Our joints are very strong. The ends of the bones fit exactly together and are covered with cartilage on top for better gliding. The joint itself is protected by the joint capsule, and ligaments and muscles strengthen it in front, back and sides. Inside the joint capsule there is a special fluid that provides smooth movement without twitching, creaking and crunching. Here's how healthy joints work. And what happens to them with osteoarthritis?
How and why osteoarthritis occurs: obesity, trauma, arthritis
For starters, how is osteoarthritis different from arthritis? Arthritis is an inflammation of the joints and can be treated and cured until complete recovery. In osteoarthritis, the cartilage of the articular surfaces of the bones is deformed, thinned, loses elasticity, covered with cracks and layered, the amount of synovial fluid decreases. And these changes are now, unfortunately, irreversible. Therefore, this disease is called degenerative, ie destructive. The destruction of the joint is influenced by age - over time, the cartilage wears out, but at the heart of everything is our upright posture, due to which a large load is placed on the knee joints.
Gonarthrosis is osteoarthritis of the knee joint. This type of osteoarthritis is more common in women and is exacerbated by obesity and venous disease. Many older people suffer from osteoarthritis, which is explained by age-related changes in the joint. At a young age, osteoarthritis can occur with joint injuries during sports or during strenuous exercise. In addition, the development of osteoarthritis is influenced by weakness of ligaments and muscles in the knee, sedentary lifestyle, arthritis, stress and metabolic disorders, and in everyday life - high-heeled shoes and carrying weights (eg shopping bags). Joint damage is bilateral, but can develop on one leg.
Manifestations of osteoarthritis: pain, crunch, stiffness
Knee pain, crunch, stiffness during bending and stretching of the joint, especially when a person gets up and sits down - all these are signs of osteoarthritis of the knee joint. However, the pain does not come suddenly. At the beginning of the disease, it is rather a discomfort in the knee, which turns into pain during heavy loads, running and exercise. If the pain is acute, it may be associated with sprains, sprains, damage to the menisci (elastic cartilaginous pads in the joint).
In osteoarthritis of the 2nd degree, knee pain becomes a common companion, especially noticeable after long walks, lifting weights. If you rest the joint, the pain disappears, but returns again when the load resumes. An additional symptom of osteoarthritis is swelling of the knee joint. In addition, there is an excessive accumulation of joint fluid (synovitis), a characteristic crunch during movement, which causes pain and then limited mobility in the knee. The patient cannot easily bend and unfold the legs. Trying to straighten it completely causes severe pain.
When osteoarthritis reaches the third degree, the knee joint sometimes completely loses its mobility. People walk on slightly bent legs at the knees, suffer from excruciating pain, which often occurs with the change of weather and can torment at rest, including at night. Patients should resort to painkillers. At this stage it is possible to change the shape of the legs - they bend either outwards (legs with a wheel) or inwards. It is not uncommon for people to rub their sore knees, intuitively trying to improve blood flow to them.
Treatment of osteoarthritis: weight loss, movement is life
The diagnosis of osteoarthritis is made by X-ray examination. Typical changes are narrowing of the joint space, the appearance of osteophytes (salt deposits), bone destruction. Many patients come to the doctor at the stage when it becomes problematic to sleep at night without anesthesia. Despite the fact that the changes in the joints are irreversible, there are some things you can do to improve the patient's life. Osteoarthritis treatment begins with weight loss. In addition, it will be necessary to rely on a rational and not too high-calorie diet, as the possibility of physical activity is limited. This is the first thing any doctor will tell a patient with osteoarthritis of the knee.
The second aspect of osteoarthritis treatment is, oddly enough, movement. When the changes in the joints are not yet fatal, not in the last stage, only the movements - but the movements are correct! - can prolong their life. There are no blood vessels in the cartilage, nutrition is by diffusion, and movement is needed for metabolism to take place, for cells to regenerate and for cartilage to live.
But which movements should be considered correct? Of course, those that do not strain the knee joint. Let's not torment the reader - the best sport for osteoarthritis is swimming. This is an excellent workout for ligaments, cartilage, muscles without vertical load, which is given when walking and standing. It is necessary to avoid running, sports games, jumping. Yes, joint pain and will not allow you to accelerate much.
The second method of movement is suitable for those who visit the gym or have purchased a simulator at home called an ellipsoid. It looks like a bicycle in an upright position and at the same time like cross-country skiing. When working on this simulator, we avoid shock loads on the knee joints and at the same time train muscles and ligaments. The ellipsoid moves smoothly, but gives a good aerobic load, therefore, training on it, we also solve the problem of overweight.
Medical and surgical treatment of the knee joint
As for the medical part of the treatment of osteoarthritis, it is the use of nonsteroidal anti-inflammatory drugs for pain. Your doctor will help you choose a dose that will eliminate both the pain and the inflammation (and it will still be present) and the swelling. Analgesics are sometimes added because the pain can be very severe - they interfere with sleep, interfere with eating and generally interfere with life. In some cases, it comes down to prescribing antidepressants.
If, despite all efforts, the described treatment of osteoarthritis does not help and the destruction of the joint continues, which leads to complete immobility (and, as you know, the less I move, the faster the fat layer grows), there is a radical remedy - surgeryreplacement of the diseased joint on the prosthesis. It consists of an imitation of the end of the femur (upper part) and the menisci, which fit on the surface of the tibia (lower). The operation is not simple, but well-established and, one might say, routine. There are many of them in the world. After the operation, a rehabilitation program was developed, which allows a person not only to start moving, but also to return to a full, active lifestyle.