Osteoarthritis of the knee joint: what it is, stages, symptoms and myths about treatment

Arthrosis of the knee joint is a complex degenerative-dystrophic disease affecting the osteochondral part of the knee.The disease mostly affects the knee region of the lower extremities.In most cases, pathological changes in the cartilage and periarticular areas, which develop against the background of injuries, biological aging of the body, and autoimmune disorders, seriously inhibit the foot's support-movement potential.The joint hardens, loses stability, normal motor and shock absorption.As a result, it is gradually deformed and finally fails completely.

Degeneration of joint tissues manifests itself not only in the form of physical dysfunction of the lower extremities, but also in the form of severe pain in them.In severe cases, the pathology causes disability, and in some cases, paralysis of the legs.Due to such a disappointing prognosis, it is important to identify the disease as early as possible and start treatment immediately.

Important information about the disease

Before studying the treatment tactics, it is important for patients to familiarize themselves with the following material in order to get complete information about the mechanism of origin of the pathology and clinical manifestations.Let's note right away that arthrosis and arthritis are closely related to each other, because the disease in question is the result of arthritis.But where do the unfortunate diseases that mercilessly destroy the most important bone connection come from?What is the severity of gonarthrosis and what are its symptoms?

Causes of arthrosis

Degenerative-dystrophic pathogenesis is "triggered" by the following provoking factors:

• previously suffered injuries - shin fractures, knee dislocations, damage to the body of the meniscus, tears and ruptures of ligaments, falls to the knees, all kinds of bruises;
• excessive physical activity;
• sedentary lifestyle;
• high body mass index;
• systemic pathologies of rheumatoid, gout, psoriatic type, systemic lupus erythematosus;
• genetically inherited weakness of the ligamentous-muscular system or congenital underdevelopment of the structural elements of the joint;
• metabolic and blood flow disorders;
• hormonal imbalance, diabetes mellitus and other endocrine pathologies;
• past or chronic infectious and inflammatory diseases.

Often, people themselves are responsible for the development of joint diseases that do not resolve.Often, having received an injury, they ignore contacting a specialist, preferring to do with the first available pain medication, homemade lotions, and the like.And several years later, due to inadequate treatment carried out in the past, they come to see a doctor already with gonarthrosis, at best - of moderate severity.And here, only physical prevention and pain-relieving ointments, as in the very early course, will not be enough;often you have to act radically using surgical tactics.

Stages of destruction

In orthopedics, this disease is divided into stages, after which the specialist begins when designing the treatment regimen.The degree, character, localization and nature of the origin of the destruction of the bone joint in the knee are determined by a number of diagnostic measures, for example, X-ray, MRI, CT, ultrasound, various types of blood and urine tests of the patient.

There can be no talk of quality treatment without detailed information about both the condition of the knee joint and the characteristics of the patient's body, as well as without visiting a doctor and receiving adequate therapeutic recommendations from him.Therefore, if you want to improve your quality of life, do not neglect to visit an experienced specialist;only he can tell you if you will get better with skilled conservative care or if only surgical intervention will be effective for your problem.

The pathology has several stages of development;According to the Kellgren classification, there are only four of them.All of them characterize the severity of morphological changes (presence of osteophytes, decrease in the volume of articular cartilage and its degree of thinning, narrowing of the joint space, etc.) and clinical signs (limited flexion/extension, weight-bearing index, nature and intensity of pain, etc.). 

• Arthrosis of the first stage This is a disease that is still in its infancy.External symptoms are mild or absent, and the fit and shape of the joint is satisfactory.X-rays or MRI photographs show small marginal osteophytes along the edges of the articular surfaces, with subtle subchondral osteosclerosis and small bone cysts in the subarticular region.The joint space is usually normal or altered, but not significantly.
• In case of illness second degree, in addition to the above indicators, the osteosclerotic focus is more pronounced and the narrowing of the interarticular space is clearly visible.When the patient walks, goes up/down the stairs, stands for a long time, sometimes at night, he begins to feel stronger and more frequent pain.Lameness develops, movements in the joint are low, especially during bending.
• The third stage it is characterized by a sharp progression of irreversible degenerations and deformations.The configuration of the joint is noticeably disturbed, the distance between the articular surfaces is significantly reduced, and bone growths in the form of spikes grow.The pain lasts and worsens and disturbs the person even at rest, the lameness worsens.Dependence on assistive devices and outside assistance appears. 
• The fourth stagedegenerative-dystrophic pathogenesis, when there are voluminous osteophytic growths, when the hyaline cartilage is completely destroyed, when the joint space disappears or is almost invisible, the epiphyses of the articular bones forming the joint are severely deformed.The knee joint is known as a completely non-viable organ of the musculoskeletal system, and a person loses the ability to function. 

