Knee osteoarthritis gonarthrosis symptoms causes therapy

Knee osteoarthritis is a chronic disease of the knee joint that damages the joint cartilage and the adjacent bone. There is pain in the knee joint.Further symptoms are movement restrictions or also a swelling in the joint. Since knee arthrosis is a progressive sign of wear and tear, older people (over 60 years of age) are particularly affected by this painful wear and tear; among people over 70 years of age, arthrosis in the knees is a problem for almost every second person. A cure is not possible; treatment is aimed at alleviating the discomfort through medication, physical therapy, exercise in the case of knee joint osteoarthritis, or surgical procedures (e.g.B. with a joint replacement) or to alleviate the pain. to stop.

Content

Summary

– Arthroses are inflammatory joint diseases. The most common form is that of the knee (gonarthrosis), which is said to affect up to 60% of people over 70 years of age. – Possible causes are accidents, overweight, malpositions and metabolic diseases. In old age, the risk of disease increases significantly. – Knee arthrosis cannot be cured, but the progression can be slowed down. Treatment is mainly with medicines and physiotherapy. In severe cases, surgical intervention is also possible. – Affected persons are given a fat-reduced diet or. a reduction of possible overweight as well as regular, knee-protecting sport (e.g., a reduction of the blood cholesterol level).B. Swimming) recommended. Arthroses are the most common joint diseases -. The most common form of osteoarthritis affects the knee joint. Although it is possible to suffer from gonarthrosis at a young age, the number of sufferers increases significantly with age. According to various estimates, the percentage of people affected by gonarthrosis is increasing from about 15% in the 50s to 50 to 60% in the 70s and older in the western world. Most patients under 45 years of age are men. Later, this ratio is reversed, so that overall more women suffer from gonarthrosis.

Causes of gonarthrosis

Although gonarthrosis mainly affects older people, it is wrong to speak of a mere symptom of old age that can be compensated for by "normal" joint diseases wear and tear occurs. Knee osteoarthritis can have many causes. If the cause is known, it is called secondary arthrosis; if the cause is unknown, it is called primary or idiopathic arthrosis.

Usually knee osteoarthritis develops over many years, several factors are involved in this process. Depending on the age of the patient, however, different causes are in the foreground:

– Accidents: Joint damage in younger patients is usually the result of accidents – often sports injuries such as meniscus and collateral ligament injuries or anterior and posterior cruciate ligament tears. Bruises can also cause immediate cartilage cracks or defects. – Leg deformities (X- or. bow legs) – One-sided stress (sports, work) – Genetic predisposition such as hemophilia and inflammatory processes – Arthritides (bacterial joint diseases) in the context of autoimmune diseases – Metabolic diseases such as diabetes – Deposition processes as in gout

Pathological changes in the knee joint

In a healthy knee joint, the contact surfaces of the bones are covered with a sliding layer of smooth cartilage about 3 to 4 mm thick, which reduces friction in the joint and acts as a shock absorber. Like a car tire, this cartilage layer is worn down over the years and loses its elasticity. As a result, cracks, meniscus damage and a change in the joint fluid occur, so that the joint can no longer be moved smoothly. In the course of time this causes an impairment of all components of the joint – the bones, joint capsule, synovial membrane as well as the tendons and ligaments. The cartilage abrasion itself does not cause pain – this is caused by the inflammation of the mucous membrane (synovitis) triggered by the cartilage particle and/or an accumulation of fluid in the bone (bone marrow edema). The inflammation is also responsible for the overheating of the joint. The joint effusion (accumulation of fluid in the joint) is responsible for this.

What symptoms can occur with gonarthrosis

The symptom of osteoarthritis is pain. However, since the joint changes slowly "creeping", the pain is – develops, it is initially asymptomatic. Only later does a "start-up pain" usually appear In the affected joint – in the morning after getting up or after sitting for a long time – and the knee feels stiff. In the further course of the disease, pain occurs after exertion; this usually occurs first when climbing stairs. As a result, inflammation of the joint mucosa occurs, which additionally causes overheating and swelling of the joint and a restriction of movement. Often noises like grinding also occur. cracking in the moving joint on. If the damage continues to progress, the pain also occurs at rest (often at night).

It is typical that the complaints usually occur in episodes. This means that pain, swelling, hyperthermia and restricted movement often occur without any apparent cause and remain for days to several weeks. As the arthrosis progresses, these episodes become more severe, occur more frequently and can last longer. In the final stage, these complaints are then permanent.

Diagnosis of gonarthrosis

At the general practitioner or. In the following visit to the orthopedist, a detailed examination of the knee joint is performed: The doctor palpates the joint to determine swelling or overheating, to localize the pain and to check the functionality (mobility) and ligament stability of the joint. The gait pattern (how does the patient behave when walking) is also important?) is examined.

On the basis of X-rays, the doctor can finally make the diagnosis or rule it out.

In addition, other procedures such as sonography (ultrasound), computed tomography or magnetic resonance imaging may also be necessary to rule out possible other joint diseases and to assess possible damage to the joint more precisely.

Therapy for gonarthrosis

The treatment of knee osteoarthritis depends on the stage of the disease. A cure is currently not possible, so therapy focuses on slowing the progression of gonarthrosis and alleviating the symptoms.

Primarily conservative measures are used. These include:

General measures: Recommendations of a low-fat diet (weight reduction), certain sports such as swimming, avoidance of activities that put stress on the knee joint (e.B. Playing tennis), possibly orthopedic aids (z.B. special shoes or insoles,) etc. Drug therapyVarious painkilling and anti-inflammatory substances are used here, e.g. cortisone.B. NSAIDs (non-steroidal anti-inflammatory drugs) or glucocorticoids (cortisone) Physical and physiotherapeutic therapy measuresFor example, exercise therapy to strengthen the muscles (stretching exercises, remedial gymnastics), or ultrasound treatment

Surgical measures are only indicated when the possibilities of conservative therapy have been fully exhausted and there is no longer any apparent success in treatment. It depends on the stage of the joint destruction and the patient's suffering, which surgical intervention is indicated.

There are basically 2 possibilities here:

Arthroscopy: Depending on the damage, the knee joint is flushed during arthroscopy, mechanical impairments or. the synovial membrane is removed or a soft tie operation is performed to improve the patellar alignment. This is the latest. Most severe measure. It is not always necessary to replace the entire knee joint with a metal knee prosthesis, in some cases only parts of the joint (the damaged layers) are replaced. The decision as to how extensive the intervention will be lies with the attending physician.

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