Arthritis of the knee joint - symptoms and treatment

The knee joints are distinguished by a particularly thick and dense cartilage lining - after all, nature intended them to withstand the weight of our body and absorb shocks when walking, running and jumping. And although the average person runs much less than his wild ancestors, this does not make it easier for the joints: they suffer from excess body weight, monotonous loads and even the wrong selection of furniture, due to which the legs do not rest, even if we are sitting. Most sports injuries occur in the knee area.

Doctors warn: gonarthritis (or arthritis of the knee joint) increasingly begins at a young age - starting at 30 years old. What are the symptoms and treatment of knee arthritis? How to treat knee arthritis?

Causes of knee arthritis

The following factors can cause arthritis of the knee joint and trigger the degenerative-inflammatory process:

hormonal changes associated with age (especially in women);
congenital abnormalities of posture, foot, hip joints, as well as acquired disorders of the musculoskeletal system;
excess body weight;
the presence of autoimmune, metabolic diseases, severe allergies;
intoxication (for example, from snake bites, insect bites);
hypothermia, dehydration or other severe stress;
endocrine disorders;
surgical interventions (any operations on the legs);
infectious diseases (in particular, urogenital and intestinal infections);
age-related changes in bone, muscle and cartilage tissue;
active sports (running, gym, strength training), especially a sports career;
injuries (both single serious injuries and a series of repeated minor injuries);
professional and everyday stress on the joint (carrying heavy objects, monotonous work in an uncomfortable position).

Depending on the causes of arthritis of the knee joint, the following types of disease are distinguished:

reactive (occurs in response to an infectious pathogen that enters the body from the outside or from an internal source of chronic infection);
rheumatoid (the joint is destroyed due to a congenital or acquired autoimmune disease);
gouty (associated with impaired metabolism of uric acid due to poor lifestyle or kidney disease);
post-traumatic (consequence of injury to the joint or periarticular tissues);
arthrosis complicated by arthritis (the inflammatory process is associated with joint wear, injury to ligaments and muscles, and impaired tissue trophism).

How to treat stage 3?

At the very beginning of this section, we have already given important information on how to treat severe pathology in the late course. Lost mobility and normal anatomical proportions will have to be restored to the knees through endoprosthetic surgery. This is the only medical and orthopedic technology that is capable of maximally or completely returning to a person the quality of life that was before he fell ill with insidious gonarthrosis.

The essence of endoprosthetics is to remove a joint distorted by the disease and install an endoprosthesis in its place - an artificial joint structure that replicates the functions and structure of a healthy knee joint. The unnatural organ takes root well because its structural parts are made from high-tech nanomaterials with a high degree of biocompatibility with the human body. Modern endoprostheses, subject to high-quality implantation and ideal step-by-step postoperative care, last for an average of 20-25 years.

What the surgeon sees during joint surgery.

Prosthetics are performed in a specialized clinic that practices this type of surgery. It is better to undergo it abroad, where the complex surgical process is carried out by highly qualified specialists who brilliantly master all the intricacies of knee implantation. Today, as reviews from world experts and patients show, medical centers in the Czech Republic have great opportunities.

If for some reason the patient cannot undergo high-quality surgical treatment, he will be recommended classical conservative therapy. It is aimed primarily at relieving pain and swelling, which are persistent and pronounced at this phase. Conventional anti-inflammatory compounds from the NSAID class have little or no effect, so often, to help feel relief, the question arises of the need for intra-articular injections based on corticosteroids. However, steroid therapy cannot be used for a long time, since the hormonal substances included in such medications are dangerous due to severe side effects.

It is too late to slow down the degenerative process with chondroprotectors, hyaluronic acid and any other stimulators of metabolism in joint tissues. There is no need for them at all now. It is recommended to wear special orthopedic devices (knee pads, insoles, orthoses, etc.), a kind of exercise therapy without stress on the joint, movement is allowed only with a cane or crutches. Sometimes limb traction is prescribed in combination with physiotherapy procedures.

