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 occurs more often in people over 50 years old.Excess body weight worsens the symptoms of the disease, while weight loss reduces its manifestation.There is also a genetic predisposition, so in some families, arthrosis occurs more often than in others.Aggravating factors include previous injuries to the knee, meniscus and ligaments.
Symptoms of gonarthrosis
The symptoms of knee osteoarthritis always progress over time.Patients often notice an aggravation of the disease in the autumn-spring periods;The pain can also depend on weather changes.
- Pain at rest, slightly less when walking;
- Limitation of the range of motion in the joints;
- Stiffness in movement;
- Increased sensitivity in the joint area;
- Swelling of the soft tissues around the joint;
- Deformation of joints.
The condition of the joint is assessed through examination and X-ray.Using x-rays, the stage of the disease is determined and the appropriate treatment is prescribed.
Treatment of knee arthrosis
The treatment of gonarthrosis begins with the simplest steps and goes to the most complex ones and is adjusted depending on the effectiveness of certain methods.
Weight loss
The less weight, the less the knee joints are overloaded and, accordingly, fewer symptoms of the disease appear.
Change of activity
Some types of physical activity related to 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 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 attachment (shbana)
With the help of orthopedic leg supports, 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 inflammation and pain caused by the disease, non-steroidal anti-inflammatory drugs (Diclofenac sodium, etc.) are used.
Hormonal injections into the joints
Injections of hormonal drugs (cortisone) effectively help reduce pain and inflammation in the joints.However, you must be extremely careful when using these drugs because... the likelihood of side effects from such therapy often outweighs the potential good results.
Biological therapy.
The most modern and effective methods of conservative treatment of joint arthrosis are methods of biological therapy.These include PRP therapy, cytokine therapy and MSK therapy.
PRPis a serum rich in platelets and growth factors obtained 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 a rapid resolution of the inflammatory process.
Cytokine therapyis a safe and effective treatment for osteoarthritis in which an active therapeutic protein, IL-1Ra, produced by the body, fights chronic progressive cartilage degeneration.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 feature - non-differentiation (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 drugs that are often used to treat osteoarthritis of the knee joint.
Denervation of the knee joint is an effective and safe method for the treatment of pain associated with osteoarthritis of the knee joint.
Denervation of the genicular nerves
In cases where conservative treatment does not bring relief and joint replacement is not possible due to some contraindications, genicular nerve denervation 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 for arthrosis of the knee joint remains controversial, but it is quite effective for the relief of some specific symptoms.
Osteotomy
A surgical procedure used to realign the axis of the lower limbs.Effective in young people with minimal damage to the cartilage layer of the joint.
Total endoprosthetics
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 replacement, in which the site of the articular cartilage defect is replaced with a metal plate.The indications for this procedure are very limited.