Knee Arthritis

Arthritis is a group of inflammatory articular diseases, as well as inflammatory-dystrophic nature.

Knee arthritis is an inflammatory process that occurs in the knee and spreads to the inside of the joint and to the periarticular tissues. In another way, the disease is called gonarthritis.

The knee joint is one of the largest in the human body, containing a lot of synovial (articular) fluid when an inflammatory factor is introduced into which arthritis occurs.

If one knee joint is affected, it is monoarthritis; if both, it is polyarthritis (multiple arthritis). The disease begins with a lesion of the joint capsule, then gradually the inflammation expands and passes to cartilage and bone tissue.

The main symptom of knee arthritis is pain, both during movement and at rest. In addition to pain, the patient experiences stiffness, decreased range of motion, redness and swelling, increased pain with pressure. The temperature may rise. Never ignore these symptoms!

Both children and adults suffer from arthritis of the knee joint, although in old age it is diagnosed incomparably more often. Moreover, it is believed that women, weightlifters, overweight people and those who have a hereditary predisposition to arthritis are more susceptible to arthritis.

Causes of knee arthritis

The causes of knee arthritis can vary. Often, inflammation occurs as a result of natural aging and destruction of hyaline cartilage. Then inflammation joins, for example, due to friction of osteophytes.

Knee arthritis can occur after a traumatic injury as a complication if rehabilitation is not carried out properly. Pathology of the knee joint is often caused by an autoimmune reaction of the body, accumulation of uric acid in the joint, congenital changes, metabolic disorders or endocrine system activity, frostbite or hypothermia, viral and bacterial infections, surgical interventions, excessive stress (the so-called “housewife’s knee”) and others.

Knee arthritis can be an independent pathology (primary arthritis) but often becomes a companion of the underlying disease, for example, hepatitis, psoriasis, systemic lupus erythematosus (secondary arthritis).

Main types

The main types of knee arthritis are:

  • Reactive (infectious). It develops due to the ingestion of an infectious agent or in the presence of a chronic inflammatory process;
  • Rheumatoid arthritis;
  • Gouty arthritis (caused by the deposition of sodium urate due to overeating, alcohol abuse);
  • Arthrosis-arthritis. It can be caused by deterioration of microcirculation in the knee area;
  • Post-traumatic arthritis of the knee joint.

With the wrong treatment of arthritis or its absence, arthritis can become chronic and subsequently lead to loss of motor function of the knee joints and disability. Moreover, the target of arthritis can be not only the musculoskeletal system but also other organs and systems: the heart, kidneys, intestines, lungs.

Symptoms and signs

The classic clinical picture of any type of arthritis is formed by a whole complex of symptoms that join and become more intense as the degrees of arthritis of the knee joint progress. Symptoms are very diverse due to a number of factors: a large area of ​​the lesion, a complex design of the knee joint, the degree of stress on the knee joint, the age and weight of the patient, and specific features of the body.

  • Pain of varying severity, aggravated by pressing, moving, fatigue, tension and bending of the knee;
  • Edema (dropsy) of the knee and swelling in the area of ​​pathology;
  • Redness (flushing) of the skin (symptoms of an inflammatory reaction);
  • Local temperature rise over the sore knee joint, indicating an inflammatory process – knee arthritis;
  • Heaviness in the legs;
  • Visible change in the shape of the knee joint, deformities, bumps, bone destruction (at an advanced stage);
  • Tissue death, cartilage degeneration;
  • Formation of nodules, seals;
  • Spindle-shaped leg with arthritis of the knee;
  • Deterioration of motor abilities, stiffness of the knee joint;
  • Accumulation of fluid in the articular cavity (with infectious knee arthritis);
  • Sweating, chills, fever, swollen lymph nodes (in some types of knee arthritis);
  • General lethargy, weakness, drowsiness, loss of appetite.

It should be noted that the symptoms of knee arthritis are both local and extra-articular. They can be pronounced clearly or be erased, subtle, but gradually increasing. At the same time, not all of the listed signs of joint disease are often present at the same time – some symptoms are added over time.

Diagnostics

Accurate diagnosis at the initial stage of the disease is the key to a successful fight against arthritis of the knee joint. Knee arthritis should be detected as early as possible so that arthritis treatment is timely and effective.

It is necessary to differentiate arthritis with bursitis, arthrosis, myalgia (muscle pain) in the knee, and other diseases of the musculoskeletal system. For this, the doctor conducts a professional comprehensive examination and studies the anamnesis. At the initial examination, the specialist evaluates the objective signs: the patient’s gait and range of motion, the degree of knee swelling, redness, joint pain and the severity of other characteristic symptoms of arthritis.

Further laboratory tests and instrumental methods are prescribed.