Symptoms and complaints

The severity of clinical manifestations depends not only on pathomorphological features, but also on individual factors.In any case, it is less pleasant in gonarthrosis;both in the 2nd and 3rd and 4th stages are very difficult to endure.A general list of symptoms includes:

• pain syndrome, mainly mechanical type (dull, painful, sharp, sudden, periodic and constant);
• the appearance of a crisis when moving;
• joint stiffness;
• limitation of range of motion;
• muscle weakness of the extremities;
• hyperthermia of the skin and swelling in the knee area;
• changes in gait, manifested by limping and swaying of the legs;
• instability or drawer syndrome;
• "Squeezing" of the knee, which occurs when the movements of the bone joint are suddenly blocked.

It is important! Conservative treatment of arthrosis of the knee joint will not help if the disease has a complicated course, which can happen in the worst case in the second stage of the development of osteochondral degenerations.In contrast to traditional conservative therapy and alternative methods, without exception, surgery for serious gonarthrosis of 2-3-4 degrees is the only way to significantly improve the quality of life for a long life.

Conservative treatment

In the initial stage of deforming arthrosis, non-surgical treatment methods are suitable.The principle of non-surgical treatment includes the following:

• systematic implementation of individually prepared exercise therapy by a specialist;
• carrying out physiotherapy procedures;
• ointment, tablet, injection, etc.the use of painkillers in the form of;
• proper nutrition and following a special diet prescribed by a doctor;
• to follow a special regime of daily physical activity;
• complete rejection of bad habits;
• unquestionable passing of repeated diagnostic control;
• annual visit to a specialized sanatorium-resort medical institution.

Surgery for arthrosis of the knee joint

Now let's get acquainted with surgical methods, which are often necessary, because the pathology is often overlooked at an early stage.Basically, we have to deal with arthrosis in full bloom, which widely affects the articular structures and affects the periarticular substance.

• Endoprostheses – In more than 95% of cases, it helps to restore the lost movement and support functions of the knee of the lower extremity as fully as possible.The operation is not easy, followed by difficult rehabilitation, but the effect is worth it.About 3 months after placing an artificial analogue in place of the native joint, which has undergone irreversible pathological changes, the entire range of motion of the leg returns and the pain syndrome is completely eliminated.
• Arthrodesis - an unusual procedure to "close" the joint due to its aggressive effect on biological structures, but sometimes it also happens, for example, when a person does not have the opportunity to implant.Its essence lies in the removal of articular surfaces and the stable connection of articular bones with each other using special fixation devices in a convenient position.Over time, a natural combination of the listed elements occurs.Artificial ankylosis completely blocks the mobility of the joint, but allows achieving good weight-bearing capacity of the limb and reducing pain.
• Knee osteotomy – is also used in extreme cases, for the same reason as arthrodesis, especially when it is necessary to postpone endoprosthesis for several years.During the surgical session, the specialist performs an artificial fracture by filling the bones and placing them at a more correct angle in order to distribute the load to the cartilaginous elements in an advantageous manner.  

Irreversible pathogenesis cannot be corrected by physical exercises, you should understand this.Ointments and even drugs from the chondroprotector series will not play a special role, if we do not take into account grandmother's recommendations for treatment with gelatin.The most they can do to help in an advanced case is to prepare the musculoskeletal system for the upcoming operation.

Modern knee implants can withstand normal daily stress and function perfectly for at least 15 years, and often 20-25 years.A person can even play some sports with a replaced joint.

Stage 3 treatment

Surgery is performed at the 3rd stage of arthrosis.Joint changes are very obvious;at this stage, the disease significantly lowers the patient's quality of life and performance.Osteochondral damage has reached a critical point where the tissues of the bone joint have no functional significance.The hyaline cover is almost completely destroyed. 

• Significant cartilage does not repair itself, including non-surgical methods.
• The exposed and flattened surfaces of the interacting bone ends exert unnatural pressure on each other, constantly rubbing against each other, seriously damaging the nearby soft tissues and becoming more deformed every day.
• A person experiences excruciating pain, not to mention losing the ability to walk normally.Patients suffer from daily suffering in which sleep is not a joy and pain does not rest during the day.Only a few report a relatively tolerable condition.
• Anti-inflammatory analgesics, as a rule, have a mild effect, but often do not "work".It makes no sense to use chondroprotectors, because strengthening and nourishing the little remnants of cartilage does not save the situation.

