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

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 region of the lower extremities.Pathological changes in 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 and shock-absorbing abilities.As a result, it gradually deforms, and in the final stages it completely fails.

Degenerations in joint tissues manifest themselves not only in the form of physical dysfunction of the lower extremities, but also 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 identify the disease as early as possible and begin 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 full information regarding the mechanism of origin and clinical manifestations of the pathology.Let us 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 ailments come from that mercilessly destroy the most important bone connection?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 suffered injuries - shin fractures, knee dislocations, damage to the body of the meniscus, tears and ruptures of ligaments, falls to the knees, all kinds of bruises;
• excessive physical activity;
• sedentary lifestyle;
• high body mass index;
• systemic pathologies of the rheumatoid, gouty, psoriatic type, systemic lupus erythematosus;
• genetically inherited weakness of the ligamentous-muscular system or congenital underdevelopment of the structural elements of the joint;
• metabolic and blood flow disorders;
• hormonal imbalance, diabetes mellitus and other endocrine pathologies;
• past or chronic infectious and inflammatory diseases.

Quite often, people themselves become responsible for the development of intractable joint disease.Often, having received an injury, they ignore contacting a specialist, preferring to make do with the first available pain medication, homemade lotions, and the like.And several years later, due to inadequate treatment carried out in the past, they come to see a doctor already with gonarthrosis, at best - of moderate severity.And here, just physical prophylaxis and pain-relieving ointments, as in the very early course, will not be enough; you often have to act radically, using surgical tactics.

Stages of destruction

In orthopedics, this disease is divided into stages, which is what the specialist then proceeds from when drawing up a treatment regimen.The degree, nature, localization, and nature of origin of destruction of the bone joint in the knee are identified through 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 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 a visit to the doctor and receiving adequate therapeutic recommendations from him.Therefore, if you want to improve your quality of life, do 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 will be 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 signs (limited flexion/extension, weight bearing indicator, nature and intensity of pain, etc.). 

• Arthrosis of the first stage This is a disease that is just in its infancy.External symptoms are mild or absent, the congruence and shape of the joint are satisfactory.X-rays or MRI photos show small marginal osteophytes along the edges of the articular surfaces, in the subarticular region there is a 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 interarticular space is clearly visible.The patient begins to experience stronger and more frequent pain when walking, going up/down stairs, standing for a long time, sometimes at night.Lameness develops, movements in the joint become inferior, especially when bending.
• Third stage characterized by a sharp progression of irreversible degenerations and deformations.The configuration of the joint is noticeably distorted, the distance between the articular surfaces is significantly reduced, and bone growths in the form of spikes are of increased size.The pain becomes prolonged and pronounced, and disturbs the person even at rest, and the lameness worsens.Dependence on supporting devices and outside help appears. 
• Fourth stagedegenerative-dystrophic pathogenesis, when voluminous osteophytic growths are present, hyaline cartilage is completely destroyed, the joint space disappears or is barely visible, the epiphyses of the articulating bones that form 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 pleasant in gonarthrosis; it is very difficult to bear both in the 2nd and 3-4th stages.The general list of symptoms includes:

• pain syndrome, mainly of the mechanical type (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 limb;
• hyperthermia of the skin 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 can already happen in the worst case at the second stage of development of osteochondral degenerations.In contrast to traditional conservative therapy and alternative methods, without exception, surgery for serious gonarthrosis of 2-3-4 degrees is the only way that for a long period of life helps to significantly improve the quality of life.

Conservative treatment

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

• systematic implementation of exercise therapy developed by a professional on an individual basis;
• conducting physiotherapy procedures;
• the use of painkillers in the form of ointments, tablets, injections, etc.;
• proper nutrition and following a special diet prescribed by a doctor;
• adherence to a special regime of daily physical activity;
• complete cessation of bad habits;
• unquestioning passage of repeated diagnostic control;
• annual visit to a specialized sanatorium-resort medical institution.

Surgery for arthrosis of the knee joint

Now let's get acquainted with surgical methods, which are often necessary, since at an early stage the pathology often goes unnoticed.Basically, we have to deal with arthrosis in full bloom, which has extensively affected the articular structures and affected the periarticular matter.

