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 most often affects the knee region of the lower limbs.Pathological changes in the cartilage and periarticular areas, which in most cases develop against the background of injuries, biological aging of the body and autoimmune diseases, seriously inhibit the locomotor potential of the legs.The joint becomes stiff, loses its stability, normal motor and shock-absorbing abilities.As a result, it gradually deforms and at the final stage fails completely.

Degenerations of the joint tissues are manifested not only in the form of physical dysfunction of the lower limbs, but also in the form of severe pain.In severe cases, the pathology causes disability, in some cases paralysis of the legs.Because of such a disappointing prognosis, it is important to identify the disease as soon 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 receive complete information about the mechanism of the origin of the pathology and its clinical manifestations.It should be noted right away that arthrosis and arthritis are closely related, since the disease in question is a consequence of arthritis.But where do those unfortunate diseases come from, which mercilessly destroy the most important bone connection?How serious is gonarthrosis and how can it be recognized based on its manifestations?

Causes of arthrosis

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

• previously suffered injuries - tibia fractures, knee dislocations, damage to the body of the meniscus, ligament tears and ligament tears, falls on the knees, all kinds of bruises;
• excessive physical activity;
• sedentary lifestyle;
• high body mass index;
• systemic pathologies of rheumatoid, gouty, psoriatic type, systemic lupus erythematosus;
• genetically inherited weakness of the ligament-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;
• previous or chronic infectious and inflammatory diseases.

Often, people themselves become responsible for the development of intractable joint diseases.Often, after sustaining an injury, they neglect to contact a professional, preferring to make do with the first available pain relievers, homemade creams, and the like.And a few years later, due to inadequate treatment in the past, they already go to the doctor 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;he often has to act radically, using surgical tactics.

Stages of destruction

In orthopedics, this disease is divided into stages, and the specialist starts from this when compiling the treatment plan.The degree, nature, localization and nature of the destruction of the knee joint bone are identified by a number of diagnostic measures, for example, radiography, MRI, CT, ultrasound, as well as various blood and urine tests of the patient.

We cannot talk about quality treatment without detailed information about the condition of the knee joint and the characteristics of the patient's body, as well as without visiting the doctor and receiving appropriate therapeutic recommendations from him.Therefore, if you want to improve your quality of life, do not ignore the visit of an experienced specialist;only he can tell whether you can get by with qualified conservative help, or whether 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 the morphological changes (presence of osteophytes, decrease in volume and thinning of articular cartilage, narrowing of the joint space, etc.) and clinical symptoms (restricted flexion/extension, load-bearing index, nature and intensity of pain, etc.). 

• Arthrosis of the first stage This is a disease that is still in its infancy.The external symptoms are mild or absent, the congruence and shape of the joint is satisfactory.X-ray or MRI photos show small marginal osteophytes at the edges of the joint surfaces, fine 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 degreein addition to the above indicators, the osteosclerotic focus is more pronounced, the narrowing of the interarticular space is clearly visible.The patient feels stronger and more frequent pain when walking, going up/down stairs, standing for a long time, sometimes also at night.Lameness develops, joint movements become weaker, especially when bending.
• Third stage characterized by a sharp progression of irreversible degenerations and deformations.The configuration of the joint is noticeably distorted, the distance between the joint surfaces is significantly reduced, and bone growth in the form of spines is increased.The pain becomes prolonged and more pronounced, bothers the person even at rest, and the lameness increases.Dependence on support tools and external help appears. 
• Fourth stagedegenerative-dystrophic pathogenesis, when voluminous osteophytic growths appear, hyaline cartilages are completely destroyed, the joint gap disappears or is barely visible, the epiphyses of the articular bones forming the joint are strongly deformed.The knee joint is recognized as a completely non-viable organ of the musculoskeletal system, and the person becomes incapacitated. 

