Osteoarthritis of the knee joint (gonarthrosis) is a degenerative disease characterized by progressive wear of the cartilaginous layer of the knee joint.
Causes of knee osteoarthritis
It appears more often in people over the age of 50.Excess body weight worsens the symptoms of the disease, while weight loss reduces its manifestation.There is also a genetic predisposition, e.g.in some families osteoarthritis occurs more often than in others.Aggravating factors include previous injuries to the knee, menisci and ligaments.
Symptoms of gonarthrosis
The symptoms of knee osteoarthritis always progress over time.Patients often note an exacerbation of the disease in the autumn-spring periods;the pain can also depend on climate changes.
- Pain at rest, which decreases slightly when walking;
- Limitation of the range of motion of the joint;
- Rigidity in movement;
- Increased sensitivity in the joint area;
- Soft tissue swelling 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 appropriate treatment is prescribed.
Treatment of knee osteoarthritis
The treatment of gonarthrosis begins with the simplest steps and then moves on to more complex ones and is adapted based on the effectiveness of certain methods.
Weight loss
The less weight, the less overload of the knee joints and, accordingly, the fewer the symptoms of the disease.
Change of activity
Some types of physical activity associated with joint overload must be limited (running, weight lifting, etc.).While physical exercises that do not overload the joint increase the range of motion, reduce pain and slow down 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 overload on the joint and prevent muscle wasting (atrophy), which is an important element in maintaining knee function.
Orthopedic insoles (insoles)
With the help of orthopedic instep supports, the biomechanics of walking are corrected, the correct distribution of weight on the knee joint is achieved and the manifestations of the disease are reduced.
Anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs (Diclofenac sodium, etc.) are used to treat the inflammation and pain caused by the disease.
Hormonal injections into the joint
Injections of hormonal drugs (cortisone) effectively help reduce pain and inflammation in the joint.However, you should be very careful when using these drugs, because… the probability of side effects of such therapy often outweighs the possible good results.
Biological therapy.
The most modern and effective methods of conservative treatment of joint arthrosis are biological therapy methods.These include PRP therapy, cytokine therapy, and MSK therapy.
PRPit is a serum rich in platelets and growth factors taken from the blood which accelerates the healing process of acute and chronic injuries.Growth factors are chemicals that start the healing process.The introduction of PRP into the lesion 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, fights the chronic progressive degeneration of cartilage.A key role in the development of joint arthrosis is played by interleukin-1 (IL-1), a substance that accelerates the inflammatory process in the joints and leads to their premature wear.Its biological antipode is the interleukin-1 receptor antagonist (IL-1Ra), which reduces inflammation, increases mobility and reduces pain.
MSK therapy- treatment with stem cells is considered an innovative and advanced therapeutic method, based on their main characteristic: undifferentiation (not belonging to any specific tissue) and, therefore, they 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 some contraindications, denervation of the genicular nerves can be resorted to.The essence of the procedure is the heat treatment of the sensitive nerves of the knee joint, which transmit pain impulses.After successful outpatient surgery, a significant long-term reduction in pain in the knee joint is possible.
Arthroscopic debridement of the knee joint
The effectiveness of arthroscopic surgery 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 extremity.Effective in young people with minimal damage to the cartilaginous layer of the joint.
Total endoprosthesis
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.