Arthrosis of the knee joint (gonarthrosis) is a degenerative disease characterized by progressive wear and tear of the cartilage layer of the knee joint.
Causes of knee arthrosis
It is most common in people over 50 years of age.Excess body weight worsens the symptoms of the disease, while weight loss reduces its manifestation.There is also a genetic predisposition, i.e.in some families, osteoarthritis occurs more often than in others.Aggravating factors include previous injuries to the knee, menisci, and ligaments.
Symptoms of gonarthrosis
Knee osteoarthritis symptoms always progress over time.Patients often note an exacerbation of the disease in the autumn-spring period;pain can also depend on changes in weather.
- Pain at rest, slightly decreasing when walking;
- Limitation of the range of motion in the joint;
- Stiffness when moving;
- Increased sensitivity in the joint area;
- Swelling of the soft tissues around the joint;
- Joint deformity.
The condition of the joint is assessed by examination and X-rays.With the help of X-rays, the stage of the disease is determined and appropriate treatment is prescribed.
Treatment of arthrosis of the knee
Treatment of gonarthrosis begins with the simplest steps and moves to more complex ones and is adjusted depending on the effectiveness of certain methods.
Weight loss
The lower the weight, the less the load on the knee joints and, accordingly, the less the symptoms of the disease.
Change of activity
Certain types of physical activity associated with joint overload should be limited (running, weight lifting, etc.).While physical exercises that do not involve overloading the joint increase the range of motion, reduce pain and slow the progression of the disease (swimming, skiing, orbitrek, etc.).
Additional support
In case of significant pain, crutches or canes are used to relieve the joint.
Physiotherapy
Strengthening the muscles around the knee joint helps reduce stress on the joint and prevents muscle wasting (atrophy), which is an important element in maintaining knee function.
Orthopedic insoles (insoles)
With the help of orthopedic pads, the biomechanics of walking are corrected, the weight distribution on the knee joint is correctly distributed and the manifestations of the disease are reduced.
Anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (diclofenac sodium, etc.) are used to treat inflammation and pain caused by the disease.
Hormonal injections into the joint
Injections of hormonal drugs (cortisone) effectively help reduce pain and inflammation in the joint.However, you should be extremely careful when using these drugs because... the likelihood of side effects from such therapy often outweighs the possible good results.
Biological therapy.
The most modern and effective methods of conservative treatment of arthrosis of the joints are methods of biological therapy.These include PRP therapy, cytokine therapy and MSK therapy.
PRPis a serum rich in platelets and growth factors taken from blood that accelerates the healing process of acute and chronic injuries.Growth factors are chemicals that initiate the healing process.The introduction of PRP into the area of injury stimulates the regeneration process, accelerates healing and promotes rapid resolution of the inflammatory process.
Cytokine therapyis a safe and effective treatment for osteoarthritis in which a therapeutically active protein, IL-1Ra, produced by the body, fights the chronic progressive degeneration of cartilage.A key role in the development of joint arthrosis is played by interleukin-1 (IL-1), a substance that increases the inflammatory process in the joints and leads to their premature wear.Its biological antipode is the interleukin-1 receptor antagonist (IL-1Ra), which reduces inflammation, increases mobility and reduces pain.
MSK therapy- treatment with stem cells is considered an innovative, advanced method of therapy, based on their main characteristic - non-differentiation (not belonging to a specific tissue), due to which they have the ability to multiply and develop into specialized cells from different tissues.
Joint fluid substitutes.
Injections with hyaluronic acid preparations are very effective and with minimal side effects help for a long time (up to 1 year) to significantly reduce symptoms and slow down the progression of the disease.
Chondroprotectors
Glucosamine and chondroitin are safe and effective medications that are often used to treat knee osteoarthritis.
Denervation of the knee joint is an effective and safe method of treating pain associated with osteoarthritis of the knee joint.
Denervation of the geniculate nerves
In cases where conservative treatment does not lead to relief and it is impossible to change the joint due to certain contraindications, denervation of the genicular nerves can be used.The essence of the procedure is temperature treatment of the sensitive nerves of the knee joint, which transmit pain impulses.After a successful outpatient procedure, a significant long-term reduction in knee joint pain is possible.
Arthroscopic debridement of the knee joint
The effectiveness of arthroscopic intervention in osteoarthritis of the knee joint remains controversial, but it is quite effective in relieving some specific symptoms.
Osteotomy
A surgical procedure used to realign the axis of the lower limb.Effective in young people with minimal damage to the cartilage layer of the joint.
Total arthroplasty
Complete replacement of the articular surfaces of the knee joint with metal implants is the only effective treatment for end-stage gonarthrosis.
Partial knee replacement
The so-called single-condylar knee replacement, in which the place of the articular cartilage defect is replaced with a metal plate.Indications for this procedure are very limited.