Osteoarthritis of the knee joint 1 degree: causes, symptoms, treatment
The content of the article:
- Epidemiology
- Pathological features
- The reasons
- Symptoms
-
Diagnostics
- X-ray examination
- Additional diagnostic methods
- Differential diagnosis
-
Treatment
-
Non-drug therapy
- Physiotherapy
- Weight loss
- Unloading the affected limb
- Drug therapy
-
- Prevention
- Video
Osteoarthritis of the knee joint of the 1st degree is the initial stage of the disease, which is asymptomatic or with mild symptoms.
With gonarthrosis, there is a gradual destruction of the articular cartilage
Gonarthrosis is a lesion of the articular cartilage and surrounding tissues, leading to degenerative-dystrophic changes. It is accompanied by severe pain syndrome, limitation of motor activity, and bone deformities.
The knee joint, taking on and distributing the load, maintains balance during a standing position, when walking, and also provides movement of the limb in several planes.
Gonarthrosis can be primary or secondary, affecting the joint of the right or left leg, or both joints.
Epidemiology
According to epidemiological studies, deforming osteoarthritis (DOA) affects from 8 to 20% of the adult population, while the most frequent localization of the pathological process, which is accompanied by temporary disability, is the knee joint.
Most often, pathology occurs in the older age group.
In older people, the incidence of DOA increases. According to some data, symptomatic gonarthrosis is observed in 5% of people over 26 years old, in the age group over 70 years old - in 11%. Regardless of age, in women, pathology is diagnosed 1.2-1.4 times more often than in men.
The disease can progress over several years or decades and lead to disability - patients with osteoarthritis account for about one third of all persons with permanent disability due to joint diseases.
Pathological features
The knee joint is a complex anatomical structure that connects three bones: the distal femur, the proximal tibia, and the patella.
The knee joint has a complex anatomical structure
It is the largest joint in the human body, in which movements are carried out in three planes:
- sagittal: flexion and extension;
- frontal: abduction and adduction;
- horizontal: flexed joint.
The knee is one of the few joints that contains in its structure menisci - cartilaginous formations, which are soft pillows that limit the articular surfaces from each other. They prevent excessive friction of the articular surfaces against each other and their wear.
The joint is unique, as it is the only place where cruciate ligaments pass in the joint cavity, which hold it in a static position, preventing the displacement of structures during movement.
With gonarthrosis, there is a loss of elasticity, abrasion of cartilaginous structures, leading to a violation of the congruence of the knee joint, the appearance of cracks on the articular surfaces, and a violation of their trophism. As a result of this pathological process, the patient complains of pain, a characteristic crunch and clicks, then motor disturbances join.
The reasons
Gonarthrosis is considered a polyetiological disease, which is not characterized by a hereditary predisposition.
One of the possible causes of the development of the disease is a history of knee injuries
In the etiology of osteoarthritis of the knee joint, there are:
- history of joint injuries (dislocations, fractures in the knee, sports injuries);
- meniscus injury;
- autoimmune processes (systemic lupus erythematosus, rheumatoid arthritis, rheumatism, ankylosing spondylitis, etc.);
- congenital defects of the musculoskeletal system (knee hypermobility, dysplasia);
- chronic specific and non-specific inflammatory processes in the joint caused by pathogens (chlamydia, tuberculosis, syphilis, staphylococcal purulent arthritis, gonorrhea).
Along with the causes of the disease, there are factors that increase the risk of knee injury. Overweight is of the greatest importance, since this condition increases the load on the joint, inevitably leading to its damage.
Other risk factors are:
- dysmetabolic and dyshormonal states (diabetes mellitus, gout, menopause, postmenopause);
- gender, age;
- professional activities associated with prolonged walking or standing.
Symptoms
The disease begins to develop gradually. As arthrosis progresses, the number and severity of symptoms increases.
The most common symptom that signals the development of knee pathology is pain syndrome. At first, pain occurs during prolonged intense physical activity and disappears after it when the limb is at rest.
In parallel with this, movements in the affected joint are limited, morning stiffness is observed, an increase in the volume of the joint.
