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.Most often, the disease affects the knee area of the lower limbs.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 diseases, seriously suppress the musculoskeletal potential of the legs.The joint becomes stiff, loses stability, normal motor and shock absorption ability.As a result, it is gradually deformed, and in the final stages it completely fails.

Degenerations of joint tissues manifest themselves not only in the form of physical dysfunction of the lower limbs, but also severe pain in them.In severe cases, the pathology causes disability and, in some cases, paralysis of the legs.Because of 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 the tactics of treatment, it is important that patients familiarize themselves with the material below in order to have complete information about the mechanism of origin and clinical manifestations of the pathology.Let's immediately note that arthrosis and arthritis are closely related, since the disease in question is a consequence of an arthritic disease.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:

• previous injuries - fractures of the tibia, displacement of the knee, damage to the body of the meniscus, tears and tears of ligaments, falling knees, any 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 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 diseases.Often, after sustaining an injury, they neglect to contact a specialist, preferring to settle for the first available pain medications, home lotions and the like.And a few years later, due to inadequate treatment carried out in the past, they come to the doctor already with gonarthrosis, at best - of moderate severity.And here only 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, from which the specialist then proceeds when preparing a treatment regimen.The degree, nature, localization and the nature of the origin of the destruction of the bone joint in the knee are identified by a number of diagnostic measures, such as radiography, MRI, CT, ultrasound and various types of blood and urine tests of the patient.

One cannot talk about 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 your quality of life, do not neglect a visit to an experienced specialist;only he can tell you whether you can cope with qualified conservative help or only surgical intervention will be effective for your problem.

The pathology has several stages of development;according to Kellgren's classification they are only four.All of them characterize the severity of the morphological changes (presence of osteophytes, decrease in the volume of articular cartilage and the degree of its thinning, narrowing of the joint gap, etc.) and clinical signs (limited flexion / extension, weight-bearing index, nature and intensity of pain, etc.). 

• Arthrosis of the first stage This is an early stage disease.External symptoms are weakly expressed or absent, the congruence and shape of the joint are satisfactory.X-rays or MRI images show small marginal osteophytes on the edges of the articular surfaces, in the subarticular area there is fine subchondral osteosclerosis and small bone cysts.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 experience stronger and more frequent pains when walking, going up/down stairs, standing for a long time, sometimes at night.Lameness develops, movements in the joint become incomplete, especially when bending.
• Third stage characterized by a sharp progression of irreversible degenerations and deformities.The configuration of the joint is significantly disturbed, the distance between the articular surfaces is significantly reduced, and the 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 support devices and external help emerges. 
• Fourth stagedegenerative-dystrophic pathogenesis, when there are voluminous osteophytic growths, hyaline cartilage is completely destroyed, the articular cleft 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 a person becomes incapacitated. 

Symptoms and complaints

The severity of the clinical manifestations depends not only on the pathomorphological characteristics, but also on the individual factor.In any case, there is not much pleasant in gonarthrosis;it is very difficult to tolerate both in the 2nd and in the 3rd and 4th stages.The general list of symptoms includes:

• pain syndrome, mainly of a mechanical type (dull, painful, sharp, sudden, periodic and constant);
• the occurrence of a movement crisis;
• joint stiffness;
• limitation of range of motion;
• muscle weakness of the limb;
• hyperthermia of the skin and swelling in the knee area;
• gait changes manifested by limping and wobbly legs;
• instability or drawer syndrome;
• "locking" 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 happen in the worst case at the second stage of the development of osteochondral degenerations.Unlike traditional conservative therapy and alternative methods, without exception, surgery for severe 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-operative 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;
• the use of painkillers in the form of ointments, tablets, injections, etc.;
• proper nutrition and compliance with a special diet prescribed by a doctor;
• observance of a special regime of daily physical activity;
• complete rejection of bad habits;
• undisputed passing of repeated diagnostic control;
• annual visit to a specialized sanatorium-resort medical facility.

Surgery for arthrosis of the knee joint

Now let's get acquainted with the surgical methods that are often necessary, since at an early stage the pathology often remains unnoticed.Basically, we have to deal with arthrosis in full swing, which has widely 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 functions of the knee of the lower limb.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 had undergone irreversible pathological changes, the full range of motion of the leg returned and the pain syndrome was completely eliminated.
• Arthrodesis - an unusual procedure to "close" the joint, due to its aggressive effect on the biological structures, but sometimes it is also performed if a person does not have the opportunity to undergo implantation, for example.Its essence consists in the removal of the articular surfaces and the fixed connection of the articular bones with each other with the help of 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 bearing capacity of the limb and reduce 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.During the surgical session, the specialist performs an artificial fracture by filing the bones and placing them at a more correct angle to favorably distribute the load on the cartilaginous elements.  

Irreversible pathogenesis cannot be corrected by exercise, you must understand this.Ointments and even drugs from the chondroprotector series, not to mention grandmother's advice to treat with gelatin, will also not play a special role.The most they can do to help in an advanced condition is to prepare the musculoskeletal system for the upcoming operation.

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

Stage 3 treatment

At the 3rd stage of arthrosis, surgery is performed.Changes in the joint are highly pronounced;in this phase, the disease greatly reduces the patient's standard of living and work capacity.Osteochondral damage has reached a critical point where the tissues of the bony junction are of no functional importance.The hyaline coating is almost completely destroyed. 