If there is pathological fluid inside the knee, the patient is periodically sent for puncture (removal of its excess). If prosthetics are contraindicated or impossible due to certain circumstances, the surgeon advises to undergo arthrodesis (complete closure of the knee) or tibial osteotomy (axis correction), but these methods, despite their aggressiveness, have a short-term effect and do not restore full range of motion.

Symptoms and signs of knee arthritis

Arthritis of one or both knee joints affects the functioning of the entire body, and therefore the manifestations of the disease are complex. The first and most noticeable symptom of knee arthritis is pain. As a rule, it is unexpected, shooting when the joint is flexed or extended (especially sharply). But it can also be aching, bursting (“legs twist”) after a long rest or overwork of the legs. Pain may occur when pressing or walking.

In addition to pain, joint symptoms of knee arthritis include:

swelling - the knees become noticeably swollen, and the leg is shaped like a spindle;
redness and increased temperature of the skin over the kneecap;
feeling of heaviness in the legs;
growths, nodes, palpable or noticeable to the naked eye, joint deformities;
changes in gait (caused by joint deformation or an attempt to compensate for the load, a “gentle” attitude towards the joint);
joint stiffness.

Extra-articular signs of knee arthritis include:

an increase in temperature that is accompanied by fever or chills or persists for a long time;
sweating;
swelling of the lymph nodes;
lack of energy, muscle weakness, drowsiness;
poor appetite and weight loss.

In addition to the inflammatory process, a common symptom of arthritis of the knee joint is a feeling of numbness, stiffness, deterioration of flexibility and mobility. You can recognize the disease in the earliest stages by the characteristic tension of the muscles, which cannot be relaxed by force of will - only “stretched” manually. In the morning, it becomes increasingly difficult for the patient to begin daily activities without some kind of warm-up in the form of rubbing, stretching, and medications for knee arthritis. After a long rest (usually overnight), the condition of the limb noticeably worsens, but after an hour of activity, pain and stiffness recede or even go away altogether.

Not all of the listed symptoms of arthritis of the knee joint are observed at the same time and greatly disturb the patient - the patient may occasionally notice only 2-3 signs until the disease progresses to later stages.

The intensity of symptoms may subside in a state of remission - sometimes it occurs even without taking medications, however, degenerative processes in the joint and its deformation in this case continue, proceeding covertly. A sharp increase in symptoms indicates that the erosion of the articular surfaces is worsening and the affected area is increasing. Treatment of knee arthritis in this case is required immediately, since the disease is aggressive.

What are the types of NSAIDs?

Non-steroidal anti-inflammatory drugs are not only the well-known ibuprofen. This group includes many drugs that differ in chemical composition, severity of analgesic and anti-inflammatory effects, and also produce side effects of varying intensity.

NSAIDs are divided into two groups based on the degree of anti-inflammatory activity:

1. Drugs that relieve inflammation well.

These include acids (salicylates, pyrazolidines, oxicams, derivatives of indoleacetic, phenylacetic and propionic acid, including ibuprofen and ketoprofen). As well as medications of non-acidic origin - alkanones and sulfonamide derivatives, for example nimesulide.

2. Analgesics – drugs with a weak anti-inflammatory effect.

Piazolones, derivatives of anthranilic acid, paraaminophenol (including paracetamol) and heteroarylacetic acid.

Absolutely all NSAID drugs inhibit the development of the inflammatory process, no matter what its origin. In addition, they have an analgesic and antipyretic effect.

