Orthopedic traumatologists carry out expert diagnostics (radiotherapy, laboratory), conservative therapy (drugs, intra-articular injections, PRP therapy, cellular technologies of regenerative medicine, etc.) and high-tech surgical treatment of gonarthrosis (osteoarthritis of the knee joint) - arthroscopy, endoprostheses, corrective osteotomy.
Gonarthrosis is observed in one in ten people over the age of 55 and in a quarter of these patients, it causes disability.
Up to 80% of patients with osteoarthritis of the knee joints report a reduction in their quality of life.
The duration of operation of a modern endoprosthesis of the knee joint 10 years after surgery is 99%, after 15 years – 95%, after 20 years – 90%.
Why does osteoarthritis of the knee joint occur?
- Most often, the cause of the development of the disease are knee injuries, especially repeated ones (damage to the menisci, dislocations, fractures, hematomas, etc.).
- Frequently repeated joint microtrauma during sports training, with constant work “on the feet”, have a similar effect.
- Excess body weight creates increased axial load and destroys the joint.
- The degenerative-dystrophic process in the joint can also occur after suffering from inflammatory diseases (arthritis due to gout, psoriasis, rheumatoid arthritis).
- Endocrine diseases, hormonal changes (eg menopause), metabolic disorders aggravate pathological changes in the joint.
Main symptoms of knee joint pain
- With grade 1 gonarthrosis - at the initial stage of the disease, periodic pain occurs in the knee joint after exercise (walking, running, prolonged standing), which disappears after rest.At this stage, there is virtually no joint deformity or mobility restriction;
- Gradually, the pain becomes more frequent and intensify, especially when going up and down stairs, as well as when starting to walk after prolonged sitting (starting pain);
- With grade 2 gonarthrosis, knee pain during exercise becomes constant, disappears only after a long rest, the patient limps when walking;
- When moving, a crunching sensation appears in the joint.The range of movements of the knee joint is limited (when bending “all the way”, sharp pain appears);
- When examining the joint area, you may notice swelling and deformity;
- With AOD of the knee joint of the 3rd degree, which corresponds to severe gonarthrosis, the pain in the joint is annoying even at rest, does not allow falling asleep, the range of movements significantly decreases, patients walk on bent legs and there is a pronounced deformation of the knee joint (O-shaped or X-shaped legs).
Diagnosis
- A survey and examination by an orthopedic traumatologist reveals typical signs of degenerative-dystrophic joint disease (pain on palpation, limited mobility, crepitus, deformation, joint effusion).
- A radiological examination of the knee joint is carried out (a narrowing of the radiological joint space, the presence of osteophytes, subchondral sclerosis is determined) and, if necessary, a CT scan of the joint.
- Ultrasound examination of the joint can detect thinning of the cartilage of the joint, changes in the ligaments, muscles, soft tissues around the joint, inflammatory effusion in the joint cavity, and changes in the menisci.
- The most accurate information is provided by magnetic resonance imaging of the knee joint, which reveals changes in cartilage and bone tissue, ligaments, menisci, synovial membrane, allowing to differentiate post-traumatic osteoarthritis of the knee joint and arthritis, tumor process.
- Diagnostic puncture and arthroscopy of the knee joint, as well as laboratory testing of synovial fluid obtained during the procedure, are widely used in the diagnosis of joint diseases.
Treatment of knee osteoarthritis
Treatment of osteoarthritis of the knee joint depends on the stage of the disease.
Conservative
In the early stages of DOA, successful complex conservative treatment is possible, aimed at relieving inflammation, restoring cartilage, eliminating pain and restoring full joint function:
- Therapeutic and protective diet - it is necessary to limit the load on the joint and ensure rest.
- Conservative drug treatment of knee osteoarthritis:
- use of analgesics, nonsteroidal anti-inflammatory drugs, chondroprotectors;
- local use of drugs in the form of ointments, gels;
- intra-articular injection - intra-articular administration of an individually selected combination of drugs, which may include hormonal agents to quickly relieve inflammation, hyaluronic acid drugs to replenish synovial fluid, etc.
- PRP therapy - intra-articular injections of PRP (own platelet-rich plasma).
- Methods of regenerative medicine - intra-articular injections of autologous cells of the stromal-vascular fraction, cells - precursors of cartilage tissue, obtained from its own adipose tissue.
- Massage, physiotherapy, manual therapy.
- Mandatory use of therapeutic physical training with a set of exercises aimed at improving blood circulation in the joint and increasing the range of movements.
Surgical
Knee arthroscopy
In case of pronounced changes in the joint (advanced osteoarthritis, traumatic defects), orthopedic traumatologists carry out surgical treatment of osteoarthritis of the knee joint arthroscopically (surgeries on the meniscus, cartilage, removal of the “mouse joint”, synovectomy, etc.).
Knee replacement
If other treatment methods prove ineffective, we perform knee replacement using modern prostheses from the world's best manufacturers.It is a reliable way to relieve the patient's pain and restore mobility and a decent quality of life.
Nowadays, there is no point in enduring the pain and discomfort caused by joint pain.Modern medical technologies make it possible to relieve knee osteoarthritis at almost all stages.Contact your doctor and take advantage of existing options.