Osteoarthritis of the knee

Arthritis called the chronic disease of a joint in which the cartilage of the progressive collapses. As the destruction of cartilage changes occur in bone, covered by cartilage and the joint capsule.

Osteoarthritis of the knee

What does the word arthritis and what are its synonyms?

The term arthritis comes from the Greek word "artros" — joint and the suffix "Otis" is a non — inflammatory disease. However, this description is not completely accurate as in case of arthrosis in the joint there are some inflammatory changes. In English-speaking countries "is our" arthritis in the majority of cases called arthritis (arthrithis), i.e., an inflammatory disease of the joint (the suffix "itis"), while we have arthritis is commonly called the defeat of the joint in rheumatic diseases, infectious, purulent lesions of the joints, etc. Sometimes this disagreement trying to fix another term: osteoarthritis, but it appears rarely.

In modern scientific articles more common term osteoarthritis (from the Greek words "osteo" — bone "artros" — joint, i.e. non-inflammatory disease of joint and bones). And again in English-speaking countries "our" osteoartroz called osteoarthritis (ostheoarthrithis), i.e., an inflammatory disease of joint and bones.

Often patients we hear the question: "at First I was diagnosed with arthritis, and now osteoarthritis write. Is everything so bad?". In fact, arthrosis and arthritis - synonyms and your doctors said about the same.

As we noted in the beginning, in case of arthrosis (osteoarthritis) the cartilage of the progressive collapses and in the process gradually involved and bones. When osteoarthritis occurs in the bone first section of the multiple sclerosis (seals) as a result of loss of the cartilage shock absorbing properties. Then there are tapering the edges of the bones (exostosis) which is often erroneously referred to as "deposits of salts"— in fact, under normal osteoarthritis no salt deposits there. In the further course of the disease, the bone begins to bend, deform, it formed cysts: often, the disease is called deforming arthrosis (osteoarthritis). In old medical books can sometimes be found the phrase "disfiguring arthritis", but now it is almost never used.

Joint pain

The exact causes of osteoarthritis has long been considered unknown, so there is another name for this disease - idiopathic osteoarthritis, ie arthritis that is caused by unknown reasons or spontaneously. Of course, now scientists did not believe osteoarthritis is a mystery, and the reasons for its development are known. Read more about causes of osteoarthritis, about what is primary and secondary arthrosis we describe below.

Osteoarthritis often affects the joints, which experience the maximum load (hip, knee, ankle joint, joints of the hand). Osteoarthritis of the hip joints called coxarthrosis (from the word "coxa" hip), ankle - crurosteoarthritis ("cruris" - the tibia), the knee - gonarthrosis ("gene" knee). In most cases osteoarthritis affects both the knee joint, with one of the joints can be destroyed stronger. In this case, it sounds like the diagnosis of bilateral gonarthrosis with a primary lesion of the right (or left) knee.

Often arthritis affected not one, but several joints, so use another term - the polyosteoarthrosis, which means the defeat of three or more joints (two symmetrical, e.g., both knees, and some other). In this case, the diagnosis is usually as follows: the polyosteoarthrosis with a primary lesion of the knee joints (or one of them).

What causes osteoarthritis of the knee?

Osteoarthritis of the knee is different. Depending on its causes there are primary and secondary osteoarthritis.

Primary osteoarthritis of the knee

Articular cartilage is constantly destroyed and renewed, and normally these processes are balanced. With age, the renewal of cartilage slows down and begins to dominate the destruction of the cartilage, which is called degradation or degeneration.

The process of synthesis and destruction of cartilage in normal balanced. If you begin to dominate degeneration will begin osteoarthritis of the knee

In most cases, degeneration of the cartilage, i.e. the development of osteoarthritis, occurs after 45-50 years, but sometimes the osteoarthritis can develop in a 20-letih. Fortunately, the development of osteoarthritis at such a young age is extremely rare.

People are prone to osteoarthritis

People are prone to osteoarthritis of the knee joint to a greater or lesser extent. Usually, if arthritis occurs, it is precisely in the age of 40-60 years, and if the age of 60, is osteoarthritis, it is likely that it is not already, or, more specifically, osteoarthritis is insignificant (certain degenerative changes in the knee joint occur in all older people, but they are expressed differently).

It is important to note that if you take and make x-rays of all people older than, say 60 years, the signs of osteoarthritis will be almost 90%, but not all of them felt their knees as a problem. Especially men, who often have "severe" arthritis does not manifest itself or cause a minimum of inconvenience.

Primary osteoarthritis occurs spontaneously, i.e. without starting factors, so it is called idiopathic, what we talked about earlier.

So, we have found that age is one of the main factors determining the development of arthritis because with age begin to dominate the process of degeneration of cartilage. One in four people aged over 55 years suffer from osteoarthritis of the knee. But we also noted that with age osteoarthritis does not develop at all. So, there are other reasons. Before we list them, note that is not the main, main reason. Osteoarthritis of the knee develops due to these reasons, with some playing a larger role, others a smaller.

Paul. Most often osteoarthritis of the knee affects women. The exact reasons are unknown, but could be explained by the following reasons. The average life expectancy of women more than men, and, accordingly, average older women are more pronounced degenerative processes. In addition, body mass women have on average slightly higher. The size of the bones in women are less than men, and, coupled with higher body weight this leads to higher pressure in the knee joint, and, accordingly, more intensive mechanical destruction of the cartilage. In podovlyayuschee most cases in women, the arthritis begins to manifest itself after the cessation of menses, and, possibly, estrogen deficiency determines development of osteoarthritis. Note that attempts to treat osteoarthritis of the knee in women, after menopause estrogen, of course, being made, but they are unsuccessful.

