Knee arthritis, or knee deforming arthropathy, is a degenerative dystrophic disease of the hyaline cartilage of the knee that covers the tibial and femoral condyles.
The symptoms of knee arthritis appear gradually over time and are mainly characterized by stiffness and pain during movement.Among arthropathy of other joints (phalanges, shoulder joints, elbow joints, hip joints), knee arthrosis is the most common disease.
The people most susceptible to knee joint disease are women and people over 40 years old.In some cases, athletes (due to increased stress) and young people (on the background of previous injuries) may develop knee arthropathy.
Causes of knee joint disease
Knee osteoarthritis does not have a single cause.In most cases, the development of the disease depends on a combination of negative factors that worsen with age and may eventually lead to the disease.The following mechanisms of joint disease have been medically determined:
Primary - occurs in old age due to the aging of body tissues and certain factors that trigger this disease (continuously increased stress, genetics, obesity).
Secondary – accounts for 30% of all cases of knee arthropathy and occurs primarily after meniscus damage, ligament rupture, tibial fractures, and other injuries.In most cases, knee symptoms begin after 3-4 years.But if the damage is severe enough, it may take 2-3 months for symptoms to appear.
Approximately 7-8% of knee joint disease occurs after forty years when active physical activity (i.e., squats and running) begins.However, due to age, the weakening of knee joint tissue tension and the characteristic age-related changes under sudden loading may cause rapid degenerative and dystrophic changes in the joint.
Another reason why a person suffers from knee joint disease may be due to concomitant diseases - varicose veins, excess weight, ankylosing spondylitis, gout, psoriasis, rheumatoid or reactive arthritis.
Knee arthritis may result from continued critical loading of the knee, regular long-term stair climbing or heavy lifting in old age, and occupational sports.The risk of knee arthritis is significantly increased due to inherited weakness of the ligamentous mechanism, diabetes and other metabolic disorders, neurological disease, and spinal injuries.
50-60% of cases of knee arthritis are caused by muscle spasm in the front of the thigh.This muscle spasm may not manifest itself long before knee pain occurs, and patients may experience leg heaviness, fatigue, and lower back pain.When the iliopsoas and rectus femoris muscles are in constant spasticity, this can cause the knee to "tighten" as we age, limiting its free movement.
Degree of knee joint disease
In most cases, arthropathy of the knee occurs on one knee.Medicine divides knee arthrosis into 3 levels depending on the intensity of the pathological process:
The first is that the bones of the joint are not deformed; periodic dull pain in the knee is a characteristic after the joint is subjected to physical stress.There may be slight swelling in the joint, which will go away on its own over time.
Level II is characterized by increased symptoms of arthropathy.The pain is long-lasting and severe, occurs with minimal physical activity (lifting heavy objects, walking), and a crunching sound may also be heard in the joints.In second degree knee arthrosis, the knee joint may become deformed and movement may be moderately restricted.
Grade 3 – There are obvious symptoms of knee arthritis.Obvious joint deformation and persistent pain lead to patient's gait disorder and limited joint movement.In third-degree knee arthritis, the pain worsens depending on the weather and can even disrupt the patient's sleep, limiting mobility to a minimum, making it impossible to find a comfortable leg position.
Diseases and pathologies confused with knee arthrosis
The meniscus blocks the knee joint when it is injured.
This disease occurs after an unsuccessful exercise, accompanied by a creaking in the knee, severe pain, which subsides after 15 minutes, and swelling of the knee the next day.
Ankylosing spondylitis, gout, rheumatism of the joints, arthritis - psoriasis, reactive, rheumatoid.
In order to differentiate between knee joint disease and arthritis, routine blood tests are necessary.In arthritis, the test results will indicate the presence of inflammatory processes in the body, whereas in arthropathy, blood tests will not change.
Inflammation of the knee tendons.
Most often, women over the age of 40 develop this condition while carrying heavy objects or walking down stairs.The pain is localized to the inner surface, but the knee's movement is not restricted.
Pain in the blood vessels of the knee.
The pain is characteristically symmetrical and occurs in both knees simultaneously.A period of accelerated bone growth characteristic of adolescents, which may occur during physical activity, a cold, or a change in weather.To describe his condition, patients use the term "twisted knee."
stages of knee arthritis
Because the disease develops gradually, it is insidious.Initially, the patient experiences only mild discomfort and pain when moving, going up and down stairs.In some cases, patients experience reduced sensation to mild joint stiffness and tightness in the popliteal area.A typical feature of knee arthritis is considered to be the symptom of initial pain, that is, after a sharp transition from a sitting position to movement, pain begins with the first step of the person, then gradually disappears, and only reappears after heavy loads.
The appearance of a knee joint with grade one arthropathy is no different than a healthy knee joint, except that in some cases patients may notice mild swelling.Additionally, in some cases, fluid begins to accumulate in the knee joint, swells and becomes a ball, and synovitis begins to develop, leading to a feeling of heaviness in the joint and limited movement.
Joint changes in primary arthropathy occur due to interruption of blood circulation in the small intraosseous vessels that nourish the hyaline cartilage.This can cause the cartilage surface to change, dry out, lose smoothness, and develop cracks.Therefore, unimpeded and soft movement between cartilages is difficult and is accompanied by ongoing microtrauma as the cartilages press against each other.Cartilage tissue that is in a continuously minimally invasive state begins to lose its shock-absorbing properties and become thinner.