Degrees and stages of knee arthritis

There are 4 stages of the pathological process:

Arthritis of the knee joint 1st degree. There are usually no obvious symptoms. There may be slight morning stiffness of the joint, slight swelling, and increased fatigue. With grade 1 arthritis of the knee joint, the pain is not severe and is periodic and irregular (“pinched”). At this stage, doctors usually give a positive answer to patients' questions about whether knee arthritis can be cured. A complete cure is possible.
Arthritis of the knee joint 2 degrees. The pain syndrome is noticeably expressed, swelling of the joint is clearly visible. An unpleasant crunching sound may occur when bending your legs. With grade 2 arthritis of the knee joint, redness of the skin and a local increase in temperature begin.
Arthritis of the knee joint grade 3. From the side, the deformation of the joint is noticeable, the patient’s gait changes. The pain is felt constantly, interfering with normal daily activities and significantly limiting the patient even when taking medications for knee arthritis.
Arthritis of the knee joint 4 degrees. The joints become ankylosed (fused) and almost completely lose mobility. Irreversible changes affect the bones. The leg muscles suffer from contractures, and the ligaments shorten. At this stage, surgery is required.

What they say about paracetamol

When treating gonarthrosis, EULAR recommends using paracetamol as the first choice drug. If this oral non-narcotic analgesic of central action gives the desired effect, it is used for long-term therapy. However, it is only suitable for treating mild to moderate pain. The recommended maximum dosage for an adult is 4 g/day. Research results have confirmed that this dose is no less effective for moderate pain than 2.6 g/day of ibuprofen for severe knee pain.

The above dosage of paracetamol does not pose a danger when taken for a long time - up to two years. Therefore, it is often prescribed in combination therapy for knee arthrosis. If the dosage exceeds 4 g/day, negative effects on the liver are possible. 2 g/day is safe, but not always effective for moderate pain.

Paracetamol – pain reliever for mild to moderate pain

Diagnosis of knee arthritis

Diagnosis of knee arthritis is possible at the earliest stages of the disease, when cartilage erosion is completely reversible with the help of drugs for the treatment of knee arthritis. Therefore, if you experience the slightest discomfort in your knees, it is better to consult a doctor. Late diagnosis is the main reason why the disease enters the chronic stage.

To evaluate symptoms and treat knee arthritis:

initial examination of the patient (visual assessment, joint palpation, mobility testing, gait observation);
radiography (detects the presence of osteoporosis, microcracks, osteophytes and neoplasms, narrowing of the joint space, disruption of the natural position of bones in the joint and other characteristic signs);
Ultrasound of the knees (determines changes in cartilage tissue, fluid accumulation in the joint);
general and biochemical blood test (to assess the inflammatory process);
blood test for rheumatoid factor (to diagnose or exclude rheumatoid arthritis);
arthroscopy (a minimally invasive technique for examining a joint from the inside through a microscopic incision);
joint fluid sample (to identify pathogenic microorganisms, reduce viscosity, assess specific cellular and protein composition);
computed tomography and magnetic resonance imaging (to collect information about the condition of soft tissues);
scintigraphy (demonstrates disease activity and bone tissue condition).

Using these methods, a doctor (rheumatologist, traumatologist or orthopedist) excludes bursitis, arthrosis, muscle pain, cysts and other symptomatically similar diseases, and prescribes highly specialized medications for the treatment of arthritis of the knee joint.

Since various factors can provoke the inflammatory process, differential diagnosis is important, with the help of which the type of arthritis is determined.

How is rheumatoid arthritis treated?

At the initial consultation, the rheumatologist will prescribe additional examinations - a blood test, x-ray of the joint, ultrasound or MRI. It is impossible to completely cure the disease, so therapy is aimed at relieving unpleasant symptoms and preventing complications.

Anti-inflammatory drugs relieve inflammation and pain.
Immunomodulatory - inhibit immune reactions.

With proper treatment, remission lasts a very long time, and sometimes the disease disappears completely, but treatment will take many years. But it is strictly forbidden to massage or warm up joints affected by rheumatoid arthritis. Such manipulations lead to exacerbations.

For rheumatoid arthritis, massage and warming are contraindicated

Treatment of knee arthritis

Treatment for knee arthritis is specific to each type of disease. For example, with rheumatoid arthritis, patients require immunosuppressive therapy, with infectious arthritis - taking antibiotic drugs to treat arthritis of the knee joint, with gout and the like - treatment of the underlying disease.

