Osteoarthritis of the knee is a chronic bone and joint disorder caused by degeneration and osteophytes of the knee cartilage, also known as proliferative arthritis, degenerative arthritis and osteoarthrosis of the knee. The disease occurs mostly in middle-aged and elderly people, but can also occur in young people; it can develop unilaterally or bilaterally.
1.Etiology
1, chronic strain long-term poor posture, weight-bearing force, excessive weight, resulting in soft tissue damage to the knee joint.
2, obesity weight increase and the onset of osteoarthritis of the knee is proportional. Obesity is also a factor in the aggravation of the disease. Obese people’s weight loss can reduce the onset of osteoarthritis of the knee.
3, bone density when the subchondral bone trabeculae become thin, become stiff, its tolerance to pressure will be reduced, therefore, in osteoporosis the chances of osteoarthritis will increase.
4, trauma and force bearing frequent knee injuries, such as fractures, cartilage, ligament damage. Abnormal state of the joint, such as in the post-patellar resection link in an unstable state, when the joint withstand muscle force imbalance and coupled with local pressure, there will be degenerative changes in the cartilage. Normal joints and activities or even after strenuous exercise is not osteoarthritis.
5, genetic factors of different races of joint involvement is different, such as hip, carpometacarpal joint osteoarthritis in the Caucasian, but people of color and the country is rare, gender also has an impact, the disease is more common in women. Data show that the incidence of osteoarthritis in women with Heberden’s nodes is two to three times higher in their mothers and sisters than in their families without the disease.
2, clinical manifestations
1, slow onset, mostly seen in middle-aged and elderly obese women, often with a history of exertion.
2. The pain in the knee joint increases with activity, characterized by paroxysmal pain at first, then persistent pain, worse with exertion and at night, and obvious pain going up and down stairs.
3. The knee joint activity is limited, or even limping. Very few patients may develop interlocking phenomenon or knee joint effusion.
4. There may be popping and grinding sounds when the joint moves, and some patients have swollen joints, and joint deformity can be seen over time.
5. Knee pain is a common complaint of patients with this disease. The early symptoms are pain when going up and down stairs, especially when going downstairs, unilateral or bilateral, and joint enlargement, mostly due to bony hypertrophy, or joint effusion. Synovial hypertrophy is rare. In severe cases, the knee is deformed.
3.Examination
Osteoarthritis is a chronic joint disease characterized by degeneration and destruction of joint cartilage and osteophytes. It is also known as proliferative knee osteoarthritis and age-related knee osteoarthritis.
It is most common in middle-aged and elderly people, with more women than men. The pathology is characterized by focal degeneration of articular cartilage, subchondral bone densification (sclerosis), marginal osteochondral redundancy and joint deformity.
4.Diagnosis
1. History of repeated strain or trauma.
2. Knee pain and stiffness, more pronounced in the morning when waking up, relieved by activity, aggravated by more activity, and relieved by rest.
3, Late pain persists, joint activity is significantly limited, quadriceps muscle atrophy, joint effusion, and even deformity and intra-articular free body.
4. Friction sounds can be detected during knee flexion and extension activities.
5. Frontal and lateral photographs of the knee joint show lip-like osteophytes on the joint edges of the patella, femoral condyles, and tibial plateau, the tibial intercondylar bulge becomes sharp, the joint space becomes narrow, the subchondral bone is dense, and sometimes intra-articular free bodies are seen.
5.Treatment
1.Non-surgical treatment (conservative treatment) includes physical therapy, drugs, injection therapy and Chinese herbal medicine treatment.
2.Surgical treatment
(1) Knee arthroscopy and cleanup This is a new and safe technique for diagnosing and treating knee diseases, which makes patients suffer less pain and complications, and has the characteristics of fast recovery and remarkable efficacy.
(2) Knee joint replacement Artificial knee joint replacement is a surgical procedure to replace the damaged knee joint partially or completely by artificially made joint parts.