Osteoarthritis of the knee joint: what it is, stages, symptoms and myths about treatment

Osteoarthritis of the knee joint is a complex disease of a degenerative-dystrophic nature that affects the osteochondral part of the knee.The disease most commonly affects the knee area of the lower extremities.Pathological changes in the cartilage and periarticular areas, which in most cases develop against the background of injuries, biological aging of the body and autoimmune diseases, significantly reduce the musculoskeletal potential of the legs.The joint becomes stiff and loses stability, normal motor function and ability to absorb shock.As a result, it gradually deforms and in the final stage fails completely.

Degeneration in the joint tissue manifests itself not only in the form of physical dysfunction of the lower extremities, but also in severe pain in them.In severe cases, the pathology leads to disability and, in some cases, paralysis of the legs.Because of this disappointing prognosis, it is important to detect the disease as early as possible and begin treatment immediately.

Important information about the disease

Before studying treatment tactics, it is important for patients to familiarize themselves with the following material in order to obtain complete information about the mechanism of formation and clinical manifestations of the pathology.We immediately note that arthrosis and arthritis are closely related, since the disease in question is a consequence of an arthritic disease.But where do unfortunate complaints come from that mercilessly destroy the most important bone connection?How severe is gonarthrosis and how can it be recognized?

Causes of osteoarthritis

The degenerative-dystrophic pathogenesis is “triggered” by the following provoking factors:

• previously sustained injuries – shin fractures, knee dislocations, damage to the body of the meniscus, tears and tears of ligaments, falls on the knees, all kinds of bruises;
• excessive physical activity;
• sedentary lifestyle;
• high body mass index;
• systemic pathologies of rheumatoid, gout, psoriasis type, systemic lupus erythematosus;
• genetically inherited weakness of the ligament-muscular system or congenital underdevelopment of the structural elements of the joint;
• Metabolism and circulatory disorders;
• hormonal imbalance, diabetes mellitus and other endocrine diseases;
• past or chronic infectious and inflammatory diseases.

It is not uncommon for people themselves to be blamed for the development of stubborn joint diseases.After an injury, they often ignore contacting a specialist and prefer to make do with the first available painkillers, homemade lotions and the like.And a few years later, due to inadequate treatment in the past, they come to the doctor with gonarthrosis, at best of moderate severity.And here, as in the very early stages, physical prophylaxis and pain-relieving ointments alone will not be enough;Often you have to act radically and use surgical tactics.

Phases of destruction

In orthopedics, this disease is divided into stages, which the specialist then uses when drawing up a treatment plan.The degree, type, localization and nature of the origin of the destruction of the bone joint in the knee are determined by a number of diagnostic measures such as radiography, MRI, CT, ultrasound and various types of blood and urine tests of the patient.

There can be no question of high-quality treatment without detailed information about both the condition of the knee joint and the characteristics of the patient's body, as well as without a visit to the doctor and without appropriate therapy recommendations from him.Therefore, if you want to improve your quality of life, you should not ignore visiting an experienced specialist.Only he can tell you whether you can get by with qualified conservative help or whether only surgical intervention is effective for your problem.

The pathology has several stages of development;According to the Kellgren classification, there are only four of them.All of them characterize the severity of morphological changes (the presence of osteophytes, a decrease in the volume of articular cartilage and the degree of its thinning, narrowing of the joint space, etc.) and clinical symptoms (limited flexion/extension, load indicator, nature and intensity of pain, etc.). 

• Osteoarthritis of the first stage This is a disease that is still in its infancy.External symptoms are mild or absent, congruence and shape of the joint are satisfactory.On X-rays or MRI images, small marginal osteophytes can be seen at the edges of the articular surfaces; in the subarticular area there is subtle subchondral osteosclerosis and small bone cysts.The joint space is usually normal or changed, but not significantly.
• In case of illness second degree, in addition to the above indicators, The osteosclerotic focus is more pronounced and the narrowing of the joint space is clearly visible.The patient experiences stronger and more frequent pain when walking, climbing stairs and standing, sometimes at night.Lameness develops and movements in the joint become worse, especially when bending.
• Third stage characterized by a strong progression of irreversible degeneration and deformation.The joint configuration is noticeably distorted, the distance between the articular surfaces is significantly reduced, and bone growths in the form of spikes are enlarged.The pain becomes longer and more pronounced, disturbing the person even at rest, and the lameness worsens.A dependency on supporting devices and outside help develops. 
• Fourth stageDegenerative-dystrophic pathogenesis, when there are voluminous osteophytic growths, the hyaline cartilage is completely destroyed, the joint space disappears or is barely visible and the epiphyses of the articular bones forming the joint are severely deformed.The knee joint is recognized as a completely non-viable organ of the musculoskeletal system and the person becomes incapacitated. 

