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

Knee arthrosis 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 areas, which in most cases develop against the background of injuries, biological aging of the body and autoimmune disorders, seriously hinder the musculoskeletal potential of the legs.The joint becomes rigid, loses stability, normal motor and suction abilities.As a result, it gradually deforms, and in the final stages it fails completely.

Degenerations in joint tissues are manifested 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 soon as possible and start 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 the pathology.Let's immediately point out that arthrosis and arthritis are closely related, since the disease in question is a consequence of an arthritic disease.But where do the unfortunate diseases that mercilessly destroy the most important bone connection come from?What is the severity of gonarthrosis and by what manifestations can it be recognized?

Causes of arthrosis

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

• previously suffered injuries - broken leg, dislocation of the knee, damage to the body of the meniscus, tears and ruptures of ligaments, falls on the knees, all kinds of bruises;
• excessive physical activity;
• sedentary lifestyle;
• high body mass index;
• systemic pathologies of the rheumatoid type, gout, psoriatic, systemic lupus erythematosus;
• genetically inherited weakness of the ligamento-muscular system or congenital underdevelopment of the structural elements of the joint;
• metabolic and circulatory 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 disease.Often, after receiving an injury, they ignore contact with a specialist, preferring to make do with the first available painkillers, homemade creams and the like.And a few 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 prophylaxis and soothing ointments, as in the early beginnings, will not suffice;often you have to act radically, using surgical tactics.

Stages of destruction

In orthopedics, this disease is divided into stages, from which the specialist then proceeds when designing a treatment regimen.The degree, nature, localization and nature of the origin of the destruction of the bone joint in the knee are identified through a series of diagnostic measures, such as radiography, MRI, CT, ultrasound and various types of blood and urine tests of the patient.

One cannot talk about 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 the quality of your life, do not ignore the visit to an experienced specialist;only he can tell you whether you can succeed with qualified conservative help or whether only surgical intervention will be effective for your problem.

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 (the presence of osteophytes, the reduction of the volume of the articular cartilage and the degree of its thinning, the narrowing of the joint space, etc.) and the clinical signs (limited flexion/extension, weight bearing indicator, the nature and intensity of the pain, etc.). 

• First stage arthrosis This is a disease that is only in its infancy.External symptoms are mild or absent, joint congruence and shape are satisfactory.X-ray or MRI pictures show small marginal osteophytes along the edges of the articular surfaces, in the subarticular region there is a subtle subchondral osteosclerosis and small bone cysts.The joint space is usually normal or altered, but not markedly.
• 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.The patient begins to experience stronger and more frequent pain when walking, climbing/descending stairs, standing for a long time, sometimes at night.Lameness develops, joint movements become inferior, especially when bending.
• The third stage characterized by a sharp progression of degenerations and irreversible deformations.The configuration of the joint is significantly distorted, the distance between the articular surfaces is significantly reduced, and the bone growths in the form of spikes are of increased size.The pain becomes prolonged and pronounced and disturbs the person even at rest and the lameness worsens.Dependence on support equipment and external assistance appears. 
• The fourth stagedegenerative-dystrophic pathogenesis, when voluminous osteophyte growths are present, hyaline cartilage is completely destroyed, the joint space disappears or is barely visible, the epiphyses of the articulating 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 disabled. 

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 pleasant in gonarthrosis;it is very difficult to endure both in the second phase and in the 3-4.The general list of symptoms includes:

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

Important! Conservative treatment of arthrosis of the knee joint will not help if the disease has a complicated course, which can already occur 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 2-3-4 degree gonarthrosis is the only way that for a long period of life helps to significantly improve the quality of life.

Conservative treatment

Non-surgical treatment methods are suitable in the initial stage of deforming arthrosis.The principle of non-surgical treatment includes:

• systematic implementation of exercise therapy developed by a professional on an individual basis;
• performing physiotherapy procedures;
• the use of sedatives in the form of ointments, tablets, injections, etc.;
• proper nutrition and following a special diet prescribed by the doctor;
• compliance with a special regime of daily physical activity;
• complete removal of bad habits;
• unquestionable passage 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, since at an early stage the pathology often goes unnoticed.Basically, we have to deal with arthrosis in full bloom, which has extensively affected the articular structures and affected the periarticular substance.

