Osteoarthritis of the knee joint (gonarthrosis) is a degenerative disease characterized by progressive wear of the cartilaginous layer of the knee joint.
Causes of knee osteoarthritis
It appears more frequently 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, that is, in certain families osteoarthritis occurs more frequently than in others.Aggravating factors include previous injuries to the knee, menisci and ligaments.
Symptoms of gonarthrosis
The symptoms of knee osteoarthritis always progress over time.Patients often notice an exacerbation of the disease in the autumn-spring periods;pain may also depend on climate changes.
- Pain at rest, decreasing slightly when walking;
- Limitation of joint range of motion;
- Stiffness in movements;
- Increased sensitivity in the joint area;
- Swelling of the soft tissues around the joint;
- Joint deformity.
The condition of the joint is assessed through examinations and x-rays.Using X-rays, the stage of the disease is determined and appropriate treatment is prescribed.
Knee osteoarthritis treatment
The treatment of gonarthrosis begins with the simplest steps and moves on to more complex ones, being adjusted according to the effectiveness of certain methods.
Weight loss
The less weight, the less the knee joints are overloaded and, consequently, the fewer symptoms of the disease appear.
Change of activity
Some 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 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 unload the joint.
Physiotherapy
Strengthening the muscles around the knee joint helps reduce stress on the joint and prevent muscle wasting (atrophy), which is an important element in maintaining knee function.
Orthopedic insoles (insoles)
With the help of orthopedic supports for the instep, the biomechanics of walking are corrected, the correct distribution of weight in the knee joint is achieved and the manifestations of the disease are reduced.
Anti-inflammatory medications
To treat the inflammation and pain caused by the disease, non-steroidal anti-inflammatory drugs (Diclofenac sodium, etc.) are used.
Hormonal injections into the joint
Injections of hormonal medications (cortisone) effectively help reduce joint pain and inflammation.However, you must be very careful when using these medications, because... the likelihood of side effects from this therapy often outweighs the possible good results.
Biological therapy.
The most modern and effective methods of conservative treatment of joint arthrosis are biological therapy methods.These include PRP therapy, cytokine therapy and MSK therapy.
PRPis a serum rich in platelets and growth factors taken from the blood that accelerates the healing process of acute and chronic injuries.Growth factors are chemicals that begin the healing process.The introduction of PRP into the injured area 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, combats chronic progressive cartilage degeneration.A fundamental role in the development of joint arthrosis is played by Interleukin-1 (IL-1), a substance that enhances 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- Stem cell treatment is considered an innovative and advanced therapeutic method, based on its main characteristic - dedifferentiation (not belonging to any specific tissue) and, therefore, they have the ability to multiply and develop into specialized cells of various tissues.
Joint fluid substitutes.
Injections of 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 often used to treat osteoarthritis of the knee joint.
Knee joint denervation is an effective and safe method of treating pain associated with knee joint osteoarthritis.
Denervation of genicular nerves
In cases where conservative treatment does not bring relief and joint replacement is not possible due to certain contraindications, denervation of the genicular nerves can be used.The essence of the procedure is heat 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 for osteoarthritis of the knee joint remains controversial, but it is quite effective in relieving some specific symptoms.
Osteotomy
Surgical procedure used to realign the axis of the lower limb.Effective in young people with minimal damage to the cartilaginous layer of the joint.
Total endoprostheses
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 unicondylar knee arthroplasty, in which the site of the articular cartilage defect is replaced with a metal plate.The indications for this procedure are very limited.