Deforming osteoarthritis of the knee joint is a poleetiological disease. This means that there are many reasons for its development. In some cases, when the most dominant cause can be assigned, gonarrosis is called secondary. In the case in which a clear cause is not determined, the diagnosis of primary or idiopathic osteoarthritis of the knee joint is established.
- deforming the osteoarthrosis of the medial part of the femoral joint;
- deforming the osteoarthrosis of the lateral part of the femoral joint;
- Deforming arthrosis of the femoral-de-elative joint.
Normally, the destruction of the articular cartilage occurs in the physiological welting process of the entire body, that is, during aging. The pathological destruction of the cartilage is considered when it occurs in advance or a more intense rhythm. The average age, which, on a completely legitimate basis, the first signs of cartilage can manifest are a period of 40 to 50 years. With deforming osteoarthritis, the disease opens in childhood with the first manifestations from 16 to 18 years, and in some cases even before. However, this is not a reason to despair.
The mechanism of the development of the disease is a vicious circle in which the final links are launched the initial and thus to infinity. However, each round of this circle exacerbates the condition of the cartilage and leads to the progression of the disease, etc. In the case of primary gonarrosis, the reason why it launches a vicious circle is unknown. However, their subsequent links are carefully studied with the aim of influencing them and slowing down the progression of the disease.
Deforming osteoarthritis develops approximately as follows. The cartilage of the daily joint of the knee joint experiences thousands of shocks that are forced to deprecate so as not to damage the most tender structures of the human body, such as internal organs and brain. Over time, due to cerebral shock data, microscopic cracks are formed in the murky layer, which also after a certain period of time are filled with synovial fluid and becomes microdists. Neighboring microdists tend to join and the formation of larger cysts.
The increase in the size of the corneal space cysts gradually begins to squeeze the blood capillaries that feed the tissue of the cartilage from the side of the bone. The supply of IT with oxygen and substances necessary to maintain vital activity, worsens, which leads to a slower synthesis of type 2 collagen.
Cartilage transport leads to two negative consequences. First, it leads to a deterioration in depreciation properties and a more intensive formation of new micriects in the subsidiary layer. Secondly, due to the compression of the cartilage, its density increases, which negatively affects the second mechanism of its nutrition through the dissemination of synovial fluid in the thickness of the cartilage tissue.
However, on the scale of the entire organism, the destruction of the joint cartilage does not go unnoticed. As a compensatory reaction in the washing cartilage approach, the activity of the condroblasts - young cells that synthesize increases in new cartilage tissue. However, this compensatory mechanism is imperfect, and its imperfection lies in the fact that most of the cartilage tissue is not formed in the place of the greatest destruction of the cartilage, but where the cartilage does not experience loads.
As a result, cone -shaped cartilage growths are formed along the edges of the joint: condropot. These condrophytes do not manifest clinically until the ossification processes begin in them. Okreteen, the condrophytes harden and become, which are called peaks in common people. As a general rule, the appearance of peaks is always accompanied by the appearance of pain and the development of inflammation in the articulation. This is due to the fact that osteophytes during the articulation movement touch the cartilage tissue and synovial cover, mechanically damaging it.
As a result, each complication of deforming osteoarthritis leads to the acceleration of the progression of pathological changes in cartilage. However, knowing the mechanism of development of gonarrosis, one can successfully affect some of its links to slow down its current and improve a long -term forecast.
Secondary gonarrosis differs from the principal in which the main reason is known, which launched a vicious circle of destruction of the joint cartilage. The additional course of the disease occurs in the same way as with primary gonarrosis, with the peculiarity that the disease is constantly aggravated by the effect of the negative factors associated with the underlying disease. For this reason, the course of secondary osteoarthritis of the knee joint, as a rule, is more aggressive.
- injuries (acute and chronic);
- Congenital Varus or Valgo deformation of the lower extremities;
- Congenital shortening of one of the lower extremities;
- Hypermobility syndrome of the knee joint;
- Congenital dysplasia of the knee joint;
- condocalcinosis;
- osteomyelitis;
- rheumatoid arthritis;
- acromegaly;
- diabetes mellitus;
- obesity;
- hypothyroidism;
- Fraud, etc.
Post -Traumatic deforming osteoarthritis is divided into acute and chronic. The acute form of the disease develops after a serious injury, more often,
, which occurs or partially extends to the joint part of the bone. The chronic form of the disease develops for a longer time and is associated, as a rule, with frequent and light injuries in the joint. These conditions are created by builders, road workers, engines, etc.
In acute gonarrosis, the disease mechanism is associated with severe inflammatory changes in joint cavity, namely, with lymphostasis, greater pressure in the joint cavity and a change in the composition of the synovial fluid. Excessive acceleration of the new cartilage fabric leads to the deformation of the articular surface at the fracture site and the growth of osteophytes.
In chronic gonarrosis, a severe inflammatory process is not observed, however, the frequent and intensive load in the cartilage tissue leads to its rapid compression, the formation of microcks and the deterioration of the cartilage supply with nutrients both on the side of the bone and the joint space.
People with this pathology can be found quite frequently. Its essence is to change the shape of the legs. With the deformation of the diverse, the legs are arched out into a horizontal plane. In other words, among the patient's legs, space is more than in healthy people. With the deformation of the valgo, the legs have an X -shaped shape when the knees are in contact with each other. Both pathologies can be programmed genetically and develop throughout life due to lower extremities fractures.