Sometimes they try to treat the results of arthrosis of the 2nd-3rd degree with minimally invasive surgery (arthroscopy), during which it is possible to remove marginal osteophytes, as well as remove torn osteochondral fragments from the joint cavity.Such manipulations, as can be seen from the reviews, slightly alleviate the patient's condition and slightly improve motor function, but temporarily.Arthrosis in the knee joint remains active and will manifest itself again in the near future. 

Pathogenesis of 3-4 degrees is a very serious problem, which can be solved only with much more complex reconstructive and plastic surgery tactics.To date, there is no procedure comparable to endoprosthetics.Replacing the knee joint with a prosthesis that completely repeats the mechanical properties of the natural body, the configuration of its shape and size, will allow you to say goodbye to both the unfortunate pathology and the disability that "rewards" you.

The disease progresses rapidly and can progress from moderate to moderate to stage 4 within a few months.Surgery should be performed as early as possible, before degenerative processes penetrate deeply into the bone.Severely damaged bones can make it difficult to insert an endoprosthesis.

Many people do not fully understand that the severity of the degenerations that occur cannot be compared with conservative and non-traditional tactics, they try to avoid surgery in every way, swallow pills by the handful, apply ointments to the painful area.Someone turns to osteopaths, private doctors who practice all kinds of alternative methods.Unfortunately, you cannot go against nature, healing will not come after them, and you have to come to terms with this fact.Therefore, throw away meaningless thoughts and be cautious.

Your fitness is entirely up to you!You can continue to suffer from stiffness and pain for a lifetime, trying in vain "empty" treatments: drugs and substandard remedies that have no evidence of the severity of the disease.Or you can undergo surgical treatment and start living a full life free from past suffering and support devices.

No need to worry about surgery;modern technologies have come a long way, and today knee joints are brilliantly replaced by long-term implants abroad.After such implantation in a good clinic, the risk of complications is minimal (1-2%), and recovery of mobility functions occurs in more than 95% of cases.After joint replacement, a 3-4 month rehabilitation course will follow, including:

• physical recovery through special therapeutic exercises;
• taking medication (antibiotics, antithrombotics, etc.);
• physiotherapy program including myostimulating, anti-inflammatory, analgesic and wound healing procedures;
• massage sessions (in later stages of rehabilitation).

Good to know! In the 1st stage, the disease can be prevented and prevented conservatively.If you do nothing and start knee arthrosis, which allows you to move from stage 1 to stage 2, drug treatment will be more problematic, but a non-surgical approach is still suitable for a certain category of patients.The last two stages are always operational.

Treatment 2 degrees

With moderately severe gonarthrosis, the quality of life is already significantly impaired.A painful knee is more disturbing, the painful syndrome manifests itself more often and more intensively than at the beginning of the disease.The pain manifests itself especially immediately after waking up in the morning, when going up and down stairs.There is often an unpleasant feeling of numbness that appears after a long walk or standing in one position for a long time.Flexion in the knee area decreases, the patient is unable to bend the leg as required by physiology.A person begins to spare a limb, he almost tries not to step on his foot, so muscle atrophy gradually occurs.

We emphasize that the treatment definitely requires a qualified, comprehensive approach.

• If the doctor does not see the need for urgent surgery, the priority is to reduce the load on the problem area.If you are overweight, it is imperative to regulate your body weight by following the diet recommended by your doctor to improve the joint affected by osteoarthritis.
• All patients are prescribed the use of special orthopedic devices when moving.This may include knee braces, compression garments, elastic bandages, canes, crutches, or walkers, depending on the problem at hand.
• In addition, the orthopedic traumatologist will prescribe a unique set of exercises that will help strengthen the muscles of the affected limb and increase endurance.
• Also, in moderate and moderate manifestations, arthrosis involves the use of drugs containing substances contained in the cartilage tissues of the knee.These include formulations based on chondroitin sulfate, injections of hyaluronic acid, and preparations with glucosamine.They cannot restore the cartilage, but they saturate it with nutritional components to achieve remission of the disease.
• Physiotherapy procedures are also recommended, but they are used only after all signs of inflammation have disappeared.Physical sessions, such as laser, magnetic or ultrasound, must be performed in a medical facility.Physiotherapy improves nutrition and metabolism in bone, muscle and cartilage tissues.If you have purchased a vibroacoustic device for home use, first ask a specialist about the possibilities of its use for your diagnosis and the features of the device.

