Knee osteoarthritis: what it is, stages, symptoms and treatment myths

Arthrosis of the knee joint is a complex disease of a degenerative-dystrophic nature that affects the osteochondral part of the knee.The disease most often 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 disorders, seriously inhibit the musculoskeletal potential of the legs.The joint becomes stiff, loses stability, normal motor ability and cushioning ability.As a result, it is gradually deformed, and in the final stages it completely collapses.

Degeneration in joint tissues 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 causes disability, and in some cases paralysis of the legs.Due to such a disappointing prognosis, it is important to recognize the disease as early as possible and start its treatment immediately.

Important information about the disease

Before studying treatment tactics, it is important for patients to familiarize themselves with the material below in order to have complete information about the mechanism of occurrence and clinical manifestations of the pathology.We immediately note that arthrosis and arthritis are closely related, because the disease in question is a consequence of arthritis.But where do the unfortunate diseases that mercilessly destroy the most important bone connection come from?What is the severity of gonarthrosis and by what manifestations can it be recognized?

Causes of arthrosis

Degenerative-dystrophic pathogenesis is "triggered" by the following provoking factors:

• previously acquired injuries - lower leg fractures, knee dislocations, damage to the body of the meniscus, tearing and rupture of ligaments, falls on the knees, all kinds of bruises;
• excessive physical activity;
• sedentary lifestyle;
• high body mass index;
• systemic pathologies of rheumatoid, gout, psoriatic type, systemic lupus erythematosus;
• genetically inherited weakness of the ligamentous-muscular system or congenital underdevelopment of structural elements of the joint;
• disorders of metabolism and blood flow;
• hormonal imbalance, diabetes mellitus and other endocrine pathologies;
• past or chronic infectious and inflammatory diseases.

Often, people themselves become responsible for the development of joint diseases that are difficult to resolve.Often, after an injury, they ignore contact with a specialist, preferring to settle for the first available painkillers, homemade lotions, etc.And a few years later, due to inadequate treatment in the past, they come to the doctor already with gonarthrosis, at best - of medium severity.Here too, only physical prophylaxis and ointments to relieve pain, as in the very early stage, will not be enough;you often have to act radically, using surgical tactics.

Stages of destruction

In orthopedics, this disease is divided into stages, from which the specialist starts when developing a treatment regimen.The degree, nature, localization and nature of the destruction of the bone joint in the knee are identified by a series of diagnostic measures, such as radiography, magnetic resonance, CT, ultrasound, and various types of blood and urine tests of the patient.

There can be no talk of 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 visiting a doctor and receiving adequate therapeutic recommendations from him.Therefore, if you want to improve the quality of your life, do not neglect to visit an experienced specialist;only he can tell you whether you can manage with qualified conservative help or whether only surgical intervention will be effective for your problem.

Pathology has several stages of development;according to Kellgren's classification there are only four.All of them characterize the severity of morphological changes (presence of osteophytes, reduction of the volume of articular cartilage and its degree of thinning, narrowing of the joint space, etc.) and clinical signs (limited flexion/extension, indicator of weight bearing, nature and intensity of pain, etc.). 

• Arthrosis of the first stage This is a disease that is still in its infancy.External symptoms are mild or absent, joint congruence and shape are satisfactory.X-ray or MRI photographs show small marginal osteophytes along the edges of the articular surfaces, subtle subchondral osteosclerosis and small bone cysts in the subarticular region.The joint space is usually normal or altered, 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 interarticular space is clearly visible.The patient begins to feel stronger and more frequent pains when walking, climbing/descending stairs, standing for a long time, sometimes even at night.Lameness develops, joint movements become inferior, especially when bending.
• The third phase characterized by a sharp progression of irreversible degenerations and deformations.The configuration of the joint is noticeably distorted, the distance between the joint surfaces is significantly reduced, and the bone growths in the form of spikes are increased in size.The pain becomes prolonged and pronounced and disturbs the person even at rest, and the lameness worsens.Dependence on support devices and external help emerges. 
• The fourth stagedegenerative-dystrophic pathogenesis, when voluminous osteophytic growths are present, the hyaline cartilage is completely destroyed, the joint space disappears or is barely visible, the epiphyses of the joint bones that make up the joint are severely deformed.The knee joint is recognized as a completely unsustainable organ of the musculoskeletal system and the person becomes disabled. 