Symptoms and complaints

The severity of clinical manifestations depends not only on pathomorphological features, but also on the individual factor.In any case, there is little that is pleasant about gonarthrosis;it is in both the 2nd and 3rd-4th.Stage very difficult to endure.The general list of symptoms includes:

• Pain syndrome, mainly of a mechanical nature (dull, aching, sharp, sudden, periodic and constant);
• the appearance of a crunch when moving;
• joint stiffness;
• limitation of range of motion;
• muscle weakness of the extremity;
• Hyperthermia of the skin and swelling in the knee area;
• Gait changes manifested by limping and wobbly legs;
• instability or drawer syndrome;
• “trapping” of the knee, which occurs when the movements of the bone joint are suddenly blocked.

Important! Conservative treatment of arthrosis of the knee joint does not help if the disease has a complicated course, which in the worst case can already happen in the second stage of development of osteochondral degeneration.In contrast to conventional conservative therapies and alternative methods, surgery for severe gonarthrosis of 2-3-4 degrees is without exception the only way to significantly improve the quality of life over a long period of time.

Conservative treatment

In the initial phase of deforming osteoarthritis, non-surgical treatment methods are useful.The principle of non-surgical treatment includes:

• systematic implementation of exercise therapy individually developed by a specialist;
• Carrying out physiotherapeutic procedures;
• the use of painkillers in the form of ointments, tablets, injections, etc.;
• proper nutrition and adherence to a special diet prescribed by a doctor;
• Compliance with a special regime of daily physical activity;
• complete abandonment of bad habits;
• unconditional passage of repeated diagnostic control;
• annual visit to a specialized sanatorium-resort medical institution.

Surgery for osteoarthritis of the knee joint

Now let's get acquainted with the surgical methods that are often necessary, since the pathology often goes unnoticed at an early stage.Basically, we are dealing with osteoarthritis in full bloom, which has severely affected the joint structures and affected the periarticular matter.

• Endoprosthetics – Helps in more than 95% of cases to restore as completely as possible the lost movement and support functions of the knee of the lower extremity.The operation is not easy, followed by difficult rehabilitation, but the effect is worth it.Approximately 3 months after installing an artificial analogue in place of the natural joint, which has undergone irreversible pathological changes, the full range of motion of the leg returns and the pain syndrome is completely eliminated.
• Arthrodesis – an unusual procedure to “close” the joint, since it has an aggressive effect on biological structures, but also sometimes occurs, for example, when a person does not have the opportunity to undergo implantation.Its essence lies in the removal of articular surfaces and the firm connection of the articular bones to each other using special fixation devices in an advantageous position.Over time, a natural fusion of the listed elements occurs.Artificial ankylosis completely blocks the mobility of the joint, but allows the limb to bear good loads and relieve pain.
• Knee osteotomy – is also used in extreme situations for the same reason as arthrodesis, especially when endoprosthetics have to be delayed for several years.During the surgical session, the specialist performs an artificial fracture by filing the bones and placing them at a more correct angle in order to favorably distribute the load on the cartilage elements.  

Irreversible pathogenesis cannot be corrected by physical exercise, you need to understand this.Ointments and even drugs from the chondroprotector series, not to mention grandmother's advice to undergo treatment with gelatin, will also not play a special role.In an advanced state, they can maximally help prepare the musculoskeletal system for the upcoming operation.

Modern knee implants can withstand normal everyday stress and function properly for at least 15 years, often even 20-25 years.You can even play sports with a replaced joint.

Level 3 treatment

In stage 3 of osteoarthritis, surgery is performed.Changes in the joint are very pronounced;During this phase, the disease significantly affects the patient's standard of living and performance.The osteochondral damage has reached a critical point at which the bone junction tissue no longer has any functional significance.The hyaline cover is almost completely destroyed. 

• Important cartilage does not repair itself, even through non-surgical methods.
• The exposed and flattened surfaces of the interacting bone ends exert unnatural pressure on each other, constantly rubbing against each other, severely injuring the surrounding soft tissue, and deforming more and more every day.
• The person feels terrible pain, not to mention lost the ability to walk normally.Patients suffer daily torment when sleep brings no joy and there is no respite from the pain during the day.Only a few people report a relatively tolerable condition.
• Anti-inflammatory analgesics usually have a mild effect, but usually do not “work”.There is no point in using chondroprotectors, since strengthening and nourishing the scanty remnants of cartilage will not save the situation.

