Osteoarthritis of the knee joint (gonarthrosis) is a degenerative disease characterized by progressive wear of the cartilage 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.Exacerbating factors include previous injuries to the knee, menisci, and ligaments.
Symptoms of gonarthrosis
The symptoms of knee osteoarthritis always progress over time.Patients usually notice an exacerbation of the disease in the autumn and spring periods;Pain can also depend on changes in weather.
- Pain at rest, which decreases slightly when walking;
- Limitation of the range of motion in the joint;
- Stiffness in movement;
- Increased sensitivity in the joint area;
- Swelling of the soft tissues around the joint;
- Joint deformity.
The condition of the joint is evaluated by examination and x-rays.Using x-rays, the stage of the disease is determined and the appropriate treatment is prescribed.
Treatment of knee osteoarthritis.
The treatment of gonarthrosis begins with the simplest steps and moves on to more complex ones, and is adjusted depending on the effectiveness of certain methods.
weight loss
The less the weight, the less overloaded the knee joints are and, consequently, the fewer symptoms of the disease appear.
change of activity
It is necessary to limit some types of physical activity associated with joint overload (running, lifting weights, 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 joint overload and prevent muscle atrophy, which is an important element of maintaining knee function.
Orthopedic insoles (insoles)
With the help of orthopedic supports for the instep, the biomechanics of gait is corrected, correct weight distribution 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-inflammatories (Diclofenac sodium, etc.) are used.
Hormonal injections into the joint.
Injections of hormonal medications (cortisone) effectively help reduce pain and inflammation in the joint.However, great care must be taken when using these medications, 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 joint osteoarthritis are methods of biological therapy.These include PRP therapy, cytokine therapy, and MSK therapy.
PPRis a serum rich in platelets and growth factors extracted from the blood that accelerates the healing process of acute and chronic injuries.Growth factors are chemicals that start the healing process.The introduction of PRP into the injury 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 key role in the development of joint osteoarthritis is played by interleukin-1 (IL-1), a substance that enhances the inflammatory process in the joints and causes 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 key characteristic: undifferentiation (they do not belong to any specific tissue) and, therefore, 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 of treating 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 certain contraindications, denervation of the genicular nerves can be used.The essence of the procedure is the heat treatment of the sensitive nerves in the knee joint, which transmit pain impulses.After a successful outpatient procedure, a significant and long-lasting 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
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 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 replacement, in which the site of the articular cartilage defect is replaced with a metal plate.The indications for this procedure are very limited.