• Endoprosthetics – helps in more than 95% of cases to fully restore lost locomotor and knee support functions 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 motion of the leg returns and the pain syndrome is completely eliminated.
• Arthrodesis – an unusual procedure for "closing" the joint, due to its aggressive effect on biological structures, but sometimes it also happens, for example, if a person does not have the opportunity to undergo implantation.Its essence lies in the removal of the articular surfaces and the fixed connection of the articulating bones to each other using special fixing devices in a favorable position.Over time, a natural fusion of the listed elements occurs.Artificial ankylosis completely blocks joint mobility, but allows you to achieve good limb weight-bearing ability and reduce pain.
• Osteotomy of the knee – it is also used in extreme situations, for the same reason as arthrodesis, especially when it is necessary to delay endoprosthetics for several years.At the time of the surgical session, the specialist performs an artificial fracture, gathering the bones and placing them at a more precise angle in order to favorably distribute the load on the cartilaginous elements.  

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

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

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

• Important cartilage does not repair itself, including non-surgical methods.
• The exposed and flattened surfaces of the ends of the interacting bones exert unnatural pressure on each other, constantly rubbing against each other, severely damaging the nearby soft tissues and becoming more deformed every day.
• The person feels terrible pain, not to mention the lost ability to walk normally.Patients experience daily suffering, when sleep is not a joy and during the day there is no rest from pain.Only a few people report a relatively tolerable condition.
• Analgesic anti-inflammatory drugs, as a rule, have a mild effect, but more often they do not "work".It makes no sense to use chondroprotectors, as strengthening and feeding the scanty remnants of cartilage does not save the situation.

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

Pathogenesis 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 that can be compared to endoprosthetics.Replacing the knee joint with a prosthesis that completely repeats the mechanical features, configuration of shapes and sizes of a natural organ will make it possible to say goodbye to both the unfortunate pathology and the disability with which it has "rewarded" you.

The disease progresses quickly and can progress from intermediate stage to stage 4 within a few months.The operation should be performed as soon as possible, before the degenerative processes penetrate deep into the bone.Severely damaged bones can make it difficult to fit an endoprosthesis.

Many, not fully understanding that the severity of the degenerations that have occurred are incomparable with conservative and unconventional tactics, try in every way to bypass the operation, swallowing pills by the handful, applying ointments to the injured area.One turns to osteopaths, private practitioners who practice all kinds of alternative techniques.Unfortunately, you cannot go against nature, healing will not follow them, and you have to accept this fact.Therefore, discard meaningless ideas and act wisely.

Your physical strength depends entirely on your decision!You can continue to suffer from stiffness and pain throughout your life, trying in vain "empty" methods of treatment: medications and non-standard drugs that have no evidence of effectiveness for the severity of your disease.Or you can undergo surgical treatment and start living a full life, free of past suffering and support equipment.

There is no need to worry about surgical intervention;modern technologies have come a long way and today knee joints are excellently replaced abroad with long-lasting 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;
• taking medications (antibiotics, antithrombotics, etc.);
• a physiotherapy program that includes myostimulating, anti-inflammatory, analgesic and wound healing procedures;
• massage sessions (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 pass 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 is already significantly impaired.An injured knee worries more, the painful syndrome appears more often and more intensely than it was at the beginning of the disease.The pain is especially pronounced immediately after waking up in the morning, while going up and down the stairs.Often there is a feeling of unpleasant numbness that appears after prolonged walking or standing in one position for a long time.Bending in the knee area decreases, the patient is unable to bend the leg, as required by physiology.A person begins to spare his limb, trying almost not to step on it, which is why gradual muscle atrophy occurs.

