Osteoarthritis of the knee

Osteoarthritis of the knee or Gonarthrosis is the most common form of osteoarthritis in Germany. This chronic disease belongs to the so-called rheumatic group of forms. Your symptoms, the course of the disease as well as prophylaxis and therapy options will be considered below.

What is knee osteoarthritis?

Osteoarthritis is generally understood to mean wear and tear on the joints that is significantly greater than a level corresponding to the respective age. This degenerative wear and tear can be treated by conventional medicine, but is ultimately not considered curable.

At Osteoarthritis of the knee - also as Gonarthrosis - at least one of three cartilaginous articular surfaces of the knee joint is affected. The articular cartilage becomes rough and loses its elasticity, so that the joint is increasingly restricted in its function and loses mobility.

If the kneecap joint is affected, retropatellar arthrosis is present. Medial osteoarthritis of the knee refers to the inner or medial parts of the femorotibial joint. And knee joint arthrosis in the outer femorotibial joint is called lateral gonarthrosis.

causes

About causal triggers of Osteoarthritis of the knee and as a result, there is disagreement about indicated therapy options. Alternative therapists view osteoarthritis as a disease of civilization that can be characterized less by wear and tear and caused by stress and wear and tear than that it arises from a sedentary lifestyle and poor diet.

The generally high value of a suitable diet with regard to knee osteoarthritis is undisputed in both camps. For conventional medicine, joint dysplasia, incorrect loading or overloading, for example due to increased body weight, as well as inflammatory reactions (secondary osteoarthritis) are classic disease triggers of knee arthrosis. Secondary osteoarthritis is also called osteoarthritis, whereas exercise-induced primary osteoarthritis is called osteoarthritis.

Medicines, namely antibiotics, can also cause osteoarthritis of the knee if they damage the hyaline joint cartilage. In principle, osteoarthritis can be classified according to its cause: If more homogentisic acid is deposited in the joint (arthrosis alcaptonurica), there is a mechanical influence of uric acid (arthrosis urica), or there is regular bleeding (hemophilic arthrosis).

Symptoms, ailments & signs

Arthrosis of the knee joint is initially expressed by the typical initial pain and stiffening of the joints. Those affected feel an unpleasant, usually dull pain in the affected knee in the morning after getting up or after sitting for a long time.

This subsides after a few steps, whereby the phases of suffering last longer and longer as the disease progresses. The same applies to the morning stiffness of the joints, which usually persists for 20 to 30 minutes. If the osteoarthritis is caused by rheumatoid arthritis, the joints often stiffen for several hours. The affected knee joint hurts when pressed and is generally less mobile than before.

This can lead to restricted mobility. Osteoarthritis can often be recognized by a grinding or rubbing noise. In addition, the affected joint is slightly swollen. Some people develop bruises around the knee. The symptoms often appear in phases, whereby the phases can vary greatly in their intensity and duration.

External circumstances such as cold and moisture often lead to an increase in symptoms, while the symptoms subside with warmth and protection. The symptoms worsen in the long term. If it is severe, the knee joint can stiffen permanently and completely lose its function.

Diagnosis & course

The progression of the disease is characterized in each case by the progressive damage and degradation of the knee cartilage. At first it is cracked and rough, then less elastic. The synovial fluid (synovial fluid) is also no longer produced to the normal extent. Eventually, the layer of cartilage between the bones shrinks. In the bone on the cartilage, sclerotherapy and bony bulges can occur.

Osteoarthritis of the knee usually progresses slowly. If the thighbone and shinbone rub painfully directly against each other from the last stage onwards, the knee joint can stiffen in the long term. Even the loss of the knee joint is possible. Knee osteoarthritis is a self-reinforcing disease:

Pain and loss of function result in compensation from our musculoskeletal system, muscle tension and repeated incorrect posture, followed by further joint deformations and increasing complaints, which finally also occur in a resting state. Muscles harden, shorten and atrophy. There is inflammation. Since cartilage tissue is not directly supplied with blood, it regenerates only very slowly.

Complications

Most patients usually suffer from severe pain due to osteoarthritis of the knee. These can occur on the joints and limbs. This leads to severe restrictions on movement and other restrictions in everyday life. It may also no longer be possible to carry out a professional activity as usual.

The affected regions of the body can also be swollen and bruises can form. Often the knees also hurt, which leads to an unhealthy relieving posture. The patient's quality of life is significantly reduced by osteoarthritis of the knee. As a rule, there is no spontaneous healing, so treatment by a doctor is definitely necessary.

Treatment of osteoarthritis of the knee does not lead to further complications. With the help of painkillers or various therapies, the pain and discomfort can be limited relatively well. A healthy lifestyle can also have a very positive effect on the life and everyday life of those affected. The life expectancy of the patient is usually not reduced by osteoarthritis of the knee. In some cases, however, surgery or prostheses may be necessary.

When should you go to the doctor?

Joint problems often go away on their own. If pain, restricted mobility and the like persist for several weeks or months, a doctor should be consulted. Signs of knee osteoarthritis should always be clarified to rule out complications. Anyone who suddenly experiences pain in the knee joint or repeatedly suffers fractures should consult their family doctor or an orthopedic surgeon. If the pain suddenly changes, it is a reason to visit the doctor again.

Especially in the case of osteoarthritis of the knee, a changed symptom picture can indicate that the osteoarthritis is progressing and changing. People who have osteoarthritis in other parts of the body should inform the responsible doctor if the knee joint is discomfort. This is especially true if the symptoms get worse quickly. If the symptoms limit the quality of life, a quick investigation is indicated. Otherwise, in addition to the physical complications, there may also be emotional problems that require independent treatment. If the symptoms occur in a child, the responsible pediatrician must always be consulted.

