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 most often occurs 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, that is, in certain families, arthrosis occurs more often than in others.Exacerbating factors include previous injuries to the knee, meniscus and ligaments.
Symptoms of gonarthrosis
Symptoms of knee osteoarthritis always progress over time.Patients often notice the worsening of the disease in the autumn-spring periods;pain can also depend on weather changes.
- Pain at rest, slightly reduced when walking;
- Limitation of range of motion in the joint;
- Stiffness in movement;
- Increased sensitivity in the joint area;
- Swelling of soft tissues around the joint;
- Joint deformity.
The condition of the joint is assessed by examination and X-ray.X-rays determine the stage of the disease and prescribe appropriate treatment.
Treatment of knee arthrosis
Treatment of gonarthrosis begins with the simplest steps and moves to more complex ones, and is adjusted depending on the effectiveness of individual methods.
Weight loss
The lower the weight, the less the knee joints are overloaded and, accordingly, the symptoms of the disease appear less.
Change of activity
Some types of physical activity associated with joint overload must 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 down the progression of the disease (swimming, skiing, orbitrek, etc.).
Additional support
In case of severe pain, crutches or sticks are used to relieve the joint.
Physiotherapy
Strengthening the muscles around the knee joint helps reduce overuse of the joint and prevent muscle loss (atrophy), which is an important element in maintaining knee function.
Orthopedic insoles (insoles)
With the help of orthopedic braces for intensity, the biomechanics of walking are corrected, the correct distribution of weight on the knee joint is achieved 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, one should be extremely careful when using these drugs, because... the probability of side effects from such therapy is often greater than the possible 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 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 the therapeutically active 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 antidote is an 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 key feature - non-differentiation (does not belong to any specific tissue), and therefore have the ability to reproduce and develop into specialized cells of different 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 that are often used to treat osteoarthritis of the knee joint.
Denervation of the knee joint is an effective and safe method of treating pain associated with arthrosis 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 certain contraindications, genicular nerve denervation can be applied.The essence of the procedure is temperature treatment of the sensitive nerves of the knee joint that transmit pain impulses.After a successful outpatient procedure, a significant long-term reduction in pain in the knee joint is possible.
Arthroscopic debridement of the knee joint
The effectiveness of arthroscopic intervention in arthrosis of the knee joint is still controversial, but it is quite effective for alleviating some specific symptoms.
Osteotomy
A surgical procedure used to realign the axis of the lower extremity.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 terminal gonarthrosis.
Partial knee replacement
The so-called unicondylar knee replacement, in which the place of the articular cartilage defect is replaced by a metal plate.Indications for this procedure are very limited.