Introduction
Osteoarthritis of the knee joint is a disease that is mainly caused by degenerative changes in the bones and cartilage of the knee joint. It is most commonly seen in middle-aged and elderly people, especially in women who are fat, and the symptoms gradually worsen with age. With the ageing of the population and the development of transportation, sports and tourism, the number of patients with osteoarthritis of the knee is gradually increasing. The basic lesion is progressive knee cartilage loss and degenerative changes in the joint edges and subchondral bone, accompanied by a mild inflammatory response, also known as degenerative knee osteoarthritis and osteoarthrosis of the knee. It seriously affects the quality of life of middle-aged and elderly people, and is attracting more and more attention.
Etiology]
1. Age factor
The knee joint is the largest weight-bearing joint in the human body. As the knee capsule atrophies, degenerates and fibroses with age, the joint becomes stiff and inflexible, and the synovial fluid secretion is abnormal, causing insufficient nutrition of the cartilage cells, the water content in the cartilage decreases, and the mucopolysaccharide, the main component of cartilage, decreases, and the articular cartilage lacks elasticity and is easily broken by wear and tear. In order to adapt to the needs of the knee joint bearing force, the edge of the articular cartilage has osteophytes, that is, the occurrence of osteoarthritis in the elderly.
2. Endocrine factors
Patients with endocrine disorders, long-term trauma to the knee joint that is not easily noticed, excessive inappropriate exercise, etc., are caused by the knee joint load, the transmission to the disorder, causing degenerative changes in the knee joint cartilage, secondary to osteoarthritis of the knee joint.
3. Obesity factor
This disease is related to weight overload, menopausal women weight gain can contribute to the occurrence of osteoarthritis.
4. Trauma Fractures, dislocations, meniscal or ligament injuries in the knee joint can cause instability of the knee joint, which is the cause of secondary osteoarthritis of the knee.
5, inflammation, septic arthritis of the knee joint and tuberculosis, rheumatoid arthritis, etc., even if the inflammation subsides, the cartilage surface of the joint is damaged to varying degrees, such as the joint still maintains a considerable degree of mobility, most secondary to osteoarthritis.
6. Joint abnormalities
The disease can be secondary to inversion and valgus deformities of the knee joint, large osteoarthrosis, multiple epiphyseal dysplasia, etc.
Clinical manifestations
Knee pain: the most common symptom of the disease, early pain is mild, mostly occurs during activity, relieved after rest, later can also be accompanied by pain at rest, and can be accompanied by night pain. Knee pain is obvious when going up and down stairs, more prominent when going downstairs, difficulty in squatting, and a babbling sound in the knee joint when moving. The pain may increase with overexertion.
Some patients may also have morning stiffness, which lasts less than 30 minutes and is relieved after activity, and is limited to swelling of the knee joint. Sometimes the joint feels like it is stumbling, but improves with movement. When you stand up from a sitting position, you may also feel that the movement of your leg is inhibited, and the muscle strength around the knee joint will become weaker. Symptoms are worse on rainy days. Difficulty with movement is the end result of the development of most patients with osteoarthritis. As the disease worsens, it may range from a mild early onset of difficulty moving in the morning or after sitting for a long time, to joint deformity, significantly reduced range of motion, and joint swelling with effusion. Physical examination may reveal joint enlargement, tenderness, rattling, deformity and dysfunction.
If you are older than 45 years of age and begin to experience the more typical manifestations described above, or if you experience joint soreness, pain, and sometimes swelling, aggravated by cloudy weather, cold, or overexertion, difficulty going down stairs, and weakness in the legs that persists without relief, then you should consider seeking medical attention, as these are early symptoms of osteoarthritis.
Most osteoarthritis of the knee develops slowly and with aggressive treatment can improve joint function, with a very small number forming dysfunction. During an acute attack of osteoarthritis, the primary treatment is rest, with attention to reducing the stress and activity of the affected joint. Avoiding and reducing the wear and tear of the articular cartilage. Therefore, appropriate restriction of the affected joint activity is beneficial to reduce pain and prevent aggravation of the disease. However, complete bed rest is not recommended.
Treatment methods
Drug treatment
(1) Anti-inflammatory and pain-relieving drugs
(2) Joint cartilage protection drugs
(3) Anti-inflammatory drugs
(4)Joint lubricants
(5) Osteoporosis treatment drugs
Diet and other treatments
(1) Eat foods high in calcium to ensure the normal needs of bone metabolism. It is advisable to eat more milk, eggs, soy products, vegetables and fruits, and take calcium supplements when necessary.
(2) Overweight people are advised to control their diet and reduce their body weight to facilitate the reduction of joint weight-bearing.
(3) Increase the intake of multivitamins, such as vitamins A, B, B1, B12, C and D, etc.
(4) Physical therapy that can be considered in conjunction.
Surgical treatment
Surgical treatment mainly includes arthroscopic and knee joint replacement surgery
Arthroscopic surgery is less invasive and involves only two small holes in the joint surface and joint cleaning with special instruments.
In the advanced stages of arthritis, when the joint has lost its function, artificial joint replacement surgery has become the ideal procedure because of its ability to relieve pain and restore function to the joint. The procedure has evolved over the past century and is now well established and widely available worldwide.
Many patients have a great deal of fear about joint replacement, but in fact, joint replacement is not a scary procedure. The procedure has been performed for nearly 100 years and the surgical technique has become very mature. With advances in artificial joint materials and newer medical philosophies, joint replacement surgery now takes just over an hour, with minimal pain and a very quick post-operative recovery.