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

Osteoarthritis of the knee joint is a complex disease of a degenerative-dystrophic nature that affects the osteochondral part of the knee.The disease most often affects the knee region of the lower extremities.Pathological changes in the cartilage and periarticular zones, which in most cases develop against the background of injuries, biological aging of the body and autoimmune disorders, severely inhibit the musculoskeletal potential of the legs.The joint becomes rigid, loses stability, normal motor capacity and shock absorption capacity.As a result, it gradually deforms and in the final stages fails completely.

Degenerations in joint tissues manifest themselves 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 begin its treatment immediately.

Important information about the disease.

Before studying treatment tactics, it is important for patients to familiarize themselves with the following material in order to have complete information about the mechanism of origin and clinical manifestations of pathology.Let us immediately note that osteoarthritis and arthritis are closely related, since the disease in question is a consequence of an arthritic disease.But where do the unfortunate ailments come from that mercilessly destroy the most important bone connection?What is the severity of gonarthrosis and by what manifestations can it be recognized?

Causes of osteoarthritis

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

• previously sustained injuries: shin fractures, knee dislocations, meniscus body damage, ligament tears and ruptures, knee drops, all types of bruises;
• excessive physical activity;
• sedentary lifestyle;
• high body mass index;
• systemic pathologies of the rheumatoid, gouty, 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.

Very often, people themselves become responsible for the development of intractable joint diseases.Often, after suffering an injury, they ignore contacting a specialist and prefer to settle for the first available pain relievers, homemade lotions and the like.And several years later, due to inadequate treatment carried out in the past, they go to the doctor already with gonarthrosis, at best, of moderate severity.And in this case, physical prophylaxis and analgesic ointments, as in the initial course, will not be enough;Often you have to act radically, using surgical tactics.

Destruction stages

In orthopedics, this disease is divided into stages, from which the specialist proceeds when drawing up a treatment regimen.The degree, nature, location and nature of the origin of the destruction of the bone joint of the knee are identified by a series of diagnostic measures, such as x-ray, magnetic resonance imaging, computed tomography, ultrasound and various types of blood and urine tests of the patient.

One 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, be sure to visit an experienced specialist;Only he can tell you if you can manage with qualified conservative help or if only surgical intervention will be effective for your problem.

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

• Osteoarthritis of the first stage. This is a disease that is only in its infancy.External symptoms are mild or absent, the congruity and shape of the joint are satisfactory.Radiographs or magnetic resonance images show small marginal osteophytes along the edges of the articular surfaces, in the subarticular region there is subtle subchondral osteosclerosis and small bone cysts.The joint space is usually normal or altered, but not significantly.
• In case of illness second grade, in addition to the previous indicators, the osteosclerotic focus is more pronounced and the narrowing of the interarticular space is clearly visible.The patient begins to feel stronger and more frequent pain when walking, going up/down stairs, standing for a long time, sometimes at night.Lameness develops, movements in the joint become inferior, especially when bending.
• Third stage characterized by a strong progression of irreversible degenerations and deformations.The configuration of the joint is noticeably distorted, the distance between the articular surfaces is significantly reduced, and the spike-like bone growths increase in size.The pain becomes prolonged and pronounced, disturbs the person even at rest, and the limp worsens.Dependence on support devices and external help appears. 
• Fourth stageDegenerative-dystrophic pathogenesis, when there are voluminous osteophytic growths, the hyaline cartilage is completely destroyed, the joint space disappears or is barely visible, the epiphyses of the articulated bones that form the joint are severely 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;It is very difficult to endure both in stage 2 and 3-4.The general list of symptoms includes:

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

Important! Conservative treatment of osteoarthritis of the knee joint will not help if the disease has a complicated course, which can occur, in the worst case, at the second stage of the development of osteochondral degeneration.Unlike traditional conservative therapy and alternative methods, without exception, surgery for severe gonarthrosis of 2-3-4 degrees is the only way that over a long period of life helps to significantly improve the quality of life.

Conservative treatment

Non-surgical treatment methods are appropriate in the initial phase of deforming osteoarthritis.The principle of non-surgical treatment involves:

• systematic implementation of exercise therapy developed by an individual professional;
• perform physiotherapy procedures;
• the use of pain relievers in the form of ointments, tablets, injections, etc.;
• proper nutrition and compliance with a special diet prescribed by a doctor;
• adherence to a special regimen of daily physical activity;
• complete cessation of bad habits;
• unquestionable passage of repeated diagnostic checks;
• annual visit to a medical institution specialized in sanatorium-resort.

Surgery for osteoarthritis of the knee joint.