Below we will look at drugs common to all types of arthritis for the treatment of arthritis of the knee joint and techniques that help stop the inflammatory process, maintain joint mobility and relieve pain.

How to treat knee arthritis with medication?

For the drug treatment of knee arthritis, the following pharmacological groups of drugs are used:

Nonsteroidal anti-inflammatory drugs for the treatment of knee arthritis (NSAIDs or NSAIDs) in the form of tablets, ointments, gels and creams. Tablets are prescribed in courses in the acute phase of the disease, while external agents can be used continuously.
Glucocorticoids (GC). These hormonal drugs are used in short courses, no more than several times a year, strictly according to doctor’s indications. Drug treatment of knee arthritis with GCs is prescribed for severe pain and ineffectiveness of NSAIDs - often in the form of intra-articular injections. The effect after administration is achieved within the first seconds.
Antispasmodics and muscle relaxants. They help relax muscles, improve joint nutrition and alleviate pain. Most often used for post-traumatic arthritis.
Angioprotectors and warming agents. Strengthen the walls of blood vessels and improve blood circulation - and therefore nutrition of the knee joint. Also recommended for post-traumatic and other types of arthritis.
Antienzyme and anabolic agents. The first tablets for arthritis of the knee joint restrain degenerative processes in the tissues of the joint, and the second accelerate their regeneration.
Chondroprotectors, vitamin-mineral and restorative complexes. In the drug treatment of knee arthritis, drugs from these groups are used for healthy synthesis of cartilage tissue and prolongation of remission.

Basic drugs - tablets for knee arthritis - are used only for rheumatoid gonarthritis. Such drugs for the treatment of arthritis of the knees help preserve the volume of red bone marrow and reduce the activity of the autoimmune disease.

Treatment of knee arthritis with tablets

Treatment of knee arthritis with tablets usually involves the use of drugs such as:

NSAIDs: ibuprofen, nimesulide, meloxicam, diclofenac, ketoprofen, piroxicam, napraxen, indomethacin, butadione and others;
glucocorticosteroids: hydrocortisone, diprospan;
vasodilators: pentoxifylline (trental), aminophylline, theonicol;
muscle relaxants: tolperisone, tizanidine;
chondroprotectors: artracam, artradol.

Tablets for knee arthritis should be prescribed by a doctor.

Ointments in the treatment of knee arthritis

Ointments for arthritis of the knee joint have an analgesic, anti-inflammatory, warming effect, improve blood circulation, elasticity of ligaments and muscles, and also distract from pain and discomfort.

The most popular drugs are voltaren-gel, menovazin, finalgon, nicoflex, fastum-gel, dolobene, diclofenac-gel, dollit-cream, ketonal-gel, indometacionic, butadionic ointment and others.

Ointments for arthritis of the knee joint can be used constantly, but there are restrictions for preparations based on bee and snake venom: they can provoke allergies and inflammation of the skin, they cannot be used by women during menstruation and children.

Treatment of knee arthritis with injections

Treatment of knee arthritis with injections (intra-articular injections) is indicated in cases where the active substance must be quickly delivered to the joint. Sometimes antibiotics are administered in this way for infectious arthritis. But most often, injections for knee arthritis include glucocorticoids. For rapid pain relief and inflammation relief, prednisolone and methylprednisolone, hydrocortisone, triamcinolone and others are used.

Surgical treatment of arthritis in the knee joint

Surgical intervention is recommended for chronic arthritis in the later stages, as well as to remove effusion or pus from the joint capsule. Depending on the symptoms and treatment of knee arthritis, your doctor may prescribe the following surgeries:

Puncture. A minimally invasive technique in which a special needle is inserted into the joint to pump out fluid and, if necessary, administer a drug.
Synovectomy. Excision of the synovial membrane is carried out to reduce pain, eliminate inflammatory foci and contain destructive processes in the joint.
Arthroplasty and endoprosthetics. Replacing a diseased joint with a prosthesis, partially or completely, is recommended when the joint is almost completely immobile, when surgery is more effective than treating arthritis of the knee joint. This complex operation helps restore knee function for up to 20 years.