• Endoprosthetics – helps in more than 95% of cases to restore as completely as possible the lost locomotor and support functions of the knee of the lower limb.The operation is not easy, followed by difficult rehabilitation, but the effect is worth it.Approximately 3 months after the installation of an artificial analogue instead of the native joint, which has undergone irreversible pathological changes, the full range of movements of the leg returns, and the pain syndrome is completely eliminated.
• Arthrodesis – an uncommon procedure for “closing” the joint, due to its aggressive effect on biological structures, but sometimes it also takes place, for example, if a person does not have the opportunity to undergo implantation.Its essence lies in the removal of articular surfaces and the fixed connection of the articulating bones with each other using special fixing 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 you to achieve good weight-bearing ability of the limb and reduce pain.
• Knee osteotomy – is also used in extreme situations, for the same reason as arthrodesis, in particular when it is necessary to delay 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 correct angle in order to advantageously distribute the load on the cartilaginous elements.  

Irreversible pathogenesis cannot be corrected by physical exercise, you must understand this.Ointments and even drugs from the chondroprotector series, not to mention grandmother’s advice to be treated with gelatin, will not play a special role either.The maximum they can do to help in an advanced state of affairs is to prepare the musculoskeletal system for the upcoming operation.

Modern knee implants can withstand normal everyday 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.

Stage 3 treatment

At stage 3 of arthrosis, surgery is performed.Changes in the joint are very pronounced; at this phase, the disease extremely reduces the patient’s standard of living and performance.Osteochondral damage has reached a critical point at which the tissues of the bone junction do not represent any functional significance.The hyaline cover is almost completely destroyed. 

• Important cartilage does not repair itself, including 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, seriously injuring nearby soft tissues and becoming even more deformed every day.
• The person feels terrible pain, not to mention the lost ability to walk normally.Patients experience daily torment, 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 analgesic drugs, as a rule, have a mild effect, but most often do not “work”.There is no point in using chondroprotectors, since strengthening and nourishing the scanty remnants of cartilage does 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 can be removed, as well as torn osteochondral fragments can be removed from the joint cavity.Such manipulations, as evidenced by reviews, somewhat alleviate the patient’s condition and slightly improve motor function, but temporarily.Osteoarthritis in the knee joint remains active and will manifest itself again in the near future. 

Pathogenesis of 3-4 degrees is a very serious problem, which can only be solved with much more complex reconstructive and plastic surgical tactics.To date, there is no procedure that can compare with endoprosthetics.Replacing the knee joint with a prosthesis that completely replicates the mechanical features, configuration of shapes and sizes of a natural organ will make it possible to say goodbye to both the ill-fated pathology and the disability with which it has “awarded” you.

The disease progresses quickly and can reach from the moderate-medium phase to stage 4 in a matter of months.Surgery should be performed as early as possible, before 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 degenerations that have occurred are incomparable with conservative and unconventional tactics, try in every way to bypass the operation, swallowing pills by the handful, applying ointments to the sore area.Someone turns to osteopaths, private doctors who practice all kinds of alternative techniques.Unfortunately, you can’t go against nature, healing will not come after them, and you need to come to terms with this fact.Therefore, discard senseless ideas and act prudently.

Your physical fitness depends entirely on your decision!You can continue to suffer from stiffness and pain for life, vainly testing “empty” methods of treatment: drugs and non-standard remedies that have no evidence of effectiveness for your severity of illness.Or you can undergo surgical treatment and begin to live a full life, free from past suffering and support devices.

There is no need to worry about surgical intervention; modern technologies have stepped far forward, and today knee joints are brilliantly replaced abroad with long-lasting implants.After such implantation, carried out in a good clinic, the risk of complications is minimal (1-2%), and restoration of mobility functions occurs in more than 95% of cases.After joint replacement, a rehabilitation course of 3-4 months will follow, including:

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

Good to know! At stage 1, the disease can be stopped and prevented conservatively.If you do nothing and start arthrosis of the knee, allowing it to move 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 an operation.

Treatment 2 degrees

With gonarthrosis of moderate severity, the quality of life already becomes significantly spoiled.A sore knee worries more, the painful 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, while going up and down the stairs.There is often a feeling of unpleasant numbness that appears after prolonged walking or standing in one position for a long time.Flexion in the knee area is reduced, the patient is not able to bend the leg, as required by physiology.A person begins to spare his limb, trying almost not to step on it, which is why gradual muscle atrophy occurs.