We reviewed the main principles on which the official treatment of arthrosis is based, which meets orthopedic standards.Since many people with stage 2 osteoarthritis.is very interested in alternative methods, looking for their salvation in them, we offer to get acquainted with the most popular of them.Let's find out if they are as unique as they are presented to us on the Internet.

Stem cells for knee treatment

We will talk about the autotransplantation of mesenchymal stem cells taken from the pelvis or femoral head to a patient with knee gonarthrosis.Cell therapy, according to interesting sources, will achieve almost self-renewal of the entire joint by activating regenerative self-healing processes in the damaged segment.Thanks to this technology, it is theoretically possible to achieve improvement in the components of the osteochondral organ.However, in practice, there is not a single "live" radiographic evidence confirming that the joint is healthy after the introduction of stem cells into the affected area.

The positive effect of stem cells on joints and bones has not been proven and is very doubtful, because this technique is not yet recognized in orthopedics.Scientists are just studying it and testing it.Moreover, there is information about the dangerous effect of stem cells on the human body, which, according to highly competent experts, can cause cancer.What about people who pay for the procedure and are satisfied with the results?We can only say one thing here: many patients will believe in eternal life for this kind of money, but the placebo effect does not last long, remember that.

Mud treatment

Medicinal mud springs containing unique components (magnesium, chromium, iodine, bromine, calcium nitrate, etc.) help reduce painful symptoms, increase blood flow to diseased areas, and stimulate metabolism.They are of greatest value to people with a mild stage of the disease or patients who have already had foot surgery.If the doctor believes that the natural remedy together with the main treatment program will reduce the aggressiveness of the pathological events (stopping the progression) and improve the general clinical picture, it is also allowed to conduct mud therapy at the 2nd level.Mud treatment is carried out in special resort-type medical institutions.Natural healing muds based on peloids are used in the form of application and in combination with the galvanization method (electrophoresis).

The use of gelatin

Natural gelatin is a safe product that helps keep joint structures in good condition.It is recommended to consume the substrate as a jelly diluted in water internally.According to the opinions of some doctors, gelatin will have a faster and more productive effect on bone, cartilage and muscle-ligament elements.Experts emphasize that this method does not have curative properties, but only helps to prevent arthrosis.Consequently, in the case of an already established pathogenesis, in the absence of pathology or in the earliest stages, gelatin treatment can be considered only as a measure to prevent the appearance or development of degenerative-dystrophic changes.When the disease is moderate and severe, this approach will not work for preventive purposes.

Ayurveda for joints

Modern alternative medicine is known for its many unusual trends, including Ayurvedic treatment of various parts of the musculoskeletal system.According to this informal theory, joint damage is associated with excess toxins accumulating in the body due to energy disharmony.The damaging mechanism of an imbalance of energy (Vata) is primarily the weakening of Agni or the digestive fire, which leads to the accumulation of undigested food residues (Ama) in the intestines.They secrete toxins, the blood carries them to the joints, where harmful substances are deposited and inhibit metabolic processes.

According to Ayurveda, osteoarthritis is classified into several types and each type has its own treatment system, each of which is based on diet, herbal medicines, taking Ayurvedic pills and powders, yoga and breathing exercises, non-traditional massage, automatic training for healing, etc.meditations and other Ayurvedic tactics cure irreversible deformities?!

Salt compresses

Salt is used to prepare a saturated saline solution, which is used to impregnate compresses that are applied to the painful area for several hours.Such therapy should not be considered as an independent remedy as a panacea for gonarthrosis.Salt can temporarily relieve pain, relieve swelling of soft tissues surrounding the bone structure, without harming biological structures.But it will not cure the disease and will not raise the patient!Its effect is purely symptomatic.The solution is prepared at the ratio of 100 g of salt to 1 liter of water at room temperature.

Worth checking out! Sometimes salt is used in a dry, heated form, placed in a bag, and local heating of the knee is performed.Sometimes like a wet but warm bandage.Hot procedures are dangerous during purulent-inflammatory processes in the joint cavity;they will only aggravate the clinical picture.Therefore, do not use such recipes without making sure that the lesion is not accompanied by a similar process.