Diagnostics
Gonarthrosis is diagnosed after a thorough examination by a family doctor and / or orthopedic traumatologist on the basis of patient complaints, life history, disease, as well as the results of laboratory and instrumental studies.
If symptoms of pathology appear, you should consult your family doctor or orthopedic traumatologist
X-ray examination
The most accessible, informative and quickest method is an X-ray examination of the knee joint.
General radiological signs of DOA:
- subchondral sclerosis;
- narrowing of the joint space;
- osteophytes located at the edges of the articular surfaces and in the places of attachment of the ligaments;
- change in the shape of the pineal glands;
- cysts in the epiphyses.
X-rays are most often prescribed to confirm the diagnosis.
Each degree of osteoarthritis is characterized by its own radiological signs:
| Power | Characteristic X-ray signs |
| First degree | There is a slight narrowing of the joint space, single osteophytes |
| Second degree | Characterized by significant narrowing of the joint space, multiple osteophytes |
| Third degree | There is a critical narrowing of the joint space or its absence, numerous osteophytes, deformation of bone structures |
X-ray images may show areas of cartilage tissue in the articulation cavity (articular mouse).
Radiography is performed in frontal and lateral projections. If additional assessment of the femoral-patellar joint is required, an axial projection of the patella is used. With gonarthrosis of the 1st degree, when the pathological process is most often localized in one of the parts of the knee joint, X-ray in frontal projection with axial load may be required to detect narrowing of the joint space.
Additional diagnostic methods
Additional methods to help establish an accurate diagnosis include:
- ultrasound procedure;
- computed and magnetic resonance imaging.
Differential diagnosis
Differential diagnosis is often necessary at the initial stages of gonarthrosis, when its clinical and radiological manifestations are minimal.
It is performed with pathologies such as rheumatoid arthritis, spondyloarthropathies and crystalline arthritis.
Treatment
Therapy for the first two stages of gonarthrosis is usually conservative. The disease can be treated on an outpatient basis using medication and non-medication methods.
Non-drug therapy
Non-drug treatment includes a diet with excess body weight, normalization of physical activity and work regime with the elimination of excessive loads on the affected joint, physiotherapy exercises (exercise therapy) and gymnastics.
Physiotherapy
Physiotherapy methods are prescribed that improve blood supply, cartilage trophism, reduce inflammatory activity, have antiexudative, analgesic, regenerative effects.
Magnetic therapy is effective for gonarthrosis
Such methods include UHF, laser therapy, light therapy, electrophoresis, magnetotherapy, phonophoresis, electromyostimulation, ultrasound therapy, etc.
Weight loss
In isolation, weight loss has little effect on the progression of arthrosis. At the same time, there is information about improving the function of the affected joint and, in some cases, reducing the intensity of the pain syndrome.
Studies have shown that a combination of weight loss interventions and exercise therapy are the most beneficial.
Unloading the affected limb
Additional means of support - crutches, canes or orthopedic shoes - have a significant impact on the biomechanics of the joint. Their use helps reduce pain and probably slows the progression of the disease.
Drug therapy
Most often, in the treatment of grade 1 gonarthrosis, non-steroidal anti-inflammatory drugs (NSAIDs) are used: Paracetamol, Ibuprofen, Diclofenac, Meloxicam, etc. They are prescribed for the purpose of pain relief, reduce inflammation and swelling of the joint.
With a replacement purpose, intra-articular administration of hyaluronic acid is prescribed
Intra-articular injections of glucocorticoids are performed in extreme cases, when NSAIDs do not achieve the desired effect.
In the treatment of gonarthrosis, it is possible to use chondroprotectors (glucosamine, chondroitin), which have a regenerative effect on cartilage tissue. Intra-articular administration of hyaluronic acid with a replacement purpose is prescribed (hyaluronic acid temporarily replaces the lubricant - the missing synovial fluid).
Prevention
For preventive purposes, it is recommended:
- monitor body weight, preventing it from increasing above normal;
- choose comfortable shoes;
- normalize motor regime, go in for swimming;
- try to avoid injuries and hypothermia of the legs;
- to refuse from bad habits.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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