In both cases, the load on one sides of the knee joint increases, with deformation of Varo, on the side sides and with valgo deformation, on the medial sides. Due to the fact that the patient's same weight presses in a smaller area, premature washing of the cartilage occurs, accompanied by inflammation, pain and morning stiffness.
Congenital shortening of one of the legs is a consequence of anomalies or can develop a few years after birth as a consequence of birth injury. As in the previous case, an unequal weight distribution occurs, and the normal leg acquires a large load. As a result, the joint cartilage of the knee joint of a healthy leg undergoes structural changes that lead to deforming osteoarthritis.
This pathological condition is not a disease, but it can lead to it. This syndrome means excessive mobility of the ligament and consistent apparatus, in which the movement of the joints of the joints within the normal axes can increase significantly. Such patients almost never suspect that they have that characteristic, since they live with it all their lives and believe that other people also work in the same way.
A hypersman sign of the knee joint is the formation of a stupid angle between the front surfaces of the thigh and the lower part of the leg with the straight -straight of the leg. In other words, the knees bend so to speak, and the legs take a burning form. In addition, such patients can easily reach the forearm with the thumb, reach their heads to the legs and, in principle, have congenital flexibility.
Symptoms of osteoarthritis of the knee joint
In the initial development stage, the pathology is manifested by knee pain, expressed moderately and arises while it is in motion, when it moves along the steps.
An unpleasant symptom may appear if a person spends a lot of time standing or tries to get up after being in a position sitting for a long time.
At rest, health generally improves.
Intense intense acute pain arises spontaneously.
Most patients previously had prolonged discomfort during physical activity and walking. In this case, growth pain can be the main sign of gonarrosis development.
The disease gradually develops, for several months or years, when it is not yet a visible deformation and severe pain. But during this period, the discomfort in the knees, which occurs from time to time.
Remember, as soon as possible consult a doctor, easier and more successful will pass the treatment.
Do not delay a visit to a specialist, waiting for irreversible consequences. Take measures as soon as you notice the symptoms of the disease.
The obvious signs of osteoarthritis of the knee joint begin to manifest as the structure of cartilage shells, a decrease in synovial fluid production and damage to the joint bag. In the initial stage of the increase in pathological changes, as a rule, there are no pronounced symptoms, but at the same time a slight stiffness in the morning may be present.
When several pronounced symptoms appear, osteoarthritis, as a rule, is already in the late stage of its development. At this time, there is already serious damage to the structures of the knee joint, so the disease enters the acute phase. The characteristic manifestations of the acute period of osteoarthritis development include:
- greater pain;
- Change of march;
- limp;
- Crunch when moves;
- Soft tissue swelling;
- an increase in the knee due to the accumulation of fluid;
- Limiting mobility in the joint.
When knee osteoarthritis develops, symptoms may grow enough, but when the disease is the transition to the last stage of the manifestation of an articulation disorder, the quality of life significantly reduces the quality of life.
- The synovial shell against the bottom of the damage to the joint surfaces begins to become inflamed, which leads to a violation of the mobility of the entire joint.
- Any movement with a damaged joint can be very painful.
- In palpation, there is a significant increase in local body temperature.
- As a general rule, the effective treatment of the osteoarthritis of the knee joint with conservative methods is possible only at the early stage of the development of the disease.
- Therefore, when signs of the disease appear, consult a doctor to consult.
In the development of a condition such as the osteoarthritis of the knee, the symptoms and the treatment are interconnected, since if in the early stages of the development of the disease, the joint surfaces can still be completely restored and improved by the local metabolism, then in the laterexposed.
First grade osteoarthritis proceeds almost without visible symptoms. This development phase is characterized by:
- leg fatigue;
- A slight decrease in mobility, which is generally observed immediately after sleep.
The symptoms of pain, if and occur, manifest in a slight degree. At this time, the osteoarthritis of the knee is seen in the X -ray in the form of small packages in the cartilage tissue and the surface of the bones.
With the osteoarthritis of the second degree knee joint, the symptoms are more pronounced. The pain already arises from the load minimally or immediately later. In the affected part of the leg, the pain is caused by almost any movement. After a fairly long break, it usually goes completely. However, the following physical actions immediately cause pain.
Approximately in the second stage of the development of the disease, the sensations of pain are added:
- Crunch in the knee joint during movements;
- a reduced opportunity for bastard in the leg normally in the knee;
- change of joint bones;
- Progressive synovitis.
A rough articulations, as a rule, is just audible, but with the course of the disease it becomes very strong and different. When trying to bend the leg in the knee, acute pain occurs. In some cases, this is possible only for a corner of 90 degrees, and then with difficulty and pain of overcoming. The change in the form of the joint also becomes obvious, which is also aggravated by the accumulation of pathological fluid in it.
The characteristic features of the third degree of osteoarthritis are serious pains that are independent of the quantity, the intensity of physical activity. The articulation annoyed a person even at night, this causes a significant inconvenience.
Radiography can show global changes in cartilage, joint surface, non -characteristic growth. The Curvature in the form of an X -shaped leads an person to disability. These are the consequences that the cartilage tissue has already worn out and the bone tissue entered the "movement. "
Gonarrosis is a disease of degenerative-divia nature, in which the destruction of the cartilage occurs and the articulation is deformed. The signs of the disease are severe pain, limb deformation, an unequal distribution of load in the bone monsus system, the development of complications and a significant decrease in mobility until the patient's disability.