Symptoms and complaints

The severity of clinical manifestations depends not only on pathomorphological characteristics, but also on individual factors.In any case, there is little pleasant in gonarthrosis;it is very difficult to bear in 2. and 3-4.A general list of symptoms includes:

• pain syndrome, mostly mechanical type (dull, painful, sharp, sudden, periodic and constant);
• the appearance of crunching when moving;
• stiffness of the joints;
• limitation of range of motion;
• weakness of the muscles of the extremities;
• skin hyperthermia and swelling in the knee area;
• changes in gait, manifested by limping and wobbly legs;
• instability or drawer syndrome;
• "jamming" of the knee, which occurs when the movements of the bone joint are suddenly blocked.

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

Conservative treatment

Non-surgical treatment methods are suitable in the initial phase of deforming arthrosis.The principle of non-surgical treatment includes:

• systematic application of exercise therapy developed by a professional on an individual basis;
• carrying out physiotherapy procedures;
• use of painkillers in the form of ointments, tablets, injections, etc.;
• proper nutrition and adherence to a special diet prescribed by a doctor;
• adherence to a special regimen of daily physical activity;
• complete cessation of bad habits;
• unquestionably passing repeated diagnostic control;
• annual visit to a specialized sanatorium-resort medical facility.

Knee joint arthrosis surgery

Now let's get acquainted with surgical methods, which are often necessary, because in the early stages the pathology often goes unnoticed.Basically, we have to deal with osteoarthritis in full bloom, which has largely 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 locomotor and supporting function of the knee of the lower extremity.The operation is not easy, difficult rehabilitation follows, but the effect is worth it.Approximately 3 months after the installation of an artificial analogue instead 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 of "closing" the joint, due to its aggressive effect on biological structures, but sometimes it also happens, for example, if a person does not have the possibility to undergo implantation.Its essence is in the removal of the joint surfaces and the fixed connection of the joint bones with each other using special devices for fixing in a favorable position.Over time, the above-mentioned elements come together naturally.Artificial ankylosis completely blocks the mobility of the joint, but allows achieving a good load-bearing capacity of the limb and reducing pain.
• Osteotomy of the knee - it is also used in extreme situations, for the same reason as arthrodesis, especially when it is necessary to postpone endoprosthetics for several years.At the time of the surgical session, the specialist performs an artificial fracture, filing the bones and placing them at a more regular angle in order to favorably distribute the load on the cartilaginous elements.  

Irreversible pathogenesis cannot be corrected by physical exercises, you must understand that.Fats and even drugs from the chondroprotector series will not play a special role either, not to mention grandmother's advice to treat with gelatin.The most they can do to help the advanced condition is to prepare the musculoskeletal system for the upcoming surgery.

Modern knee implants can withstand normal daily stress and function perfectly for at least 15 years, and often 20-25 years.A person can even play some sports with a replaced joint.

Treatment phase 3

In stage 3 of arthrosis, surgery is performed.The changes in the joint are very pronounced;at this stage, the disease greatly reduces the patient's standard of living and performance.Osteochondral damage has reached a critical point where the connective tissue has no functional significance.The hyaline covering is almost completely destroyed. 

• Important cartilage does not regenerate itself, including non-surgical methods.
• The exposed and flattened surfaces of the ends of the bones in interaction exert unnatural pressure on each other, constantly rubbing against each other, seriously injuring the nearby soft tissues and becoming more and more deformed every day.
• The person feels terrible pain, not to mention the lost ability to walk normally.Patients experience daily suffering, when sleep is not a joy, and during the day there is no rest from pain.Only a few people report a relatively tolerable condition.
• Anti-inflammatory analgesics, as a rule, have a mild effect, but most often they do not "work".It makes no sense to use chondroprotectors, because strengthening and feeding the scarce cartilage remains does not save the situation.