Radiography remains the main diagnostic method. It allows detecting osteoporosis in the knees (porosity and fragility of the bone tissue of the knee), a measure of narrowing of the joint space, signs of ankylosis of the joint, the presence of bone defects, including cysts. In chronic arthritis, X-ray reveals dislocations and subluxations of the knee joint, osteophytes (bone growths). These are all considered diagnostic symptoms of arthritis.

Increasingly, modern medicine uses arthroscopy – an examination of the knee joint, which helps to thoroughly identify the dynamics of pathological changes in the knee.

For completeness of the data, other examinations may be indicted: ultrasound (to detect effusion and changes in the knees), computed tomography (CT), magnetic resonance imaging (MRI) (to obtain data on the state of soft tissues), radionuclide scintigraphy (shows the activity of the inflammatory process and the reaction bone tissue of the knee).

The nature of inflammation in the knee joint is sometimes clarified by cytological and microbiological analysis of synovial (articular) fluid obtained by puncture. In the course of the study, the degree of transparency and viscosity of the liquid, the cellular composition, the amount of protein and enzymes, and the presence of microorganisms are determined.

Biochemical and clinical blood tests and rheumatic tests are required. A high-quality examination will help the treating specialist to form the optimal treatment.

Treatment

The tactics of treating arthritis of the knee joint is prescribed by a rheumatologist or arthrologist. Consultation with an orthopedic traumatologist may be recommended. Mostly, the treatment of the joint is conservative, but in some cases, surgery may be recommended – prosthetics of artificial joints.

Treatment of arthritis of the knee joint, like arthritis of any other localization, must be comprehensive. That is, it is necessary to treat arthritis in several directions, using several means and methods at once, the joint action of which is enhanced according to the principle of synergy (consistency).

Typically, knee arthritis therapy to relieve symptoms includes medications and chondroprotectors, physical therapy (such as magnetic pulse therapy), exercise therapy, non-flare knee massage, and lifestyle revisions.

The physician selects medicines taking into account each particular case, the individual characteristics of the organism, and the course of the disease of a particular patient.

You should immediately accept the fact that the treatment of knee arthritis will be long-term. And if arthritis has already passed into a chronic state, then it will have to be treated for life, periodically repeating courses of magnetotherapy and taking medications in order to slow down the progression of the disease, alleviate negative symptoms in the joints and improve overall well-being.

In severe cases of arthritis, endoprosthetics may be required – replacement of the joint with an artificial prosthesis (if the joint is completely destroyed and the limb has lost its mobility). Surgical treatment is usually resorted to in extreme cases.

Changing the lifestyle with arthritis of the knee joints includes adequate physical activity, establishing the correct mode of work and rest, following a diet and getting rid of excess weight, avoiding risk factors for inflammation in the joint, and giving up bad habits.

It is not possible to cure chronic arthritis, but a competent therapeutic complex will help a patient with knee pathology feel acceptable, reduce pain, and lead a relatively active life. Therefore, you need to start treating yourself as early as possible!

Consider the components of the treatment complex for knee arthritis.

Medicines

  • Non-steroidal anti-inflammatory drugs (NSAIDs) (usually over-the-counter). Ibuprofen and diclofenac are especially popular in the treatment of arthritis. They help to eliminate inflammation, swelling and pain in the joint at the time of exacerbation. Long-term use of pills can negatively affect the gastric mucosa. External preparations – ointments, gels, creams – can be applied to the knee area;
  • Glucocorticosteroids (usually by injection). These hormonal pharmaceuticals for arthritis are used only as a last resort. They are able to quickly stop pain in the joint;
  • Basic drugs such as “Rheumatex”, “Plaquenil” can be used for rheumatoid arthritis of the knee joint. They slow down the progression of the disease;
  • Antispasmodics – used to remove muscle spasm in the area of ​​damage and reduce pain in the knee;
  • Muscle relaxants – used to relax skeletal muscles and reduce knee pain in arthritis;
  • Antienzyme drugs (proteolysis inhibitors) – used to inhibit the progression of dystrophy and degeneration of cartilage, joints, bones and other tissues of the knees in arthritis;
  • Angioprotectors – “protectors” of blood vessels. They help to strengthen the walls of blood vessels and provide high-quality blood supply to the knee joint – an important condition for treatment;
  • Medicines for enhancing microcirculation in the joint and its nutrition are an important element in the treatment of arthritis of any etiology;
  • Anabolic agents help accelerate the regeneration processes in the tissues of the knee joint;
  • Chondroprotectors (glucosamine and chondroitin). “Building materials” for the cartilage tissue of the joint, stimulate its synthesis by the body, fight the destruction of the joints, and are able to suppress inflammation in the knee, respectively, to reduce pain. Long-term treatment is needed. They are used very widely for the treatment of arthritis, but they do not have sufficient evidence of efficacy;
  • Vitamins, trace elements, fortifying agents (including calcium, collagen, antioxidants) are indispensable components of treatment for arthritis, which improve the properties of joints.