Weight. Of course, the more weight, the greater burden we have to carry our knee joints. In addition, obesity reduces physical activity and leads to weakness of the muscles of the thigh. For the more active synthesis of cartilage necessary movement (without excess pressure), and sedentary lifestyle, the process of degeneration of cartilage begin to dominate. Thigh muscle is an important stabilizer of the knee, and with weakness of these muscles of movement in the knee joint become more loosening, which accelerates the destruction of cartilage. All these processes can be described as a vicious circle: the more weight, the faster it collapses the knee joint, the more pain, the harder to move, which again leads to excessive weight.

Weight with osteoarthritis

The vicious cycle of obesity and osteoarthritis of the knee

On the other hand does not have arthritis of the knee develops in only full of people - those who have no obesity can also suffer from osteoarthritis. Again, this is because osteoarthritis has no single cause.

Heredity. It has long been observed that osteoarthritis of the knee, "family" disease. If the arthrosis is or was your parents, then, unfortunately, the probability of this disease is high, and you. Scientists have found many genetic features responsible for, for example, individual features of the structure of the main protein of cartilage, collagen, but, unfortunately, these discoveries have no practical significance, because to affect human genes for the prevention or treatment of osteoarthritis, we can not yet. There is evidence that osteoarthritis of the inheritance passed through the female line, which partly explains their greater propensity to the disease.

Primary osteoarthritis of the knee does not occur for only one reason, and only in their entirety. While osteoarthritis of the knee in varying degrees, is present in almost all people over 60 years of age, but the severity of osteoarthritis is very different, and not always arthritis detected on x-ray, manifests itself. It is actually even more difficult: not every pain in the knee joint in an elderly person, especially in the age of 40-60 years, will be accompanied by characteristic changes of osteoarthritis on radiographs.

For example, researchers found that 76% of older people with complaints of pain in the knee on radiographs revealed osteoarthritis. That is, not any pain in the knee joint in an elderly person – and certainly osteoarthritis of the knee. Moreover, among all older persons detected on the radiograph of osteoarthritis of the knee only 81% will be required to produce complaints of pain. That is not always available osteoarthritis pain.

Strictly speaking, there is no mandatory connection of severity of pain severity of knee OA on radiographs. It happens that changes on radiographs are very minor and the pain is strong and sometimes Vice versa: on radiographs the joint is completely destroyed, and the people in it can ride a bike, do yoga, work as a painter, and such cases we meet almost every day.

Radiograph of the knee joint

Most often osteoarthritis of the knee starts with an inner (medial) division.

Radiograph of the knee joint affected by osteoarthritis on the inside. A blue arrow marked by the outer division of the joint, and orange, the internal joint. Note how much narrower the gap between the bones on the inner side: on the radiograph cartilage is not visible, and it is this gap, and means cartilage. In this case, the inner side of the knee joint cartilage is almost gone and bone rubs against bone.

With the gradual abrasion of the cartilage on the inner side of the knee joint, the leg starts to bend. Because osteoarthritis often affects both the knee joint that is bilateral, it is starting to bend, deform both legs, and there is a O-shaped deformity of the legs (varus deformity).

Rarely (approximately 10% of cases), osteoarthritis affects the outer parts of the joint, and in this case, it starts X (valgus) deformity.

Of course, when the bending load on the inner (with O-ring) or outer (in X-shaped) versions of the strain increases even more, and osteoarthritis will develop faster and permanently.

Osteoarthritis can begin not only in the inner or outer division, but also between the kneecap (the patella) and the intercondylar sulcus of the femur. This option is called patello-femoral arthritis occurs it is usually due to tilt, patellar subluxation, syndrome of the lateral giperpirexii , which is on our website in a separate article, or after fractures of the patella , which you too can read in a separate article.

Secondary osteoarthritis of the knee

Knee arthritis can develop due to any specific reasons, in this case, it is called secondary osteoarthritis. Now we will briefly talk about the options of secondary osteoarthritis.

Post-traumatic arthrosis of the knee joint. Injuries of the knee, of course, do not add the joint health and almost all of them, one way or another, increase the risk of developing osteoarthritis.

One of the most common injuries of the knee joint – meniscus ruptures, which is on our website in a separate article . Unfortunately, any person with a history of substance ever tear of the meniscus increases the risk of osteoarthritis. If damaged medial (inside) meniscus, and osteoarthritis likely develops in the inner division of the knee joint. And, accordingly, if rupture of the outer meniscus, and osteoarthritis will develop in the external part of the joint. Note that the meniscus tear is not always necessarily lead to osteoarthritis, uvelichivaet the likelihood of its development. Of course, the more damaged the meniscus, the higher the risk of developing osteoarthritis.

Post-traumatic arthrosis of the knee joint

Another reason for the development of osteoarthritis of the knee – torn ligaments, e.g. the anterior cruciate ligament rupture . As a result of rupture of a ligament in the joint may appear instability, which, of course, will lead to damage of the cartilage and development of osteoarthritis. Naturally, damage to the cartilage depends on degree of instability, which may be different.

Much more severe the knee injury – fracture of the condyles of the tibia or fracture of the condyles of the femur If the fracture line enters the joint surface, then this fracture is called intra-articular. Virtually any intra-articular fracture is accompanied with displacement of fragments, and thus, the shape of the articular surface. The resulting displacement step inevitably leads to the progressive destruction of the cartilage and the appearance of arthrosis. Of course, the more severe the fracture, the more intra-articular fracture fragments, the more damaged the cartilage and a higher risk of developing osteoarthritis. After a hard multisplintered fractures of the condyles of the tibia osteoarthritis develops in almost 100% of cases even on a perfectly executed operation osteosynthesis (eliminating the displacement of bone fragments bone together with screws, plates, etc.)