Sometimes the consequences of 2-3 degree arthrosis are tried to be treated with minimally invasive surgery (arthroscopy), during which marginal osteophytes and torn osteochondral fragments can be removed from the joint cavity.Such manipulations, as evidenced by examinations, alleviate the patient's condition to some extent and slightly improve motor function, but temporarily.Osteoarthritis in the knee joint remains active and will manifest itself again in the near future. 

The pathogenesis of 3-4 degrees is a very serious problem, which can only be solved by much more complex reconstructive-plastic-surgical tactics.To date, there is no procedure that can be compared to endoprosthetics.Replacing the knee joint with a prosthesis that completely repeats the mechanical characteristics, shape and size configuration of the natural organ will allow you to say goodbye to both the unfortunate pathology and the disability it "rewarded" you with.

The disease progresses rapidly and can go from mild to moderate to stage 4 in a few months.The operation should be performed as soon as possible, before the degenerative processes penetrate deep into the bone.Severely damaged bones can make it difficult to place an endoprosthesis.

Many, not fully realizing that the severity of the resulting degeneration is incomparable to conservative and unconventional tactics, try to avoid surgery by all means, swallowing pills on the hand, applying ointments to the painful area.Someone turns to osteopaths, private doctors who practice all kinds of alternative techniques.Unfortunately, you cannot go against nature, healing will not come after them and you have to accept that.Therefore, discard senseless ideas and act judiciously.

Your physical fitness depends entirely on your decision!You can continue to suffer from stiffness and pain for life, trying in vain "empty" methods of treatment: drugs and non-standard drugs that have no evidence of effectiveness for your severity of the disease.Or you can undergo surgical treatment and start living a full life, free of past suffering and support devices.

There is no need to worry about surgical intervention;modern technologies have come a long way, and today knee joints abroad have been brilliantly replaced by long-lasting implants.After such implantation, performed in a good clinic, the risk of complications is minimal (1-2%), and movement functions are restored in more than 95% of cases.Joint replacement is followed by a rehabilitation course of 3-4 months, including:

• physical recovery through special therapeutic exercises;
• taking medications (antibiotics, antithrombotics, etc.);
• a physiotherapy program that includes 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 osteoarthritis of the knee, allowing it to go 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 stages are always surgery.

Treatment 2 degrees

With gonarthrosis of moderate severity, the quality of life already becomes significantly impaired.A painful knee is more worrying, the pain syndrome manifests itself more often and more intensely than it was at the beginning of the disease.The pain is especially pronounced immediately after waking up in the morning, when going up and down the stairs.Often there is a feeling of unpleasant numbness that occurs after walking for a long time or standing for a long time in one position.Flexion in the knee area is reduced, the patient is unable to bend the leg, as required by physiology.A person begins to spare his limb, trying almost not to step on it, due to which gradual muscle atrophy occurs.

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

• If the doctor does not see an urgent need for surgery, the priority is to reduce the load on the problem area.If you are overweight, in order to ensure good relief of the joint affected by osteoarthritis, it is imperative to adjust your body weight by following the diet recommended by your doctor.
• All patients are prescribed the use of special orthopedic aids when moving.This, depending on the problem at hand, may include knee braces, compression garments, elastic bandages, a cane, crutches or a walker.
• In addition, the orthopedic traumatologist will prescribe a unique set of exercises that will help strengthen and increase the endurance of the muscles of the affected limb.
• Also, arthrosis in moderate to moderate manifestations involves the use of drugs that include substances present in the cartilage tissue of the knee.These include chondroitin sulfate formulations, hyaluronic acid injections, and glucosamine preparations.They cannot restore the cartilage, but they saturate it with nutritious components, so that remission of the disease can be achieved.
• Physiotherapy procedures are also recommended, but they are applied only after all signs of inflammation have disappeared.Physical sessions, for example, laser, magnet or ultrasound, should take place in a medical facility.Thanks to physiotherapy, nutrition and metabolism in bone, muscle and cartilage tissues improves.If you have purchased a vibroacoustic device for home use, first ask a specialist about the possibilities of using it for your diagnosis and the working characteristics of the device.

