to get a full 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 started. The therapy is primarily aimed at delaying cartilage destruction and its restoration. The classic scheme involves the use of the following drugs:

1. Means from the group of analgesics that help relieve pain. Let the patient feel better, improve night sleep. In a hospital, injections are effective, which are done 1 to 3 times a day under the supervision of a specialist. It is not recommended to use funds for a long time, as they do not affect the course of the pathological process, but only relieve acute pain.
2. Non-steroidal anti-inflammatory drugs. Funds are available in tablet and injectable form, they can not only eliminate acute pain, but also slow the progression of the pathology, relieve 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 guarantees a prolonged action. It is not recommended to take medicines for a long time, as they often adversely affect 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, these drugs contain glucosamine and chondroitin. It is recommended to take them for a long time. Typically, an 8-12 week course is prescribed with regular visits to a specialist to detect improvements. A longer reception is possible with clear indications.
4. Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. Helps relieve swelling and reduce pain. It is allowed to use only in a hospital in the form of intramuscular or intravenous injections.
5. Non-steroidal anti-inflammatory drugs. Funds are available in tablet and injectable form, they can not only eliminate acute pain, but also slow the progression of the pathology, relieve 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 guarantees a prolonged action. It is not recommended to take medicines for a long time, as they often adversely affect 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, these drugs contain glucosamine and chondroitin. It is recommended to take them for a long time. Typically, an 8-12 week course is prescribed with regular visits to a specialist to detect improvements. A longer reception is possible with clear indications.
7. Glucocorticoids. They are used to treat advanced cases when the pain syndrome is not eliminated by conventional means. Helps relieve swelling and reduce pain. It is allowed to use only in a hospital in the form of intramuscular or intravenous injections.

In addition to these funds, the patient receives a course using an external agent in the form of an ointment, cream or gel. The last option is more preferable because it quickly penetrates the joint cavity and has a therapeutic effect. They can be used within 14 days. It is not recommended to extend the course on your own, as the risk of complications increases.

In the most severe cases, the patient is injected directly into the joint cavity. You can use conventional painkillers, but the best therapeutic effect is achieved with the introduction of hyaluronic acid preparations. Injections are given once for 7 days. For complete elimination of pain, 3-5 injections are enough. After such therapy, the effect persists for 6 months. The patient has the ability to move normally 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 gasket or its individual parts. This is usually indicated for osteoarthritis, caused by a serious knee injury. The operation is performed under general anesthesia and the recovery period is quite long and difficult.

Gonarthrosis is a severe degenerative-dystrophic pathology, which, if not treated properly, leads to patient disability. It is recommended that you immediately consult a doctor when the first signs of a violation appear.