We emphasize that the treatment necessarily includes 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 for the joint affected by arthrosis, it is necessary to regulate your body weight by following the diet recommended by your doctor.
• All patients are prescribed the use of special orthopedic equipment during movement.This, depending on the problem at hand, may include knee braces, compression garments, elastic bandages, a cane, crutches or a walker.
• In addition, 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.
• Also, arthrosis in moderate to moderate manifestations involves the use of medications that include substances present in the cartilage tissue of the knee.These include formulations based on chondroitin sulfate, hyaluronic acid injections, and glucosamine preparations.They cannot restore the cartilage, but saturate it with nutritional components, so that remission of the disease can be achieved.
• Physiotherapy procedures are also recommended, but they are used only after all signs of inflammation have disappeared.Physical sessions, for example, laser, magnet or ultrasound, must take place within the medical facility.Thanks to physiotherapy, nutrition and metabolism in bone, muscle and cartilage tissue improves.If you have purchased a vibroacoustic device for home use, first ask a specialist about the possibility of using it for your diagnosis and the features of the device's operation.

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

Stem cells for the treatment of the knee

We will talk about the autotransplantation of mesenchymal stem cells in a patient with gonarthrosis of the knee, taken from the pelvic or femoral crest.Cell therapy, according to interested sources, will achieve almost self-renewal of the entire joint by activating the regenerative processes of self-healing in the damaged segment.Thanks to this technology, it is theoretically possible to improve the component units of the osteochondral organ.However, in practice, there is not yet a single "live" radiographic evidence that would confirm 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 has not been proven and is very doubtful, as this technique has not yet been recognized in orthopedics.Scientists are just studying and experimenting with it.Moreover, there is information about the uncertain effect of stem cells on the human body, which, according to very competent specialists, can provoke cancer.What about those people who paid for the procedure and were satisfied with the result?Here we can say only one thing: many patients will believe in eternal life for that kind of money, but the placebo effect does not last long, remember that 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 greatest value to people with a mild stage of the disease or patients who have already undergone foot surgery.It is also allowed to perform mud therapy at level 2 if the doctor believes that a natural medicine in combination with the main treatment program will reduce the aggression of pathological phenomena (stop the progression) and improve the overall clinical picture.Mud therapy is practiced in special health resort-type medical institutions.Natural healing muds based on peloid are used in the form of application and in combination with the method of galvanization (electrophoresis).

The use of gelatin

Natural gelatin is a safe product that helps maintain joint structures in good condition.The jelly-like substrate, diluted in water, is recommended to be consumed internally.According to the reviews of some doctors, gelatin will have a faster and more productive effect on bones, cartilage and muscle-ligamentous elements.Experts point out that this method has no medicinal properties, it only helps prevent arthrosis.Consequently, in the case of the already established pathogenesis, treatment with gelatin in the absence of pathology or in the earliest stages can only be considered as a measure to prevent the appearance 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 outstanding trends, including Ayurveda 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 disturbed energy balance (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, which the blood transports to the joints, where harmful substances settle 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, herbal medicine, taking Ayurvedic tablets and powders, yoga and breathing exercises, unconventional massage, self-training for healing, etc.treatment with other Ayurvedic thoughts and tactics cure irreversible deformities?!

Salt compresses

Salt is used to prepare a saturated saline solution, which is used to saturate compresses that are applied to the injured area for several hours.Such therapy should not be considered as an independent remedy, much less as a remedy for gonarthrosis.Salt can temporarily relieve pain, relieve swelling of the soft tissues that cover the bone structure, without damaging the biological structures.But it will not cure the disease and will not put the patient back on his feet!Its effect is purely symptomatic.The solution is prepared at the rate of taking 100 g of salt per 1 liter of water at room temperature.

It's worth watching! Sometimes salt is used in dry, hot form, which is placed in a bag and local heating of the knee is performed.Sometimes like wet but hot clothes.Hot procedures are dangerous in case of purulent-inflammatory processes in the joint cavity;they will only worsen the clinical picture.Therefore, do not use such recipes without being sure that the lesion is not associated with a similar process.