Physiotherapy for knee arthritis

Physiotherapy is used to treat chronic arthritis and is prohibited in the acute stage of the disease (except for certain types of magnetic pulse therapy). Physiotherapeutic techniques enhance the effect of medications, improve joint mobility and nutrition, and have a strengthening effect on muscles. They also stimulate tissue regeneration in the joint and immunity, effectively combat contractures, swelling, inflammation and pain. The most common physiotherapeutic procedures for gonarthritis include:

laser therapy;
magnetic therapy;
ultrasound therapy;
UHF therapy;
acupuncture (acupuncture);
diadynamophoresis;
amplipulse;
exercise therapy complex for knee arthritis;
mud therapy and paraffin therapy;
massotherapy.

Rheumatoid arthritis: what is it and how is it treated?

Rheumatoid arthritis is an autoimmune-inflammatory disease. It affects more often women of different ages, and the joints of the ankles, knees, hands and ankles are affected.

It is believed that the cause of rheumatoid arthritis is a malfunction of the immune system, and provoking factors are hypothermia, stress, infection or injury. The mechanism of joint destruction can be triggered by influenza, tonsillitis or a common ARVI. Recognizing the disease is quite simple:

the joint swells and hurts (swelling can last from several months to several years);
joints are affected symmetrically - on both arms or legs;
the pain intensifies at night or in the morning, subsides or goes away in the evening;
rheumatoid nodules the size of a pea form in the joint; they are dense to the touch;
weakness, loss of appetite, chills and a slight increase in temperature are present.

Unlike arthrosis, in which pain, on the contrary, intensifies after physical activity, with rheumatoid arthritis, warming up the joint helps get rid of discomfort.

Over time, the joints become deformed and limited in mobility. The disease affects all new joints. Pathological fluid accumulates in the knee - a Baker's cyst is formed with the risk of rupture. The cervical spine often becomes inflamed - pain appears in the neck and under the back of the head.

Sometimes people with rheumatoid arthritis lose significant weight

Physical therapy for knee arthritis

Daily therapeutic exercises for knee arthritis help slow the progression of the disease and reduce the load on the joint by strengthening the muscles and connective tissue. It also reduces pain and discomfort, helps maintain and even restore mobility in the joint.

Examples of exercises for knee arthritis:

Stand straight, with your back to the wall. Raise your leg to the side so that your shin is touching the wall and your big toe is facing forward, then lower it.
With your arms folded across your chest, sit on a chair, keeping your back straight. Slowly rise from the chair, and then slowly lower yourself down.
Standing straight, lift your ankle behind your back so that your heel touches your buttocks. Do not help yourself with your hands unless this is indicated in the exercise for knee arthritis! After 3 seconds, lower your leg.
Lie on your side on the floor and place your bent arm under your head. Bend your knee and hip joint approximately 90° and lift your knee as high as possible.
Lying on your stomach, rest your forearm on the floor in front of you. Bend the knee opposite your forearm and, grabbing your ankle with your hand, slowly pull your leg up. During exercises for knee arthritis, the muscles on the front of the thigh should stretch. Then roll over onto your back and, holding your leg under your knee, pull it towards your chest, feeling the stretch in your back muscles.
Perform the “lying bicycle” exercise until noticeable signs of fatigue appear. Avoid suddenly throwing your leg forward - if the leg muscles are not strong enough for prolonged work, it is better to return to the exercise later.

All exercises for arthritis of the knee joint should be performed 15 times on each leg or (for example, “bicycle”) for at least 1 minute.

Creating an individual set of exercises for knee arthritis and teaching the correct technique should be carried out by a qualified instructor.

Please note that exercise therapy for knee arthritis is only allowed in a state of remission. When arthritis worsens, rest is advisable.