We emphasize that treatment necessarily involves 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 for the joint affected by arthrosis, it is imperative to adjust your body weight by following the diet that your doctor recommends.
• All patients are prescribed the use of special orthopedic devices when moving.This, depending on the existing problem, may include knee braces, compression garments, elastic bandages, a cane, crutches, or a walker.
• Additionally, 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 medications that include substances present in the cartilaginous tissues of the knee.These include formulations based on chondroitin sulfate, injections of hyaluronic acid, and preparations with glucosamine.They cannot restore cartilage, but saturate it with nutritional components, so that remission of the disease can be achieved.
• Physiotherapy procedures are also recommended, but they are used only after all signs of inflammation have disappeared.Physical sessions, for example, laser, magnet or ultrasound, should take place within the medical facility.Thanks to physiotherapy, nutrition and metabolism in bone, muscle, and cartilage tissues improves.If you bought a vibroacoustic device for home use, first ask a specialist about the possibility of using it for your diagnosis and the operating features of the device.

We have reviewed the basic principles on which the official treatment of arthrosis is based, meeting the standards of orthopedics.Since many people with stage 2 osteoarthritis.are very interested in alternative methods, looking for their salvation in them, we offer to get acquainted with the most popular of them.And let’s find out whether 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 to a patient with knee gonarthrosis, taken from the crest of the pelvic or femur.Cell therapy, according to interested sources, 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 improvement in the constituent units of the osteochondral organ.However, in practice, there is not yet a single “live” radiographic evidence that would confirm that after the introduction of stem cells into the affected area, the joint became healthy.

The positive effect of stem cells on joints and bones has not been proven and is highly doubtful, since this technique has not yet been recognized in orthopedics.Scientists are just studying and experimenting with it.Moreover, there is information regarding the unsafe effect of stem cells on the human body, which, according to highly competent specialists, can provoke cancer.What about those people who paid for the procedure and were satisfied with the result?Here we can only say one thing: many patients will believe in eternal life for that kind of money, but the placebo effect does not last long, do not forget about this too.

Mud treatment

Therapeutic mud springs containing unique components (magnesium, chromium, iodine, bromine, calcium nitrate, etc.) help reduce 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 surgery on the leg.It is also permissible to carry out mud therapy at level 2 if the doctor believes that a natural remedy in combination with the main treatment program will reduce the aggression of pathological phenomena (stop progression) and improve the overall clinical picture.Mud therapy is practiced in special health resort-type medical institutions.Natural healing muds based on peloids are used in the form of applications and in combination with the galvanization method (electrophoresis).

Uses of gelatin

Natural gelatin is a safe product that helps maintain joint structures in good condition.The jelly-like substrate, diluted in water, is recommended to be consumed internally.According to reviews of some doctors, gelatin will have a faster and more productive effect on bone, cartilage and muscle-ligamentous elements.Experts emphasize that this method does not have medicinal properties, it only helps prevent arthrosis.Consequently, in the case of already established pathogenesis, gelatin treatment in the absence of pathology or in the earliest stages can be considered solely 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 extraordinary trends, including Ayurveda treatment of various parts of the musculoskeletal system.According to this unofficial theory, joint damage is associated with excess toxins accumulated in the body due to energetic disharmony.The damaging mechanism of the disturbed balance of energy (Vata) is primarily the weakening of Agni, or digestive fire, which leads to the accumulation of undigested food residues (Ama) in the intestines.They secrete toxins, which the blood transports to the joint, where harmful substances settle 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 arthrosis cannot be reversed even through scientific high technologies, how can you believe that herbalWill powders, treatment with thoughts and other Ayurvedic tactics cure irreversible deformities?!

Salt compresses

Salt is used to prepare a saturated saline solution, which is used to impregnate compresses that are applied to the sore spot for several hours.Such therapy should not be considered as an independent remedy, much less as a panacea for gonarthrosis.Salt can temporarily soothe pain, relieve swelling of the soft tissues covering the bone structure, without harm to biological structures.But it will not cure the disease and will not put the patient back on his feet!Its effect is purely symptomatic.The solution is prepared at the rate of taking 100 g of salt per 1 liter of room temperature water.

Worth checking out! Sometimes salt is used in dry, heated form, which is placed in a bag, and local heating of the knee is performed.Sometimes as wet but hot dressings.Hot procedures are dangerous in case of purulent-inflammatory processes in the joint cavity; they will only aggravate the clinical picture.Therefore, do not use such recipes without being sure that the lesion is not accompanied by a similar process.