Osteoarthritis of the knee is a chronic joint disease in which the main changes are degeneration of the articular cartilage surfaces and secondary osteophytes. The main manifestations are pain and unfavorable movement of the knee joint. X-rays show narrowing of the joint space, dense subchondral bone, fractured trabeculae, sclerosis and cystic changes. There is lip-like growth at the edge of the joint, so it is also called osteochondral hyperplasia. In the later stage, the bone ends are deformed and the joint surface is uneven. The cartilage in the joint peels off and the bone fragments into the joint, forming intra-articular free bodies. Osteoarthritis represents the aging of the joint, so it is also called age-related arthritis.
Etiology.
1.Joint degeneration
2.Trauma
3.Strain injury
4.Overweight
5.Cold and cold
6.Other
Symptoms.
1, pain, limp
2, unfavorable activity, difficulty in going up and down stairs and squatting
3, deformity
4, sometimes combined with swelling
Signs.
1, pressure pain around the knee joint
2.Decreased mobility of the knee joint
3. Swelling of the joint in some patients with combined synovitis
Suggested examination
1.Frontal and lateral views of the knee, patellar axial position, full length of both lower limbs in standing position
2. CT and MRI examination if necessary
Treatment modalities
1.Non-surgical treatment
(1) Muscle strength exercise Actively perform muscle strength restoration exercises such as straight leg raising of the knee joint.
(2) Physiotherapy, acupuncture, massage and acupressure can relieve muscle spasm, improve local blood circulation and reduce pain.
(3) Drug therapy Topical drugs are preferred, and various topical preparations of Chinese and Western medicines, such as Furtalin emulsion, have certain effects. Oral anti-inflammatory and analgesic drugs, such as acetaminophen, celecoxib, etoricoxib, etc., can be administered after assessing the associated risks when topical drugs are not effective, and treatment with glucosamine sulfate and chondroitin sulfate, which are chondroprotective agents with a certain degree of anti-inflammatory and anti-chondrolytic effects, can also be tried.
(4) Corticosteroid injection Corticosteroid is a long-acting anti-inflammatory agent that can reduce inflammation and adhesions around the knee joint.
2.Arthroscopic minimally invasive surgery treatment
Minimally invasive arthroscopic techniques are used to treat lesions in the knee joint, which are less invasive and have faster recovery, and can slow down the development of knee osteoarthritis.
(1) Indications for surgery: mild to moderate knee osteoarthritis combined with mechanical entrapment and strangulation symptoms, which can originate from the free body, meniscus, synovial folds, etc.
(2) Surgical method: Usually a standard approach through the medial and lateral knee joints is used to explore the structures in the knee joint in a certain order, remove the free body depending on the exploration, repair/repair the injury, remove the synovial folds, and perform chondroplasty or cartilage grafting if necessary.
3. Knee arthroplasty
Knee arthroplasty is the replacement of a broken joint by an artificial substitute (knee prosthesis) to relieve pain, correct deformity and restore function, and is the ideal surgical option for the end stage of osteoarthritis of the knee.
(1) Indications for surgery: Patients with severe knee osteoarthritis.
(2) Surgical method: usually take the anterolateral incision, reveal the joint and perform sequential osteotomy and soft tissue balancing, remove the broken cartilage surface, implant the artificial prosthesis and then suture it, postoperative routine functional rehabilitation exercises.
Prevention
Osteoarthritis of the knee is caused by strain on the basis of degenerative changes, so prevention is focused on reducing accumulation of injuries. To prevent knee osteoarthritis, it is important to start with daily life, avoiding long periods of time in one position, not to mention blindly repeatedly flexing and extending the knee joint, rubbing and pressing the patella; paying attention to cold and dampness, keeping warm, and avoiding excessive strain on the knee joint; minimizing up and down steps and other exercises that make the knee joint bend and bear weight to reduce the wear and tear on the joint cartilage.