Specificity 3rd degree

This pathology is one of the most common among all joint diseases. It tends to progress, thereby significantly inhibiting the motor functions of the knee joint. But it is precisely this section of the leg that is responsible for maintaining weight and allowing a person to perform tasks of the most varied complexity, namely walking, jumping, squatting, running, etc. By letting a joint slip, a person, roughly speaking, dooms himself to disability. Late diagnosis and lack of necessary treatment in the early stages do not lead to anything good. The more advanced the clinical picture, the less and less chance there is of avoiding surgery.

If we consider the disease according to the generally accepted European classification of the development of degenerative-dystrophic changes, then stage 3 is the penultimate degree of a moderate illness. In a large number of cases, conservative treatment turns out to be ineffective or ineffective at all, and these are good reasons for undergoing surgery to replace the knee joint with an artificial implant.

This is what the diagnosis looks like on an x-ray.

As for all kinds of non-surgical and minimally invasive tactics, know that even if they produce an effect at a very difficult stage, it will be no more than temporary symptomatic. It is possible to stop the development of gonarthrosis, please note that it is not even possible to cure it entirely, using non-traumatic methods, but only in the first two stages. Therefore, if you give preference to conservative treatment, do not count on a miracle healing: the knee will not straighten out, the cartilage will not be reborn, and, consequently, all motor problems will be with you.

We say all this so that naive people, far from the intricacies of orthopedics and traumatology, do not have illusions regarding the healing capabilities of widely advertised drugs and physical techniques. At this stage of knee arthrosis, they are unproductive.

Stages of gonarthrosis, from absence to the last degree.

Attention! At stage 3 of gonarthrosis, there are no longer living areas of functional importance left for prevention. The maximum benefit you can find for yourself in non-surgical tactics is to slightly reduce the pain syndrome and to some extent prepare the muscles for the upcoming surgery.

Nutrition for knee arthritis

A diet for knee arthritis includes low-calorie and low-carbohydrate foods, excluding foods that can cause allergies. It is advisable to eat food with a minimum amount of salty and smoked foods, but with an increased amount of calcium and vitamin D3.

For knee arthritis, nutrition should include fatty fish, animal cartilage, jellied meat, jelly and other sources of collagen, antioxidants and fatty acids.

We hope this material helped you understand how to cure knee arthritis! Be healthy!

Types of pain therapy for arthrosis

In the second and third stages of osteoarthritis, the following options are possible:

symptomatic fast-acting drugs, such as non-steroidal anti-inflammatory drugs or paracetamol;
slow-acting drugs that gradually eliminate the signs of the disease - chondroprotectors;
local remedies - ointments and gels with NSAID effect;
physiotherapeutic procedures;
antioxidant therapy;
muscle relaxants;
physiotherapy;
orthopedic treatment – orthoses, knee pads;
Spa treatment.

Orthopedics can combat pain due to arthrosis

Arthrosis

Compared to arthritis, this disease is not an inflammatory joint disease. However, damage to the articular cartilage occurs. The cause may be both involutional changes and injuries or wear of cartilage tissue due to excessive loads. Osteoarthritis can manifest as swelling and pain. Also, in some cases, the disease can lead to changes in other organs and systems. It can lead to both a decrease in range of motion and range of motion. Most often, arthrosis affects the hip joints, knee joints, and spinal joints. Osteoarthritis, an infrequently used term to describe degenerative joint diseases. To understand, it is important to first understand the anatomy of the joint. The ends of the bones that form the joint have a smooth surface called the subchondral bone. Behind this is articular cartilage, which is a strong but elastic connective tissue that protects bones, facilitates movement between surfaces, and also acts as a shock absorber. It is this cartilage that forms the articular surface, and not the bones themselves. The joint has synovial membranes that secrete synovial fluid into the joint space, which lubricates the joint surfaces and acts as a shock absorber. The outer joint capsule provides strength to the joint.