Sometimes they try to treat the consequences of grade 2-3 arthrosis with minimally invasive surgery (arthroscopy), during which marginal osteophytes, as well as torn osteochondral fragments, can be removed from the joint cavity.Such manipulations, as reviews show, somewhat alleviate the patient's condition and slightly, but temporarily, improve motor function.Osteoarthritis in the knee joint remains active and will manifest itself again in the near future. 

The pathogenesis of grade 3-4 is a very serious problem that can only be solved with much more complex reconstructive and plastic surgical tactics.To date, there is no procedure comparable to endoprosthetics.Replacing the knee joint with a prosthesis that fully recreates the mechanical properties, configuration of shapes and sizes of a natural organ allows you to say goodbye to both the unfortunate pathology and the disability with which you were “rewarded” as a result.

The disease progresses rapidly and can progress from moderate to stage 4 within a few months.The operation should be carried out as early as possible, before degenerative processes penetrate deep into the bone.Severely damaged bones can make it difficult to insert an endoprosthesis.

Many, not fully realizing that the severity of the degenerations that have arisen are incomparable with conservative and unconventional tactics, try in every possible way to avoid the operation, swallowing handfuls of tablets and applying ointments to the sore spot.Someone turns to osteopaths, private doctors who practice all sorts of alternative techniques.Unfortunately, you cannot go against nature, healing will not happen according to it and you have to come to terms with this fact.Therefore, discard useless ideas and act prudently.

Your physical fitness depends entirely on your decision!You can suffer from stiffness and pain all your life, trying in vain “empty” methods of treatment: medications and non-standard remedies, the effectiveness of which has not been proven given the severity of your disease.Or you can undergo surgical treatment and begin living a fulfilling life, free from the suffering and devices of the past.

You don't have to worry about surgery;Modern technologies have come a long way, and today knee joints abroad are excellently replaced with long-lasting implants.After such an implantation, carried out in a good clinic, the risk of complications is minimal (1-2%), and the restoration of mobility functions occurs in more than 95% of cases.After joint replacement, a rehabilitation course of 3-4 months follows, which includes:

• physical recovery through special therapeutic exercises;
• taking medications (antibiotics, antithrombotics, etc.);
• a physiotherapy program with myostimulating, anti-inflammatory, analgesic and wound healing procedures;
• Massage sessions (in the later stages of rehabilitation).

Good to know! In stage 1, the disease can be stopped and prevented conservatively.If you do nothing and start arthrosis of the knee joint so that it goes from stage 1 to stage 2, drug treatment will be much more problematic, but for a certain category of patients, a non-surgical approach is still appropriate.The last two steps are always surgery.

Treatment 2 degrees

With moderate gonarthrosis, the quality of life is significantly impaired.A painful knee causes more concern, the pain syndrome manifests itself more frequently and more intensely than at the beginning of the disease.The pain is particularly pronounced immediately after waking up in the morning when climbing stairs.An unpleasant feeling of numbness often occurs after walking or standing in one position for a long time.Flexion in the knee area is limited, the patient is unable to bend the leg as required by physiology.A person begins to rest his limbs and tries almost not to step on them, which is why gradual muscle atrophy occurs.

We emphasize that treatment necessarily requires a qualified, comprehensive approach.

• If the doctor does not see an urgent need for an operation, the focus is on relieving the problem area.If you are overweight, for good relief of the joint affected by osteoarthritis, it is essential to adjust your body weight according to the diet recommended by your doctor.
• All patients are prescribed the use of special orthopedic aids when moving.Depending on the problem at hand, this may include knee braces, compression stockings, elastic bandages, a cane, crutches or a walker.
• In addition, the orthopedic traumatologist will prescribe a unique set of exercises that will help strengthen the muscles of the affected limb and increase its endurance.
• Moderate to moderate osteoarthritis also requires medications containing substances present in the cartilage tissue of the knee.These include formulations based on chondroitin sulfate, injections with hyaluronic acid and preparations with glucosamine.They cannot restore cartilage, but rather saturate it with nutrients so that remission of the disease can be achieved.
• Physiotherapeutic procedures are also recommended, but they are only used after all signs of inflammation have disappeared.Physical sessions, for example with laser, magnet or ultrasound, should take place within the medical facility.Thanks to physiotherapy, nutrition and metabolism in bone, muscle and cartilage tissue improve.If you have purchased a vibroacoustic device for home use, first ask a specialist about the possible use for your diagnosis and the functional features of the device.

