Osteoarthritis of the knee

Arthritis called the chronic disease of the joint, where the articular cartilage is progressively destroyed. While the destruction of the cartilage changes, and bone, that covers the cartilage, and articular capsule.

Osteoarthritis of the knee

What is the meaning of the word arthritis and what are its synonyms?

The term arthritis comes from the Greek word "artros" — the joint and the suffix "ozis" — the non-inflammatory disease. However, this description is not entirely accurate, as with osteoarthritis of the knee there are some inflammatory changes. In the countries of the English language, "our" osteoarthritis in the vast majority of cases specified as arthritis (arthrithis), that is, the inflammatory disease of the joint (the suffix "itis"), while we have the arthritis usually called defeat joint in rheumatic diseases, infectious diseases, purulent defeat of the joint, etc. Sometimes this disagreement, trying to solve another term: artrose-arthritis, but rare.

Modern scientific articles is more common the term arthritis (from the Greek words "osteo" — bone "artros" — articulation, i.e. non-inflammatory disease of the joints and of the bones). And, once again, in the countries of the English language, "our" osteoartroz called osteoarthritis (ostheoarthrithis), that is, the inflammatory disease of the joint and the bone.

Often patients feel question: "the First thing I put the diagnosis of osteoarthritis, and now write to osteoarthritis. Is that bad?". In reality, the arthrosis, arthritis and synonyms, and the doctors have said the same thing.

As we have already emphasized at the beginning, when arthrosis (osteoarthritis) the cartilage is progressively destroyed, and in the process gradually involved and bones. With osteoarthritis of the dice before that occurs, the phase plates (seals), as a result of loss of cartilage damping must be owned. Then occur the wedge on the edges of the bones (exostosis), which is often mistakenly referred to as the "salt deposits"— in fact, during the normal osteoarthritis no salts no. With the further course of the bone begins to bend, warp, it will form cysts: often the disease is deformation arthrosis (osteoarthritis). In the old books of medicine, it is sometimes possible to meet the phrase "disfiguring arthritis," but now it is virtually never used.

The pain in the joints

The exact causes for the development of osteoarthritis have long been considered to be unknown, then there is another name of this disease is idiopathic arthritis, i.e. osteoarthritis, due to unknown reasons or spontaneously. Of course, now, scientists do not believe osteoarthritis mystery and the reasons for its development are known. Read more about causes of osteoarthritis, as to what is primary and secondary osteoarthritis will explain below.

Osteoarthritis usually affects those joints that suffer from the maximum load (hip, knee, ankle, joints, brush). Osteoarthritis of the hip called coxarthrosis (from the word "thigh" - the articulation of the), ankle - crurosteoarthritis ("cruris" - shin), knee - gonarthrosis ("gene" - the knee). In most cases osteoarthritis affects both the articulation of the knee, with one of the joints can be destroyed more strong. In this case, the diagnosis seems to be bi-directional gonarthrosis with primary lesion on the right (or left) of the knee.

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

Because it occurs osteoarthritis of the knee?

Osteoarthritis of the knee can be different. Depending on the cause of its appearance, highlight primary and secondary osteoarthritis.

Primary osteoarthritis of the knee

The articular cartilage is constantly collapses and is updated, and are normal these processes are arranged. With age, the update of the cartilage slows down and begins to prevail, the destruction of the cartilage, which is called the process of degradation, or degeneration.

The process of synthesis and destruction of articular cartilage in the normal balanced. If it starts to prevail the degeneration, then it will osteoarthritis of the knee

In the majority of cases the degeneration of the cartilage, namely the development of osteoarthritis, occurs after the age of 45-50, but sometimes the osteoarthritis can develop, and a 20-letih. Fortunately, the development of osteoarthritis at such a young age is extremely rare.