Cartilage is elastic connective tissue. Cartilage cells (chondroblasts) produce and secrete a large number of different substances, such as collagen, into the extracellular matrix. It is this matrix that is responsible for the properties of cartilage, namely its strength and flexibility. Sometimes chondroblasts remain inside the matrix and are called chondrocytes. Cartilage is constantly subject to wear and damage. Cartilage cells constantly replenish the cartilage matrix and thus maintain the integrity of the cartilage.

With age, the ability to regenerate any tissue decreases, but does not stop completely. Even in young people, the body's ability to repair tissue is limited by time. If there is constant and excessive wear and tear on the articular cartilage beyond the time required for repair, then the cartilage will weaken. This is the reason why the disease is more common in older people and more often in those who lead an active lifestyle. There are other factors that complicate regenerative processes, such as inflammatory mediators, which affect normal cartilage regeneration when there is even slight inflammation. Likewise, if there are some medical diseases (such as diabetes) that slow down or stop the activity of cartilage cells, the cartilage gradually wears out. When the cartilage weakens, cartilage ruptures occur, and fragments can float in the joint cavity. Bone tissue is also affected by arthrosis and a condition called osteoarthritis occurs.

Symptoms

Symptoms develop very slowly. In the early stages of cartilage erosion, there may be no symptoms. In addition, arthrosis is a degenerative disease, not an inflammatory condition, and therefore may not manifest itself for a long time. Once symptoms begin, the condition gradually worsens, also over a long period of time. The leading symptom of arthrosis is pain.

The pain is usually isolated to the affected joint. The pain usually worsens during and after movement in the affected joint. In milder cases, pain does not appear during movement, but only some time after exercise. There may also be pain on palpation in the joint area. But pain with arthrosis is usually not accompanied by swelling, as is the case with inflammatory phenomena in the joint (for example, with rheumatoid arthritis).

Joint stiffness is another common symptom. This is most noticeable when waking up in the morning and after a long period of rest. Movement can reduce stiffness, but excessive movement will eventually lead to pain. Joint stiffness tends to get worse over time as the disease progresses. Even when joint stiffness decreases, normal range of motion is not restored. Over time, this leads to a significant decrease in motor activity. The joint may also experience a crunching sound when moving, especially as the disease progresses. Normally, the articular cartilage at the ends of bones rubs against each other, but due to the smooth surface and good lubrication by synovial fluid, this friction does not lead to the appearance of sounds. With arthrosis, the cartilage surface is not so smooth and this leads to the appearance of sounds when moving in the joint (crunching, grinding). Firming – large joints, such as the knees, become firmer to the touch. Bone growths that occur with arthrosis (osteophytes) form over time and can be felt under the skin in the form

Diagnostics

As a rule, diagnosis does not present any particular difficulties and is based on a combination of examination data and instrumental data (radiography, CT, MRI, ultrasound of joints). But given that arthritis also causes changes in cartilage tissue, a careful differential diagnosis of degenerative changes in joints with the consequences of a long-term inflammatory process is necessary. Therefore, laboratory diagnostics are also necessary when diagnosing arthrosis.

Treatment

The disease is more often observed in older people and therefore treatment is most often symptomatic. The key to conservative treatment is to reduce symptoms of pain and improve joint functionality. Drug treatment (for example, NSAIDs) should be prescribed taking into account the concomitant somatic pathology present in older people. A good effect is achieved by intra-articular injection of synovial fluid endoprostheses (Fermatron, Ostenil, etc.), which reduces friction in the joint, improves joint function and reduces pain. Intra-articular administration of long-acting steroids (for example, diprospan) is also possible. Recently, prolotherapy has begun to be used, which consists of introducing substances into tissues that improve the regeneration of connective tissue.

Physiotherapy can quite effectively reduce pain and reduce inflammation.

Exercise therapy. Dosed physical activity allows you to maintain the functionality of the joints, but the loads must be selected carefully, since excess loads lead to increased pain.

Surgery. In case of severe arthrosis of large joints (for example, coxarthrosis or gonarthrosis) and significant dysfunction of the joint and persistent pain, endoprosthetics is recommended.