Symptoms and complaints

The severity of the clinical manifestations depends not only on the pathomorphological characteristics, but also on the individual factor.In any case, there is little that is pleasant about gonarthrosis;both the 2nd and 3rd-4th are very difficult to wear.section.A general list of symptoms includes:

• pain syndrome, mainly of a mechanical nature (dull, aching, sharp, sudden, intermittent and constant);
• the appearance of a crunch during movement;
• joint stiffness;
• limitation of range of motion;
• muscle weakness of the limb;
• skin hyperthermia and swelling in the knee area;
• gait changes manifested by limping and wobbly legs;
• instability or branch syndrome;
• "stuck" of the knee, which occurs when the movements of the bone joint are suddenly blocked.

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

Conservative treatment

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

• systematic implementation of exercise therapy individually developed by a specialist;
• conducting physiotherapy procedures;
• use of pain relievers, ointments, tablets, injections, etc.in the form of;
• proper nutrition and adherence to a special diet prescribed by a doctor;
• following a special system of daily physical activity;
• complete abandonment of bad habits;
• unquestionable passage of the repeated diagnostic check;
• annual visit to a special sanatorium resort medical facility.

Surgery for arthrosis of the knee joint

Now let's get acquainted with surgical methods, which are often necessary, since the pathology often goes unnoticed in the early stages.Basically, we have to deal with flourishing arthrosis, which has extensively affected the joint structures and periarticular substance.

• Endoprosthesis - in more than 95% of cases, it helps restore the lost locomotor and support functions of the knee of the lower limb as completely as possible.The operation is not easy, followed by difficult rehabilitation, but the effect is worth it.About 3 months after an artificial analogue was installed instead of the native joint, which had undergone irreversible pathological changes, the full range of motion of the leg returned and the pain syndrome completely disappeared.
• Arthrodesis – the unusual procedure of "closing" the joint, due to its aggressive effect on biological structures, but it sometimes happens, for example, if a person does not have the opportunity to have an implant.Its essence is the removal of the joint surfaces and the fixed connection of the joint bones with special fixing devices, in an advantageous position.Over time, a natural fusion of the listed elements occurs.Artificial ankylosis completely blocks the mobility of the joint, but makes it possible to achieve good load-bearing capacity of the limb and reduce pain.
• Knee osteotomy – it is also used in extreme situations, for the same reason as arthrodesis, especially when endoprosthetics must be postponed for several years.During the operation, the specialist performs an artificial fracture, files the bones and places them at a more precise angle in order to distribute the load on the cartilaginous elements in a beneficial way.  

Irreversible pathogenesis cannot be corrected by physical exercise, you must understand this.Ointments and even drugs from the chondroprotector series, not to mention grandmother's advice on treatment with gelatin, will not play a special role.The most they can do to help advanced conditions is to prepare the musculoskeletal system for the upcoming surgery.

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

Stage 3 treatment

In the 3rd stage of arthrosis, surgery is performed.The changes in the joint are very pronounced;in this phase, the disease greatly reduces the patient's quality of life and performance.Osteochondral damage has reached a critical point at which the tissues of the bone junction no longer represent functional importance.The hyaline covering is almost completely destroyed. 

• Important cartilages do not heal on their own, not even with surgical methods.
• The exposed and flattened surfaces of the interacting bone ends exert unnatural pressure on each other, constantly rubbing against each other, seriously injuring the nearby soft tissues, and becoming more deformed day by day.
• The person is in excruciating pain, not to mention losing the ability to walk normally.Patients experience daily torment when sleep is not a joy and during the day there is no rest from pain.Only a few report a relatively tolerable condition.
• Anti-inflammatory pain medications are usually mild, but most often they don't "work".It makes no sense to use chondroprotectors, since strengthening and feeding the scarce remains of cartilage will not save the situation.

Sometimes they try to treat the 2-3 with minimally invasive surgery (arthroscopy).the consequences of grade arthrosis, during which the marginal osteophytes can be removed, as well as the torn osteochondral fragments from the joint cavity.Such manipulations, as evidenced by the reviews, somewhat alleviate the patient's condition and slightly improve motor function, but temporarily.Osteoarthritis in the knee joint remains active and will manifest itself again in the near future. 

