All joints synovial affected degenerative-dystrophic diseases – arthritis, but some more, some less. Most often osteoarthritis affects the hip and knee joints because they are important exposed to loads, and knee joints, and even injury. If the arthritis is localized the knees, diagnosed gonarthrosis (arthrosis deformans of the knee joint). Osteoarthritis of the knee – often, an illness that leads to a temporary disability and invalidity. Which one of the joint osteoarthritis of the knee, for some reason, it develops and how this is manifested the disease, how to treat it – this topic of the article.
A bit of terminology
Osteoarthritis – non-inflammatory joint disease that begins with the processes in the degenerative articular cartilage, then the process is articulated in the area of mating of the bone, the synovium, the muscles that take support in the joint. Another name of this disease to osteoarthritis, indicates that the processes that are pathological occur in the bone tissue.
To Refine the localization of the disease name, add the name of: osteoarthritis of the knee, arthrosis of the ankle. Already in an advanced phase of the territorial expansion of the joint sites of lead deformation serious of the body, it from the joint to arthrosis of the knee and other articulating joints are called deforming, abbreviated as DOÂ. The diagnosis of DOÂ means the same thing as osteoarthritis.
What the and osteoarthritis and what else they called him? Very often in the Internet you can find the phrase of the knee gonarthrosis, arthrosis of the hip joint. If the first definition and a tautology, since the second a mixture of the names of two different types of diseases of the joints. The fact that, for convenience, indicate the most common types of use name of arthritis, which makes reference to the location. Thus, the first part of a compound word, "gonarthrosis" is traced to the ancient word grega which means "knee". And say, the gonarthrosis and osteoarthritis of the knee, can also be used as a DOÂ name of the joint of the knee, osteoarthritis of the knee. But the names of gonarthrosis of the knee joint and the like are redundant.
The knee area
In the literature, one may also find references about osteoarthritis femoro-patellar joint, or syndrome patellofemoral. And understand why it is necessary to get acquainted with the area of the knee joint. This un and condylar joint:
- the surface articulation of the femur and a convex head;
- the tibia and the vacuum.
In addition to the main bones in the formacio of the knee joint, pren part of the un small bone sesamoid known as the knee or elbow joint. The rear part of the surface of the upper edge articulates with the femur. Patella in Latin s called and the of the patella femoral os – femara. And say, if translated into Russian word femoropatellar, s obtained from the un femoro-patellar. This does not, the un independent joint, and an integral part of the complexity of the knee joint. The bond Has the position in the correct the ligaments, but sometimes moves to a cause of the injury or initially has the configuration that leads to the instability.
The displacement, instability of the kneecap – the main factors leading to the development of the so-called patellofemoral osteoarthritis. The causes include traumatic damage to the cartilage of the kneecap a shock, falls. The Experts tend to use the term syndrome patellofemoral pain, as a mechanism of development and clinical picture of this disease and different from the classical, typical for osteoarthritis. The disease is treatable, because the thinning of the cartilage (chondromalacia a) there are only 3 stages, the prognosis and fairly favorable. But in the absence treatment of right, enters on the disease gonarthrosis.
The causes of the disease
What the and osteoarthritis of the knee and the causes that provoke? The un, as we have already mentioned – of the injury and instability of the patella, running syndrome patellofemoral (doctors often view as pietros).
The cause of osteoarthritis of the knee include:
- congenital weakness of muscles and ligaments that stabilizes the knee joint;
- vascular disease of the lower extremities (varicose veins, thrombophlebitis), that disrupts blood supply to the knee;
- protracted inflammatory processes in the joint cavity periarticular and tissues;
- endocrine diseases, especially diabetes;
- the injuries of the lower extremities.
Osteoarthritis of the knee, threatening people with diagnosed DOÂ ankle, the hip, the foot plan. Submarine With the ankle or the hip joints, the violation of the support function of the foot increases the load on the knees. The With age, the incidence of arthrosis of the knee joints increases. Due to This, deceleration of metabolic processes regeneration and the and the of the processes, circulation disorders of the blood, the natural wear and tear of the cartilage, changes in hormonal levels.
Gonarthrosis at an early age often develops in persons with genetic predisposition, genetic defects of connective tissue. Also, a prone to athletes and people dedicated to heavy load of physical work in the legs. Very trade unions by the prejudice of knees weight.
Symptoms
If you have any arthritis of localization gradually increase symptoms from stage to stage. 1 stages of osteoarthritis, the patient experiences physical discomfort:
- the legs get tired quickly;
- in the beginning of the movement, there are un brief pain, feeling of tightness, stiffness, but an hour and a half these symptoms disappear;
- the pain can be resumed original works of art of a time loading, but disappears original work of art the rest.
2 stage small enough to load and require cause pain, a longer stay, so that was more. From this stage, often an inflamed synovium mechanical union of pain and inflammatory which are produced in the rest. For synovitis characterized by the increase due to the knee the accumulation of inflammatory effusion in the joint cavity, the skin often become red, hot to the touch.
If early contractures (limitation of joint mobility) are mainly related to the movement during pain, according as the disease progresses, the knee, the joint, contractures become resistant. Grow osteophytes avoid examine which movements are more right and lose their elasticity of the ligaments, weakening of muscles, reduction of the production of intra-joint lubricant – synovial fluid. 3 stage range of motion and reduced much more, some patients can only perform the movement ranges installation in the knee. Finally, in a subsequent phase of the joint and deformed due to the bone growth of the leg bent at the knee (X-shaped, or in the form of deformation).