We reviewed the basic principles on which the official treatment of arthrosis is based, in accordance with the standards of orthopedics.Of many people with stage 2 osteoarthritis.who are very interested in alternative methods, looking for their salvation in them, we offer you to get acquainted 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 the autotransplantation of mesenchymal stem cells to a patient with gonarthrosis of the knee, taken from the top of the pelvis or femur.Cell therapy, according to interested sources, will achieve almost self-renewal of the entire joint by activating the regenerative processes of self-healing in the damaged segment.Thanks to this technology, it is theoretically possible to achieve improvement of the constituent units of the osteochondral organ.However, in practice there is still no "living" radiographic evidence to 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 very doubtful, because this technique is not yet recognized in orthopedics.Scientists are just studying and experimenting with it.Moreover, there is information about the unsafe effect of stem cells on the human body, which, according to highly qualified experts, can cause cancer.What about those people who paid for the procedure and were satisfied with the result?Here we can say only one thing: many patients will believe in eternal life for such money, but the placebo effect does not last long, do not forget this either.

Mud treatment

Medicinal mud springs that contain unique components (magnesium, chromium, iodine, bromine, calcium nitrate, etc.) help reduce painful symptoms, increase blood flow to diseased areas, and stimulate metabolism.They have the greatest value for people with a milder stage of the disease or patients who have already undergone leg surgery.Mud treatment at level 2 is also allowed if the doctor believes that the natural remedy in combination with the main treatment program will reduce the aggressiveness of the pathological phenomena (stop the progression) and improve the overall clinical picture.Mud therapy is practiced in special health care institutions of the spa type.Natural medicinal muds based on peloids are used in the form of applications and in combination with the method of galvanization (electrophoresis).

The use of gelatin

Natural gelatin is a safe product that helps maintain joint structures in good condition.A gelatinous substrate, diluted in water, is recommended for internal use.According to the reviews of some doctors, gelatin will act faster and more productively on bones, cartilage and muscle-ligament elements.Experts point out that this method has no medicinal properties, but only helps in the prevention of arthrosis.Accordingly, in the case of already established pathogenesis, treatment with gelatin in the absence of pathology or in the earliest stages can be considered exclusively as a measure to prevent the appearance or progression of degenerative-dystrophic changes.When the disease is moderate and severe, this approach will not work for preventive purposes.

Ayurveda for joints

Modern alternative medicine is known for many outstanding trends, including Ayurvedic treatment of various parts of the musculoskeletal system.According to this unofficial theory, joint damage is related to excess toxins that build up in the body due to an energetic imbalance.The damaging mechanism of disturbed energy balance (Vata) is primarily the weakening of Agni, i.e. the digestive fire, which leads to the accumulation of undigested food residues (Ama) in the intestines.They secrete toxins, which the blood carries 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 massages, self-training for treatment, etc.Of course, all this sounds tempting, but one cannot believe that even high technology will be trusted to reverse her arthrosis.powders, thought treatment and other Ayurvedic tactics cure irreversible deformities?!

Salt wraps

A saturated physiological solution is prepared from salt, which is used to impregnate dressings that are placed on the painful area for several hours.Such therapy should not be considered as an independent remedy, and even less as a remedy for gonarthrosis.Salt can temporarily relieve pain, relieve swelling of the soft tissues that cover the bone structure, without damaging the biological structures.But it will not cure the disease and will not get the patient back on his feet!Its effect is purely symptomatic.The solution is prepared by taking 100 g of salt per 1 liter of water at room temperature.

It's worth a look! Sometimes salt is used in a dry, heated form, which is placed in a bag, and local heating of the knee is performed.Sometimes like wet but warm bandages.Hot procedures are dangerous in case of purulent-inflammatory processes in the joint cavity;it will only worsen the clinical picture.Therefore, do not use such recipes without being sure that the lesion is not followed by a similar process.