Treatment & Therapy

The Osteoarthritis of the knee may be part of the normal aging process - if the knee joint hurts under light stress, for example going down stairs, this can be the first symptoms of the disease. After diagnosis, there are essentially three treatment options available: With conservative treatment, the focus is on reducing the symptoms of osteoarthritis of the knee and slowing the course of the disease. That means giving painkillers or anti-inflammatory drugs, for example cortisone can reduce irritation.

Injecting hyaluronic acid can also help with improved joint lubrication. The condition of the knee joint cartilage does not improve without complaints, but the ligaments and muscles work relaxed. To strengthen the muscles, especially the extensor muscles in the thigh, physiotherapy, adequate training, electrical stimulation and electrical muscle stimulation are helpful. Regular exercise favors the natural stabilization of the knee joint, because it stimulates the metabolism, promotes the supply of nutrients and at the same time the removal of harmful waste products.

Alternative therapists are mainly concerned with the focus on a healthy metabolism. In their eyes, it is important to avoid acidic foods such as meat, sausage and eggs, as well as ready-made and cooked foods. The proportion of raw vegetables, fresh fruit and vegetables should be increased. Vital substances such as calcium, magnesium, vitamin C and vitamin D are important for building up or regenerating bone and cartilage substance. Weight control, more exercise and a change in diet stop overloading and slagging and have a positive effect on the metabolism. Therapeutic fasting has been shown to help osteoarthritis patients.

The third and final treatment route is arthroscopic therapy. During surgical interventions, ligaments can be regenerated, cartilage smoothed, the leg axis corrected and the kneecap repositioned. After this joint-preserved operation of the not yet completely destroyed knee, only the joint replacement remains: knee prosthesis or partial prostheses.

Outlook & forecast

The prognosis of knee osteoarthritis is described as unfavorable. It is a chronic disease with a progressive disease course. Without treatment there is a steady increase in problems. Restrictions in movement, pain and a decrease in physical capacity are the consequences. Ultimately, the person concerned needs walking aids or a wheelchair in order to be able to move.

Further developments improve with medical and medical care. Although there will be no cure or freedom from symptoms, doctors and medical professionals can delay the progress of the disease. The sooner a diagnosis is made possible, the better the options for action. Through the administration of medication, targeted training for optimal movement and the cooperation of the patient, existing complaints are alleviated. In addition, the course of the disease can be positively influenced. Bad posture is corrected and the muscular system is supported.

Despite all efforts, knee osteoarthritis cannot be completely stopped in its development. In the advanced stages of the disease, doctors recommend surgery. An implant is used so that the person concerned can move around. This improves the general quality of life. The surgery is associated with various risks and side effects. At the same time, the patient must learn to be able to move with an artificial knee joint.

prevention

A healthy lifestyle with moderate, regular exercise and a moderate diet rich in vital substances is accordingly the best prevention Osteoarthritis of the knee In particular, gentle movements such as swimming, cycling, hiking or aqua aerobics unproblematically promote the natural health of the knee: strong muscles, well-cared for and lubricated knee joints.

Aftercare

Knee joint osteoarthritis needs consistent follow-up care, which is primarily aimed at preventing or at least delaying the deterioration of the diagnosis. Follow-up care is coordinated with the treating orthopedic surgeon and physiotherapist and requires active cooperation from the patient for an optimal course.

As part of the aftercare, it is especially important to stabilize the weakened knee through targeted muscle building. For this purpose, patients learn suitable exercises from physiotherapists or in rehab sports, which are then carried out independently at home or in the gym. The muscles hold the knee joint like a corset during many movements and often prevent further damage. There are also exercises that maintain or promote mobility in the knee.

Protecting the knee is nevertheless important in terms of preventing further wear and tear. This includes that massive bending and twisting movements that stress the joint are better avoided. However, light endurance movements are desirable. They promote the synovial fluid, the so-called synovia, which can improve the gliding ability in the knee joint.

The doctor or physiotherapist decide which sports are suitable for the individual case. However, sport with duels or jumps is absolutely unsuitable for knee osteoarthritis due to the high risk of injury or further wear and tear. The stability in the knee joint can be additionally improved during sport by wearing a knee brace.

You can do that yourself

In the case of osteoarthritis of the knee, a healthy diet and consistent exercise are particularly helpful. Those who do sport regularly reduce the discomfort and postpone the installation of an artificial knee joint. Trigger point acupressure and stretching exercises have proven particularly effective. In connection with gentle sports such as swimming, the joint can be made mobile again relatively risk-free.

A consistent diet also helps many osteoarthritis patients. On the one hand, a healthy and balanced diet ensures weight reduction and thus also relieves the strain on the knee joints. On the other hand, certain foods reduce the discomfort while others make them worse. Acid-heavy foods such as meat, sausage and eggs as well as ready-to-eat foods should be avoided. A suitable nutrition plan is best worked out with a nutritionist. In addition, warm mud baths have an anti-inflammatory effect, loosen up cramped muscles and promote the metabolism.

Other natural remedies that help with osteoarthritis of the knee are e.g. Spice mixes, leeches of the incense capsules. Bathtubs with medicinal herbs such as chamomile or lemon balm also help against joint wear. In consultation with the doctor, therapeutic fasting can also be carried out. In general, all measures should be discussed with a doctor beforehand so that no undesirable complications occur later.