What the and osteoarthritis of the knee and symptoms to distinguish the syndrome of the patellofemoral? For the last feature:
- the pain is localized in the aspect above the knee, usually felt when jogging, they get stronger during squats, the elevation of the chair, walking to the stairs;
- swelling in the region of the patella;
- hobbling motion;
- clicks during the movement, and clicks and pain do not occur simultaneously.
The inflammation of the knee, the march of the changes, the pain, a feature of osteoarthritis, but the pain en sense and deep the joint, often suffers from a lot of its inner face. Movement of pain is often accompanied by I crepitus. To determine the location with precision of the whole process required demonstrates functional and raigs-x.
Methods of diagnosis
The diagnosis of DOÂ makes original works of art comprehensive examination of the patient. First, the doctor listens to the complaints, s is student the history, of the feet examined, palpated joints, acts passive movements and asks the patient to perform active range. And Gonarthrosis unilateral and bilateral. In lesions unilateral of the limb is healthy in comparison with the patient. Evaluate the range of motion, muscle strength, the measure of the circumference of the thighs and shins, feet in length. Because of osteoarthritis and is accompanied by atrophy of the muscles and ligaments affected leg and reduced in volume and shortened.
Original works of art of the physical examination laboratory and assign hardware:
- the main method of diagnosis of osteoarthritis – x-ray, the picture is taken a minimum of 2 projections;
- Computed tomography united nations type de raigs x examination of l', which gives a layered image of a set;
- evaluate the state of cartilage, soft tissue, the volume of synovial fluid allows ultrasound;
- highly method of the un informative diagnosis – magnetic RESONANCE imaging;
- test are assigned to the distinguish osteoarthritis from arthritis and other inflammatory diseases.
In the diagnosis and in determining the extent of osteoarthritis in the knee joints, based on data from two rays of sunshine x.
- The lower tends to be irregular joint space narrowing, osteophytes, initial in the form of small cusps at the edges of the articulation locations.
- The narrowing motion of the light of 50% or more, several large osteophytes, of the compacted bone tissue (osteosclerosis) in the places of loading more. In the background of the focus of osteosclerosis may be observed from the illustration – testopodobnymi of the cavity.
- The almost complete absence of the joint gap, which is pronounced osteosclerosis, osteophytes coarse, deformation of the surfaces of articulating bones, smoothing of their relief, the curvature of the axis of the limb is.
Treatment
Next question: to what osteoarthritis of the knee and how to treat it? Treatment for this disease very and divers, and this is very important integrated approach, a combination of drug and non-drug therapy. The treatment must begin with the limitation of the load on the knees. And necessary to refuse to run, jump, lift, the patients with overweight should lose weight.
Those who have the muscles are weakened due to a sedentary lifestyle, must move more, why not, but overload the knee. The shoes should be comfortable, when walking it is recommended to use the un club, also of the un orthopedist can pick up the knee, orthosis and other devices for the unloading and stabilization of the joint. Certainly the need to follow a diet.
The medication
As a treatment for arthritis if accompanied by pain? Most often they are cut use of non-steroidal anti-inflammatory drugs take it orally and used in the form of ointments, gels. In addition to prescribing irritating ointment. During intense process can inflammatory is to demonstrate that the injection into the joint of drugs hormonal in combination with local anesthetics. But treatment only this alleviates the symptoms, and a term courses of short duration, according to testimony.
In the 1-2 stages of treatment symptomatic necessarily combined should be with the long-term administration of chondroprotectors. These drugs lent the breakdown of cartilage, and in a first phase and even contribute to your recovery. Perfectly relieve the pain and mobility re-establish intra-joint injections of hyaluronic acid.
Drugs in osteoarthritis can also be managed with vasodilators and drugs to improve the microcirculation, and that is shown in disorders of the circulatory joint. To relieve the muscle spasms help muscle relaxants. Specific A tool for the treatment of arthritis along with cartilage protectors, and drug which neutralizes the activity of a protein that destroys cartilage.
Non-drug treatment
Indicated for osteoarthritis of the knee and non-drug treatment. Methods non-pharmacological treatments include:
- physiotherapy electrophoresis, ultrasound, magnetic therapy, laser therapy wave therapy shock, irradiation, ultraviolet, and others;
- application of paraffin, ozokerite;
- compresses with Dimexidum, medicine bile, bischofite;
- massage with the influence not primarily on the joint itself and its surrounding muscles;
- manual therapy – stretching mild or reduction of the joint;
- Physical therapy, fitness therapy. To master the exercises in this formacio video, accurate with complexes of a photo, but better and start to exercise under the supervision of an instructor.
In some clinical tested innovator of the un's method of treatment – therapy with cell dl·lules mother. Allows you to restore cartilage tissue sense having to resort to surgery.
1 stage of gonarthrosis show only conservative treatment, starting with 2 it is possible to perform the surgery. More for surgery advanced osteoarthritis:
- arthroscopic debridment of – of removing osteophytes and necrotic areas of cartilage through a small incision;
- arthroscopic chondroplasty – fix articular cartilage;
- arthroplasty – joint replacement artificial.
The first of the two operations s usually done in 2 stages, to give temporary effect for 1-2 years. The endoprosthesis is shown in 3 stages of osteoarthritis of the knee, and the only way to avoid examining the disability. Implants only last 15-20 years before requiring re-operation.
Gonarthrosis or arthrosis of knee unions between the three most common types of arthritis. Knee pain can point not only to the development of osteoarthritis, but the damage to the ligaments or meniscus, arthritis and many other diseases. Therefore, the appearance of symptoms of anxiety you need to consult and get un doctor tested.
Often osteoarthritis of the knee progresses slowly from the first symptoms to total loss of the function of a whole can take a couple of decades. Completely care gonarthrosis impossible, but s if you start the treatment at an early stage and more likely to slow down their development and the delay in the last stage, which leads to disability.