3-4 degree pathogenesis is a very serious problem that can only be solved with much more complex reconstructive and plastic surgery tactics.To date, there is no procedure comparable to endoprosthesis.Replacing the knee joint with a prosthesis that completely repeats the mechanical characteristics of the natural organ, the configuration of its shape and size, allows you to say goodbye to both the unfortunate pathology and the disability with which it "rewarded" you.

The disease progresses rapidly and can progress from the mild-moderate phase to stage 4 within a few months.The operation should be performed as early as possible, before the degenerative processes penetrate deep into the bone.Severely damaged bones can make endoprosthesis placement difficult.

Many people do not fully realize that the severity of the degenerations that have occurred is incommensurable with conservative and unconventional tactics, they try to avoid surgery in every way, swallowing pills by the handful and applying ointments to the painful area.Some turn to chiropractors and private doctors who practice all kinds of alternative techniques.Unfortunately, you can't go against nature, healing doesn't come after them, and you have to make peace with this fact.That's why throw away the senseless ideas and tread carefully.

Your physical fitness depends entirely on your decision!You can suffer from stiffness and pain for a lifetime, despite trying "empty" treatment methods: drugs and non-standard remedies that have no evidence of effectiveness for 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 surgical intervention;modern technologies have come a long way and now knee joints are brilliantly replaced abroad with permanent implants.After such implantation in a good clinic, the risk of complications is minimal (1-2%), and in more than 95% of cases mobility functions are restored.After the joint replacement, a 3-4 month rehabilitation course follows, which includes:

• physical recovery with special therapeutic exercises;
• taking medications (antibiotics, antithrombotics, etc.);
• a physiotherapy program that includes muscle-stimulating, anti-inflammatory, pain-relieving and wound-healing procedures;
• massage treatments (in the later stages of rehabilitation).

Good to know! In stage 1, the disease can be stopped and prevented conservatively.If you do nothing and start arthrosis of the knee, allowing it to go from stage 1 to stage 2, drug treatment will be much more problematic, but for a certain category of patients, a non-surgical approach is still appropriate.The last two stages are always operations.

Treatment 2 degrees

In the case of gonarthrosis of moderate severity, the quality of life deteriorates significantly.Painful knees are more of a concern, the painful syndrome occurs more often and more intensely than at the beginning of the disease.The pain is especially pronounced right after waking up in the morning, when going up and down the stairs.There is often a feeling of unpleasant numbness that occurs after a long walk or standing for a long time in one position.Bending in the area of the knee decreases, the patient cannot bend the leg as required by physiology.The person begins to spare his limb, he tries almost not to step on it, so gradual muscle atrophy occurs.

We emphasize that the treatment necessarily requires a skilled, comprehensive approach.

• If the doctor does not see an urgent need for surgery, the priority is to reduce the load on the problem area.If you are overweight, in order to provide adequate relief for the joint affected by arthrosis, you must change your weight by following the diet recommended by your doctor.
• All patients must use special orthopedic devices during movement.This may include knee braces, compression garments, elastic bandages, a cane, crutches or a walker, depending on the problem at hand.
• In addition, the orthopedic traumatologist prescribes a unique set of exercises that help strengthen and increase the endurance of the muscles of the affected limb.
• In addition, moderate or moderate arthrosis implies the use of drugs that contain substances present in the cartilaginous tissues of the knee.These include preparations based on chondroitin sulfate, injections of hyaluronic acid, and preparations made with glucosamine.They cannot restore the cartilage, but instead saturate it with nutritious ingredients, so remission of the disease is possible.
• Physiotherapy procedures are also recommended, but they are used only after all signs of inflammation have disappeared.Physical sessions such as laser, magnet or ultrasound should be performed in the medical facility.Physiotherapy improves nutrition and metabolism in bone, muscle and cartilage tissue.If you have purchased a vibroacoustic device for home use, first ask a specialist about its possibility for diagnostics and the operational characteristics of the device.