Now let's get acquainted with surgical methods, which are often necessary, since at an early stage the pathology often goes unnoticed.Basically we are faced with osteoarthritis in full development, which has extensively affected the joint structures and affected the periarticular matter.

• endoprostheses – helps in more than 95% of cases to restore as completely as possible the lost locomotor and support functions of the knee of the lower limb.The operation is not easy, followed by difficult rehabilitation, but the effect is worth it.Approximately 3 months after the installation of an artificial analogue in place of the native joint, which has undergone irreversible pathological changes, the full range of movements of the leg is restored and the pain syndrome is completely eliminated.
• arthrodesis – a rare procedure to “close” the joint, due to its aggressive effect on biological structures, but it is also sometimes performed, for example, if a person does not have the opportunity to undergo implantation.Its essence lies in the removal of articular surfaces and the fixed connection of the articulated bones with each other using special fixation 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 – is also used in extreme situations, for the same reason as arthrodesis, in particular when it is necessary to delay endoprosthesis for several years.At the time of the surgical session, the specialist performs an artificial fracture, filing the bones and placing them at a more correct angle to advantageously distribute the load on the cartilaginous elements.  

Irreversible pathogenesis cannot be corrected with physical exercise, it must be understood.Ointments and even medications from the chondroprotector series, not to mention grandmother's advice to treat yourself with gelatin, will also not play a special role.The most they can do to help in an advanced situation 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 to 25 years.A person can even play some sports with a replaced joint.

Stage 3 treatment

In stage 3 osteoarthritis, surgery is performed.The changes in the joint are very pronounced;In this phase, the disease extremely reduces the patient's standard of living and performance.Osteochondral damage has reached a critical point at which the bony union tissues do not represent any functional importance.The hyaline cover is almost completely destroyed. 

• Important cartilage does not repair itself, even through non-surgical methods.
• The exposed, flattened surfaces of the interacting bone ends put unnatural pressure on each other, constantly rubbing against each other, severely damaging nearby soft tissues, and becoming more deformed every day.
• The person feels terrible pain, not to mention the loss of the ability to walk normally.Patients experience daily torment, when sleeping is not a joy and during the day there is no respite from pain.Only a few people report a relatively tolerable condition.
• Anti-inflammatory painkillers, as a rule, have a mild effect, but most often they do not "work."There is no point in using chondroprotectors, since strengthening and nourishing the scant remains of cartilage does not save the situation.

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

The pathogenesis of 3-4 degrees is a very serious problem that can only be solved with much more complex plastic and reconstructive surgical tactics.To date, there is no procedure that can be compared to endoprostheses.Replacing the knee joint with a prosthesis that completely reproduces the mechanical characteristics, configuration of shapes and sizes of a natural organ will allow you to say goodbye to both the unfortunate pathology and the disability that has “awarded” you.

The disease progresses rapidly and can go from the moderate-medium phase to stage 4 in a matter of months.Surgery should be performed as soon as possible, before degenerative processes penetrate deep into the bone.Severely damaged bones can make it difficult to place a stent.

Many, not fully realizing that the severity of the degenerations that have arisen are incomparable with conservative and unconventional tactics, try by all means to avoid the operation, swallowing pills by the handful and applying ointments to the painful area.Someone turns to osteopaths, private doctors who practice all kinds of alternative techniques.Unfortunately, you cannot go against nature, healing will not come after them and you need to accept this fact.Therefore, discard meaningless ideas and act with caution.

Your physical condition depends entirely on your decision!You may continue to suffer from stiffness and pain for life, trying in vain "empty" treatment methods: non-standard medications and remedies that have no evidence of effectiveness for the severity of your illness.Or you can undergo surgical treatment and begin living a full life, free of past suffering and assistive devices.

There is no need to worry about surgical intervention;Modern technologies have come a long way and today knee joints are brilliantly replaced abroad with durable implants.After such implantation, carried out in a good clinic, the risk of complications is minimal (1-2%) and the restoration 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;
• take medications (antibiotics, antithrombotics, etc.);
• a physiotherapy program that includes myostimulating, anti-inflammatory, analgesic and wound healing procedures;
• Massage sessions (in the last stages of rehabilitation).

Good to know! In stage 1, the disease can be stopped and prevented conservatively.If nothing is done and knee osteoarthritis starts, allowing it to move 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 an operation.

Treatment 2 degrees

With gonarthrosis of moderate severity, the quality of life already deteriorates significantly.Knee pain is more worrying, the pain syndrome manifests itself with greater frequency and intensity than at the beginning of the disease.The pain is especially pronounced 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.Bending in the knee area is reduced, the patient cannot bend the leg, as physiology requires.A person begins to save his limb, trying almost not to step on it, which is why gradual muscle atrophy occurs.