People prone to osteoarthritis

People are prone to osteoarthritis of the knee, to a greater or lesser extent. As a general rule, if osteoarthritis occurs, just in the age of 40-60 years, and if in 60 years a person is not arthritis, probably, not the will, or, more specifically, osteoarthritis is insignificant (those or other degenerative changes of the knee found all the elders, but are expressed in a different way).

It is important to note that if we take and do an x-ray to all the older men, for example, of 60 years, signs of osteoarthritis will be nearly 90%, but not all of them when you feel the knees as problematic. This is especially true for men, who often already "serious" osteoarthritis do not occur or cause the minimum inconvenience.

Primary osteoarthritis occurs spontaneously, that is without pitchers of factors, so it is called idiopathic, which we have talked about previously.

Then, we discovered that age is one of the main factors that determine the development of arthritis because with age they begin to prevail in the processes of cartilage degeneration. Every four people over the age of 55 years suffer from osteoarthritis of the knee. But we have also noticed that with age osteoarthritis develops is not all. Then, there are other reasons. Before I list them, note that there the main, the root cause. Osteoarthritis of the knee develops on a mixture of reasons, some play an important role, while others less so.

Paul. This osteoarthritis of the knee affects women. The exact causes of this unknown, but you can try to explain the reasons. The average life expectancy of women more than in men, and, as a result, the average of the middle-aged women are more obvious degenerative processes. In addition, the body weight in women on the average a little higher. Size bones in women than men, and, together with the higher the body mass, this leads to higher pressure in the knee, and, consequently, the more intense the mechanical destruction of the cartilage. In podovlyayuschee most of the cases, women have osteoarthritis begins to manifest itself already after the cessation of the menstrual cycle, and, perhaps, the lack of estrogen causes the development of osteoarthritis. Note that attempts to treat osteoarthritis of the knee in women after the menopause estrogen, of course, there are, but have failed.

Weight. Of course, the greater is the mass of the body, the greater the load of having to carry our knee. In addition to this, the overweight reduces physical activity and leads to weakness of the muscles of the thigh. For the more active synthesis of the cartilage are required for movement (without excess pressure), and with sedentary life-style processes of degeneration of the cartilage begin to prevail. The muscles of the thigh - are important stabilizers of the knee, and with weakness of these muscles movement in the knee become more slack, which accelerates the destruction of cartilage. Generally, these processes can be described as a vicious circle: the bigger the mass of the body, the faster it is destroyed, the knee, the more pain, the more difficult move, which once again leads to an excess of body weight.

Weight with osteoarthritis

The vicious circle of obesity and osteoarthritis of the knee

On the other hand, not necessarily osteoarthritis of the knee develops only in the morbidly obese, those in which there is obesity, may also suffer from osteoarthritis. Once again, this problem occurs because the osteoarthritis is not there is a reason.

The legacy. Time noted that the osteoarthritis of the knee - a "family" disease. If the arthrosis is, or was, to your parents, then, unfortunately, the likelihood of this disease is high and if you. Scientists have discovered a number of features gene responsible, for example, the different characteristics of the structure, the main protein of cartilage - collagen, but, unfortunately, these discoveries have no practical meaning, in fact, influence the genes of a person for the prevention or treatment of osteoarthritis, we are still. There are data that indicate that the inheritance of osteoarthritis is transmitted in the female line, which in part explains their greater propensity to this disease.

Primary osteoarthritis of the knee does not occur only for one reason, and only for their totality. When osteoarthritis of the knee, to a different extent, is present in almost all people over the age of 60 years, but the severity of osteoarthritis is very different, and not always the osteoarthritis, identified on x-ray, is manifested. In reality, it is even more difficult: not all of the pain in the knee elderly person or, more, aged between 40-60 years will be accompanied by a characteristic for the arthritis changes on x-ray.

For example, scientists have discovered that 76% of older people with complaints of knee pain on an x-ray is detected osteoarthritis. That is, not all knee pain in the older person – not necessarily osteoarthritis of the knee. With this, among all the elders identified on x-ray osteoarthritis of the knee, only 81% will be able to file a complaint with the pain. That is, is not always available, osteoarthritis hurts.