We reviewed the basic principles on which the official treatment of arthrosis is based, in accordance with orthopedic regulations.Because many people have stage 2 osteoarthritis.they are very interested in alternative methods, they look for their salvation in them, we recommend that you familiarize yourself with the most popular ones.And let's see if they are as unique as they are presented online.

Stem cells for knee treatment

We will talk about the autotransplantation of mesenchymal stem cells for a patient with knee gonarthrosis, taken from the pelvis or the femoral crest.According to interested sources, cell therapy almost achieves 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 improve the components of the osteochondral organ.However, in practice, there is not yet a single "live" radiographic evidence that confirms that the joint has become 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 highly doubtful, as this technique is not yet recognized by orthopedics.Scientists only study and experiment with it.Moreover, there is also information about the unsafe effects of stem cells on the human body, which, according to highly competent specialists, can provoke cancer.What about those who paid for the procedure and were happy with the results?We can only say one thing here: many patients will believe in eternal life for this much money, but the placebo effect does not last long, let's not forget that either.

Sludge treatment

Medicinal mud springs containing unique components (magnesium, chromium, iodine, bromine, calcium nitrate, etc.) help reduce painful symptoms, increase blood flow in the diseased areas, and stimulate metabolism.Their greatest value is for those suffering from a mild stage of the disease or patients who have already undergone surgery on their legs.Level 2 mud therapy is also allowed if the doctor believes that the natural remedy in combination with the main treatment program will reduce the aggression of the pathological phenomena (stop the progression) and improve the general clinical picture.Mud therapy is performed in special medical facilities.Peloid-based natural healing muds are applied in the form of an application and combined with the electrophoresis method.

Using gelatin

Natural gelatin is a safe product that helps keep joint structures in good condition.The jelly-like substrate diluted with water is recommended to be consumed internally.According to some doctors, gelatin will have a faster and more productive effect on bones, cartilage and muscle ligaments.Experts emphasize that this method has no medicinal effect, it only helps prevent arthrosis.Consequently, in the case of already established pathogenesis, gelatin treatment in the absence of pathology or in the earliest stages can be considered solely as a measure to prevent the appearance or progression of degenerative-dystrophic changes.If the disease is moderate to severe, this approach does not work for preventive purposes.

Ayurveda for the joints

It is known for its many extraordinary trends in modern alternative medicine, including Ayurvedic treatment of various parts of the musculoskeletal system.According to this unofficial theory, joint damage is associated with excess toxins accumulated in the body due to energetic disharmony.The damaging mechanism of disturbed energy balance (Vata) is primarily the weakening of Agni, i.e. the digestive fire, which leads to the accumulation of undigested food residues (Ama) in the intestines.Toxins are secreted, which the blood transports to the joint, where harmful substances settle and inhibit metabolic processes.

According to Ayurveda, osteoarthritis is divided into several types, and each type has its own treatment system, each based on diet, herbs, taking Ayurvedic tablets and powders, yoga and breathing exercises, unconventional massage, self-healing training, etc.Of course, all of this sounds tempting, but if arthrosis is to be believed, arthrosis cannot be reversed even with high scientific technology.do thoughts and other Ayurvedic tactics cure irreversible deformities?!

Salt poultice

Salt is used to prepare a saturated saline solution, which is used to impregnate poultices applied to the painful area for several hours.Such therapy should not be considered an independent remedy, much less a panacea for gonarthrosis.The salt temporarily relieves pain, relieves the swelling of the soft tissues covering the bone structure, without damaging the biological structures.But it doesn't cure the disease and it doesn't get the patient back on his feet!Its effect is purely symptomatic.The solution is prepared by adding 100 g of salt to 1 liter of water at room temperature.

Worth a look! Sometimes salt is used in a dry, heated form, which is placed in a bag and local heating of the knee is performed.Sometimes as a moist but hot dressing.Hot procedures are dangerous in the case of purulent-inflammatory processes occurring in the joint cavity;they only aggravate the clinical picture.Therefore, do not use such recipes without making sure that the lesion is not accompanied by a similar process.