The development of pathological processes leads to changes in bone structure.The joint area becomes flattened and spinous growths (osteophytes) appear at the edges.The joint capsule degenerates, the synovial fluid thickens, and the synovial membrane atrophies.This causes a significant deterioration in the trophic processes of cartilage and accelerates its degeneration.
When the disease progresses to the second stage, symptoms begin to intensify, pain occurs even with light load, and the pain is concentrated on the medial front side of the joint.Rest can relieve pain, but returning to exercise can cause severe pain.
The mobility of the joint is significantly reduced, and trying to bend the leg as far as possible causes severe pain, and a noticeable rough crunching sound is heard when moving.Synovitis is more common; due to the accumulation of large amounts of fluid, the joint enlarges and changes its structure.
Third-degree arthrosis of the knee is accompanied by significant deformation of the bones, in which the bones appear to be pressed against each other.Cartilage tissue almost disappears, and restrictions on joint movement increase.Straightening the joint becomes very difficult, and pain begins to plague the patient around the clock, both while walking and at rest.Because the joints are severely deformed, the legs become O- or X-shaped, the gait becomes unstable and wobbly, and patients often cannot do without a cane or crutches.
Diagnosis and Treatment of Knee Arthropathy
On routine examination, it cannot be determined whether a patient has first-degree arthropathy of the knee.If it is degree 2 or 3, there will be swelling and edema (accompanied by synovitis) during the examination, a creaking sound will be heard, the movement will be stiff, the axis of the limbs will change, and the joints will be obviously deformed.
Today, in addition to radiography, CT and MRI methods are widely used for the diagnosis of arthropathy, making it possible to study bone structural diseases in more detail and to examine pathological changes in soft tissues.
Treatment of the disease involves complex plastic surgery and medications.Orthopedic surgeons may prescribe mud therapy, therapeutic exercises, massage, and physical therapy.
Medical treatment involves the use of chondroprotectants, which replace synovial fluid.In some cases, intra-articular steroid injections are given.Patients are also advised to undergo health resort treatments.
If treatment fails in young patients with severe limitations in movement and pain, joint replacement surgery can be performed, providing a recovery period of 3-6 months.
What happens to arthritic knees?
Articular cartilage plays an important role in human movement and is a smooth, elastic and durable lining through which joint bones can move smoothly against each other and also absorb and distribute the load of walking.
But due to excessive regular loading, genetic predispositions, metabolic disorders in the body, long-term muscle spasms and damage, cartilage can lose its smoothness and start to thin.The soft sliding of the joint bones is replaced by intense friction, and first-grade arthropathy occurs, in which the cartilage loses its shock-absorbing properties.
The degradation process continues and shock malabsorption leads to flattening of the bone surface and the formation of osteophytes in the form of bone growth.In this case, the disease has reached the second degree and is accompanied by degeneration of the synovium and joint capsule.Lack of pumping and movement can cause the knee joint structure to shrink, the consistency of the knee joint fluid to become more viscous, and the nutritional process of the cartilage to be destroyed, leading to further deterioration of the patient's condition.
Thinning of the cartilage causes the distance between the joint bones to decrease by up to 80%.When walking, due to abnormal friction and lack of shock absorbers, the process of destruction of the joints rapidly increases, which quickly leads to third-degree arthropathy with obvious symptoms:
Pain when moving, especially going up or down stairs.
Pain during exercise and at rest, morning stiffness.
The patient begins to limp, trying to avoid the painful joints.
Severe cases of this disease require the use of crutches or canes.
Tertiary arthropathy of the knee is characterized by an almost complete absence of cartilage tissue, which results in minimal joint mobility.Therefore, there is no magic method, super drug or ointment that can restore worn cartilage tissue and normal function of the joint is not possible given the extent of bone deformation.In this case, only surgery can help.
Gymnastics treats knee joint disease
Any treatment for knee arthritis should only be done as prescribed by your doctor.Therapeutic gymnastics consists of slow, rhythmic exercises that do not include squats, twisting joints, and jumping.It is best to do gymnastics in the morning, sitting or lying down, for 20 minutes each time, and repeat each action 10 times.
The main goals of therapeutic exercises are to relax painful muscle spasms, increase blood supply to the joints, slow the progression of the disease, and prevent further cartilage destruction.Physical exercise is prohibited during an exacerbation of the condition.
Lying on your back, you can perform bicycle exercises, but you need to straighten your legs parallel to the ground, make a circular motion with your feet, move your legs to both sides, slide alternately along the floor, and count to 10.
Sit on a chair, put your legs down, straighten your legs, and bend your feet at the same time. Maintain this position and count to 10. Use your hands to alternately pull each knee toward your abdomen, and slowly return to the starting position.
Focusing on the wall, stand on the floor and alternately swing your legs back and forth.
Place your straight leg on a chair in a bouncy leaning motion while resting your hands on your thigh as if trying to straighten your leg further.
Lying on your stomach, alternately lift and hold the straight leg for a count of up to 3 times.
Sit on the floor, spread your legs to the sides, and move along the floor, pulling your knees toward your belly on an inhale and returning them to the starting position on an exhale.