• The important cartilage does not regenerate itself, including by non-surgical methods.
• The exposed and flattened surfaces of the interacting ends of the bones exert unnatural pressure on each other, constantly rubbing against each other, seriously injuring the nearby soft tissues and becoming more deformed every day.
• The person is in excruciating pain, not to mention losing the 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 they do not "work".It makes no sense to use chondroprotectors, since strengthening and nourishing the scarce remnants of cartilage does not save the situation.

Sometimes they try to treat the consequences of 2-3 degree 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 relieve the patient's condition and slightly improve motor function, but temporarily.Knee osteoarthritis remains active and will recur in the near future. 

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

The disease progresses rapidly and can go from mild-moderate stage to stage 4 in a few months.The operation should be performed as early 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 degenerations that have occurred are incomparable to conservative and unconventional tactics, try in every way to bypass the operation, swallowing pills by the handful, applying ointments to the inflamed 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 fact.Therefore, discard the senseless ideas and act sensibly.

Your 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 the severity of your disease.Or you can undergo surgical treatment and start living a fulfilling life, free of past suffering and support devices.

No need to worry about surgery;modern technology has come a long way and today knee joints are brilliantly replaced abroad with long-lasting implants.After such implantation, performed in a good clinic, the risk of complications is minimal (1-2%), and the recovery of motor 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 drugs (antibiotics, antithrombotics, etc.);
• 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 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 medium severity, the quality of life already deteriorates significantly.The inflamed knee worries more, the painful syndrome appears more often and more intensely than 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 tingling that occurs after prolonged walking or standing in one position for a long time.Flexion in the knee area is reduced, the patient cannot 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 the treatment necessarily includes a qualified, complex 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 provide good relief to the arthritic joint, it is imperative to correct your body weight by following the diet recommended by your doctor.
• All patients are prescribed the use of special orthopedic devices during movement.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 tissues of the knee.These include formulations based on chondroitin sulfate, hyaluronic acid injections, and glucosamine preparations.They cannot restore the cartilage, but they saturate it with nutritional components so that remission of the disease is achieved.
• Physiotherapy procedures are also recommended, but they are used only after the disappearance of all signs of inflammation.Physical sessions, such as laser, magnet or ultrasound, must be carried out in the medical facility.Thanks to physiotherapy, nutrition and metabolism in bone, muscle and cartilage tissue are improved.If you have purchased a vibroacoustic device for home use, first ask a specialist about the possibility of using it for your diagnostics and the device's performance characteristics.

We looked at the main principles on which the official treatment of arthrosis, meeting the standards of orthopedics, is based.Since many people with osteoarthritis in stage 2. are very interested in alternative methods, looking for their salvation in them, we propose 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 of a patient with gonarthrosis of the knee, taken from the crest of the pelvis or the 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 an improvement in the constituent units of the osteochondral organ.In practice, however, there is still no "live" X-ray evidence to confirm that after the introduction of stem cells into the affected area, the joint has become healthy.

The positive effect of stem cells on joints and bones has not been proven and is very doubtful, since this technique is not yet recognized in orthopedics.Scientists just study it and experiment.In addition, there is information about the dangerous impact of stem cells on the human body, which, according to highly qualified specialists, can provoke 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 about that.

Treatment with mud

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 to people with a mild stage of the disease or patients who have already undergone leg surgery.It is also permissible to conduct mud therapy at level 2, if the doctor believes that a natural medicine in combination with the main treatment program will reduce the aggression of the pathological phenomena (stopping the progression) and improve the overall clinical picture.Mud therapy is practiced in special health resorts of the resort type.Natural healing clays based on peloids are used in the form of applications and in combination with the galvanization method (electrophoresis).

Using gelatin

Natural gelatin is a safe product that helps maintain joint structures in good condition.The gelatinous substrate diluted in water is recommended to be consumed internally.According to the reviews of some doctors, gelatin will have a faster and more productive effect on bones, cartilage and muscle-ligament elements.Experts emphasize that this method has no curative properties, it only helps to prevent arthrosis.Therefore, in the case of an already established pathogenesis, treatment with gelatin in the absence of pathology or in the earliest stages can be considered only 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 unusual trends, including Ayurvedic treatment of various parts of the musculoskeletal system.According to this unofficial theory, joint damage is related to an excess of toxins accumulated in the body due to energy disharmony.The damaging mechanism of energy imbalance (Vata) is primarily the weakening of Agni, or the digestive fire, which leads to the accumulation of undigested food residues (Ama) in the intestines.They release toxins that the blood transports to the joint, where the 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, intake of Ayurvedic tablets and powders, yoga and breathing exercises, non-traditional massage, self-training for treatment, etc.Of course, all this sounds tempting, but if osteoarthritis cannot be reversed even by high scientific technology, how can you believe that herbal will powders, thought therapy 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 an inflamed area for several hours.Such therapy should not be considered as an independent medicine, even less as a panacea for gonarthrosis.Salt can temporarily calm the pain, relieve the swelling of the soft tissues covering the bone structure, without harming the biological structures.But this will not cure the disease and will not put the patient on his feet!Its action is purely symptomatic.The solution is prepared at the rate of 100 g of salt per 1 liter of water at room temperature.

Worth checking out! 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 hot bandages.Hot procedures are dangerous for purulent-inflammatory processes in the joint cavity;they will only worsen the clinical picture.Therefore, do not use such recipes without making sure that the lesion is not accompanied by a similar process.