We have reviewed the basic principles on which the official treatment of arthrosis is based and which correspond to the standards of orthopedics.Since many people suffer from stage 2 osteoarthritis.If you are very interested in alternative methods and seek salvation in them, we offer to familiarize yourself with the most popular of them.And let's find out if they are as unique as they are presented to us on the Internet.

Stem cells for knee treatment

We will talk about autotransplantation of mesinchemal stem cells from the iliac or femoral crest in a patient with knee gonarthrosis.According to interested sources, cell therapy will achieve almost self-renewal of the entire joint by activating regenerative self-healing processes in the damaged segment.Thanks to this technology, it is theoretically possible to achieve an improvement in the components of the osteochondral organ.However, in practice, there is not yet a single “living” X-ray evidence that would confirm that the joint has become healthy after the introduction of stem cells into the affected area.

The positive effect of stem cells on joints and bones has not been proven and is highly doubtful, as this technology is not yet recognized in orthopedics.Scientists are currently studying and experimenting with it.In addition, there is information about the unsafe effect of stem cells on the human body, which, according to highly competent specialists, can cause cancer.What about the people who paid for the procedure and were happy with the results?Here we can only say one thing: Many patients will believe in eternal life for so much money, but the placebo effect does not last long, you should not forget that.

Sludge treatment

Therapeutic mud springs with unique ingredients (magnesium, chromium, iodine, bromine, calcium nitrate, etc.) help relieve painful symptoms, increase blood flow to diseased areas and stimulate metabolism.They are of greatest value for people with a mild stage of the disease or patients who have already undergone leg surgery.It is also permissible to carry out level 2 mud therapy if the doctor believes that a natural remedy in combination with the main treatment program reduces the aggressiveness of pathological phenomena (stops progression) and improves the overall clinical picture.Mud therapy is practiced in special spa-style medical facilities.Natural healing muds based on peloids are used in the form of applications and in combination with the galvanization method (electrophoresis).

Possible uses of gelatin

Natural gelatin is a safe product that helps keep joint structures in good condition.It is recommended to take the jelly-like substrate diluted with water internally.According to some doctors' reviews, gelatin has a faster and more productive effect on bones, cartilage and muscle-ligamentous elements.Experts emphasize that this method has no medicinal properties, but only helps prevent arthrosis.Consequently, with already established pathogenesis, gelatin treatment in the absence of pathology or in the earliest stages can be considered exclusively as a measure to prevent the occurrence or progression of degenerative-dystrophic changes.This approach to prevention is not suitable for moderate and severe disease.

Ayurveda for joints

Modern alternative medicine is known for many extraordinary trends, including Ayurvedic treatment of various parts of the musculoskeletal system.According to this unofficial theory, joint damage is associated with excessive accumulation of toxins in the body due to energetic disharmony.The harmful mechanism of disturbed energy balance (Vata) is primarily the weakening of Agni, the digestive fire, which leads to the accumulation of undigested food residues (Ama) in the intestines.They excrete toxins that the blood transports to the joint, where harmful substances are deposited and inhibit metabolic processes.

According to Ayurveda, osteoarthritis is classified into several types and each type has its own treatment system.The basis of each of them is diet, herbal medicine, taking Ayurvedic tablets and powders, yoga and breathing exercises, unconventional massage, auto-training for healing, etc. Of course, all this sounds tempting, but if osteoarthritis cannot be reversed even by cutting-edge scientific technologies, then how can you believe that herbal powders, mind treatment and other Ayurvedic tactics cure irreversible deformities?!

Salt compresses

A saturated saline solution is prepared from salt, which is used to impregnate compresses that are applied to the sore spot for several hours.Such therapy should not be viewed as an independent remedy and certainly not as a panacea for gonarthrosis.Salt can temporarily relieve pain and relieve swelling of the soft tissue covering the bone structure without harming biological structures.But it will not cure the disease or get the patient back on his feet!Its effect is purely symptomatic.The solution is prepared with 100 g of salt per 1 liter of room temperature water.

It's worth taking a look! Sometimes salt is used in dry, heated form, which is placed in a bag and local warming of the knee is carried out.Sometimes as wet but hot dressings.Hot procedures are dangerous for purulent-inflammatory processes in the joint cavity;They will only make the clinical picture worse.Therefore, you should not use such recipes without making sure that the lesion is not accompanied by a similar process.