Physiotherapy

Physiotherapy methods used to treat gonarthritis (arthritis of the knee joints) are varied. It is necessary to supplement the medical complex with physiotherapy in order to increase the combined effect of various agents and treat inflammation of the knee joint much more effectively.

As a rule, laser therapy, magnetotherapy, amplipulse therapy, UHF, ultrasound, darsonvalization, diadynamic therapy, massage, acupuncture, kinesiotherapy, exercise therapy (physiotherapy exercises), mud, therapeutic baths, paraffin therapy are widely used.

Let us dwell in more detail on the most common types of physiotherapy for knee arthritis.

  • Laser therapy improves the metabolism in the joint, accelerates the course of physicochemical reactions in cells and increases cellular activity, which has a positive effect on the speed of recovery processes, reducing pain, swelling in the knees, relieving inflammation in the joints, activating blood circulation, stimulating immunity;
  • Magnetotherapy treatment with magnetic fields. It is aimed at normalizing the metabolic processes of the joint, accelerating regeneration, eliminating the inflammatory process, relieving pain and swelling, improving the blood supply to the joint. It is able to improve the mobility of the affected limb, suppress the reproduction of harmful microorganisms in the joint, and accelerate the elimination of inflammation and decay products from the joint. These are safe and widely used method of treatment, suitable even for elderly and debilitated patients, and convenient for use at home;
  • Amplipulse therapy – the method of treatment consists in influencing the joint area with the alternating sinusoidal current. It affects neuromuscular tissues, restores the activity of the circulatory system, promotes neurostimulation of cells in arthritis. It relieves swelling and pain relief, participates in the stimulation of blood flow and nutrition of cartilaginous and muscle tissues around the joints, prevents pathological growths characteristic of arthritis;
  • UHF therapy is the effect on the patient’s body of a high-frequency electromagnetic field with a certain frequency of electromagnetic oscillations. UHF therapy is aimed at relieving pain and swelling in the joint. This treatment can reduce inflammation in the knee and prevent it from spreading to nearby tissues;
  • Ultrasound with hydrocortisone increases the penetration of the drug into the joint for arthritis, increases the effectiveness of the drug;
  • Massage for arthritis of the knee joints is carried out only during the period without exacerbation. It activates blood flow and nutrition of the organ, strengthens muscles, relieves stiffness, increases motor capabilities, and helps to treat arthritis more effectively.

Most treatments are allowed only if the chronic arthritis of the knee is in remission. The exception is some devices of magnetic impulse therapy with a special mode, specially designed to combat exacerbations of diseases of the joints and spine (including arthritis) in clinical and home conditions.

Efficiency is provided by the course passage of procedures, which gives a cumulative and long-term effect in the treatment of a serious disease – arthritis of the knee joints.

Treating arthritis is an urgent matter. Perform it in a timely and professional manner, under the supervision of a doctor. Long life of joints is a guarantee of your long activity!

Knee arthritis quiz

During the past 4 weeks……

1. How would you describe the pain you usually have in your knee?

  • none
  • very mild
  • mild
  • moderate
  • severe

2. Could you kneel down and get up again afterwards?

  • yes, easily
  • with little difficulty
  • with moderate difficulty
  • with extreme difficulty
  • no, impossible

3 .Have you had any trouble washing and drying yourself (all over) because of your knee?

  • no trouble at all
  • very little trouble
  • moderate trouble
  • extreme difficulty
  • impossible to do

4 .Are you troubled by pain in your knee at night in bed?

  • not at all
  • only one or two nights
  • some nights
  • most nights
  • every night

5. Have you had any trouble getting in and out of the car or using public transport because of your knee? (with or without a stick)

  • no trouble at all
  • very little trouble
  • moderate trouble
  • extreme difficulty
  • impossible to do

6. How much has pain from your knee interfered with your usual work? (including housework)

  • not at all
  • a little bit
  • moderately
  • greatly
  • totally

7. For how long are you able to walk before the pain in your knee becomes s eve re? (with or without a stick)

  • no pain > 60 min
  • 16 – 60 minutes
  • 5 – 15 minutes
  • around the house only
  • not at all – severe on walking

8. Have you felt that your knee might suddenly “give away” or let you down?

  • rarely / never
  • sometimes or just at first
  • often, not at first
  • most of the time
  • all the time

9. After a meal (sat at a table), how painful has it been for you to stand up from a chair because of your knee?

  • not at all painful
  • slightly painful
  • moderately pain
  • very painful
  • unbearable

10. Could you do household shopping on your own?

  • yes, easily
  • slightly painful
  • moderately pain
  • very painful
  • unbearable

11. Have you been limping when walking, because of your knee?

  • rarely / never
  • sometimes or just at first
  • often, not just at first
  • most of the time
  • all of the time

12. Could you walk down a flight of stairs?

  • yes, easily
  • with little difficulty
  • with moderate difficulty
  • with extreme difficulty
  • no, impossible
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