We emphasize that treatment necessarily involves a qualified and 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, to ensure good relief to the joint affected by osteoarthritis, it is essential to adjust your body weight by following the diet recommended by your doctor.
• All patients are prescribed to wear special orthopedic devices when moving.This, depending on the problem, may include knee pads, compression garments, elastic bandages, a cane, crutches or a walker.
• Additionally, the orthopedic traumatologist will prescribe a unique set of exercises that will help strengthen and increase the endurance of the muscles of the affected limb.
• In addition, osteoarthritis in moderate to moderate manifestations involves the use of medications that include substances present in the cartilaginous tissues of the knee.These include formulations based on chondroitin sulfate, hyaluronic acid injections and preparations with glucosamine.They cannot restore cartilage, but rather 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, for example with laser, magnet or ultrasound, must take place within the medical center.Thanks to physiotherapy, the nutrition and metabolism of bone, muscle and cartilage tissues is improved.If you purchased a vibroacoustic device for home use, first consult a specialist about the possibility of using it for your diagnosis and the operating features of the device.

We have reviewed the basic principles on which the official treatment of osteoarthritis is based, complying with orthopedic standards.Since many people with stage 2 osteoarthritis are very interested in alternative methods, seeking salvation in them, we offer you to know the most popular ones.And 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 mesinchemical stem cells to a patient with knee osteoarthritis, extracted from the crest of the pelvis or the femur.Cell therapy, according to interested 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 an improvement in the constituent units of the osteochondral organ.However, in practice, there is still not a single "live" radiographic evidence confirming that after the introduction of stem cells into the affected area, the joint became healthy.

The positive effect of stem cells on joints and bones is unproven and very doubtful, since this technique has not yet been recognized in orthopedics.Scientists are simply studying it and experimenting with it.In addition, there is information about the harmful effect of stem cells on the human body, which, according to highly competent specialists, can cause cancer.What about those people who paid for the procedure and were satisfied with the result?Here we can only say one thing: many patients will believe in eternal life for that amount of money, but the placebo effect does not last long, do not forget about this too.

mud treatment

Therapeutic 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 great value for people with a mild stage of the disease or patients who have already undergone surgery on the leg.It is also allowed to carry out mud therapy at level 2 if the doctor believes that a natural remedy in combination with the main treatment program will reduce the aggression of pathological phenomena (stop progression) and improve the overall clinical picture.Mud therapy is practiced in special spa-type medical institutions.Natural healing muds based on peloids are used in the form of applications and in combination with the galvanization method (electrophoresis).

Uses of gelatin

Natural gelatin is a safe product that helps keep joint structures in good condition.It is recommended to consume the gelatinous substrate internally, diluted in water.According to the reviews of some doctors, gelatin will have a faster and more productive effect on bones, cartilage and musculo-ligamentous elements.Experts emphasize that this method does not have medicinal properties, it only helps prevent osteoarthritis.Consequently, in the case of an already established pathogenesis, treatment with gelatin in the absence of pathology or in the early stages can be considered solely as a measure to prevent the emergence or progression 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 many extraordinary trends, 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 energy disharmony.The harmful mechanism of energy imbalance (Vata) is mainly the weakening of Agni, or digestive fire, which leads to the accumulation of undigested food residues (Ama) in the intestines.They secrete toxins that the blood transports to the joint, 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, the basis of each of them is diet, medicinal herbs, intake of Ayurvedic tablets and powders, yoga and breathing exercises, unconventional massages, self-training for healing, etc.Of course, all this sounds tempting, but if osteoarthritis cannot be reversed even by high scientific technologies, how can you believe that herbal will powders, pansy treatment and other Ayurvedic tactics cure irreversibly?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.This therapy should not be considered as an independent remedy and much less as a panacea for gonarthrosis.Salt can temporarily relieve pain and relieve swelling of the soft tissues covering the bone structure, without damaging the biological structures.But it will not cure the disease and will not make the patient recover!Its effect is purely symptomatic.The solution is prepared by taking 100 g of salt per 1 liter of water at room temperature.

It's worth checking out! Sometimes dry, heated salt is used, which is placed in a bag and local heating of the knee is performed.Sometimes I eat moist but warm dressings.Hot procedures are dangerous in case of purulent inflammatory processes in the joint cavity;They will only aggravate the clinical picture.Therefore, do not use these types of recipes without being sure that the injury is not accompanied by a similar process.