Strictly speaking, there is no obligation of communication, the manifestations of pain with a manifestation of osteoarthritis of the knee on x-ray. It happens that the changes on x-ray very minor and the pain is strong, and the opposite happens: on the x-ray the joint is completely destroyed, and man if this can go cycling, doing yoga, working as a house painter, and in such cases we meet almost every day.

X-ray of the knee

This osteoarthritis of the knee begins with an inside (medial) of the department.

X-ray of the knee affected by osteoarthritis on the inside. Blue arrow marked outside the department of the hip and orange – department inside of the joint. Please note, as already the crack between the bones, from the inside: on the x-ray cartilage is not visible, and it is this slot, and means cartilage. In this case, the inner part of the knee cartilage does not remain practically nothing, and already the bone rubs on bone.

When the gradual wear of the cartilage in the inner part of the knee, the leg begins to distort. Because osteoarthritis often affects both the articulation of the knee, that is, a double meaning, then they start to bend, warp both legs, and occurs Or in the shape of a foot deformity (varus deformation).

Less (about 10% of cases), osteoarthritis affects the external departments of the municipality, and in this case, begins in the form of X (hallux valgus) deformity.

Of course, for the correction of the curvature of the internal load (in the form) or the outside (if in the form of (X) options of deformation increases even more, and osteoarthritis will develop quicker and in a permanent way.

Osteoarthritis can start not only inside or outside the department, but also between the places of interest such as the patella (the places of interest such as the patella and intercondylar groove of the thigh. This option is called patello-femoral arthrosis and what happens is that, usually, because of the tilt, subluxation places of interest such as the patella, syndrome side giperpirexii , that on our website and is dedicated to an article or after fractures of the places of interest such as the patella , which you can read in a separate article.

Secondary osteoarthritis of the knee

Osteoarthritis of the knee can develop because of some specific reasons, in this case, the osteoarthritis is called secondary. Now talk briefly about the options of secondary osteoarthritis.

Post-traumatic arthrosis of the knee. The knee injury, of course, do not add the joint health and almost all have, in one way or another, increase the risk of development of osteoarthritis.

One of the most common knee injuries – retinal tears of the meniscus, which is on our website and is dedicated to an article . Unfortunately, not every person with way never the rupture of the meniscus increases the likelihood of development of osteoarthritis. If it is damaged the medial (inside) meniscus, and osteoarthritis is very probably develop within the department of the knee joint. And, as a result, if you break the outer meniscus, and osteoarthritis will develop in the department of articulation. Note that the meniscus tear is not always, necessarily, leads to osteoarthritis, uvelichivaet the probability of its development. Of course, the more the meniscus is damaged, the greater the risk of osteoarthritis.

Post-traumatic osteoarthritis of the knee

Another reason for the development of osteoarthritis of the knee – retinal tears of the ligaments, for example, rupture of the anterior cruciate ligament . Therefore, the ligament rupture in the knee may appear to be instability, which, naturally, leads to damage of the cartilage and development of osteoarthritis. Of course, the damage of the cartilage depends on the degree of instability, which may be different.

Much more severe the trauma to the knee – fracture of the condyles, tibial plateau or a fracture of the condyles of the thigh-If the fracture line involves the articular surface, the fracture called intra-articular. Virtually any intra-articular fracture accompanied by counterweight fragments, and in this way, it changes the shape of the articular surface. Appears after the displacement step, and inevitably leads to the progressive destruction of cartilage and the onset of osteoarthritis. Of course, the heavier the fracture, the more the intra-articular fracture fragments, the more you damage the cartilage and the greater the risk of development of osteoarthritis. After the heavy multisplintered fractures condyles, tibial osteoarthritis develops in almost 100% of cases even if it is performed step by step, the operation of osteosynthesis (resolution, offset-fragments of bones and their connection with screws, plates, etc.)