Osteoarthritis is a chronic joint disease in which the main changes are degeneration of the cartilage surfaces of the joints and secondary osteophytes. The main manifestations are joint pain and inflexibility. X-rays show narrowing of the joint space, dense subchondral bone, broken trabeculae, sclerosis and cystic changes. There is lip-like hyperplasia at the edge of the joint. 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 an intra-articular free body. Osteoarthritis, also known as degenerative arthritis, is not actually an inflammatory condition, but is primarily a degenerative condition that involves premature aging of the joints, particularly the articular cartilage. Osteoarthritis represents the aging of the joints and is therefore called age-related arthritis. The broader term osteoarthritis also includes a number of other aseptic arthritic disorders.
Causes
1, chronic strain injury: long-term poor posture, weight bearing, excessive weight, resulting in soft tissue damage to the knee joint.
2, obesity: the increase in weight and the onset of osteoarthritis of the knee is proportional. Obesity is also an aggravating factor. Weight loss in obese people can reduce the onset of osteoarthritis of the knee.
3, bone density: when the subchondral bone trabeculae become thin and stiff, its tolerance to pressure is reduced, so the chances of osteoarthritis in osteoporotic patients 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: joint involvement varies from race to race, such as hip, carpometacarpal joint osteoarthritis in Caucasians, 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 mothers and sisters of women with Heberden’s nodes is two to three times higher than in family members without the disease.
Manifestations
1. Slow onset, mostly in middle-aged and elderly obese women, often with a history of exertion.
2. Pain in the knee joint increases with activity, characterized by paroxysmal pain at first, then persistent pain, more so 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.
It can also be caused by joint effusion. Synovial hypertrophy is rare. In severe cases, the knee is deformed.
6. Knee stiffness and inflexibility, especially in the morning and after sitting for a long time, often cannot walk on the ground immediately, but need to move around for a while, and can walk only after the stiffness and pain are reduced.
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 movement is significantly limited, quadriceps 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 radiographs of the knee joint in weight-bearing position 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 significantly narrower, the subchondral bone is dense, and sometimes intra-articular free bodies are seen.
Treatment plan
Conventional treatment
1.Non-surgical treatment (conservative treatment) includes physiotherapy, drugs, injection therapy and Chinese herbal medicine for the affected knee.
2.Surgical treatment
(1).Knee arthroscopic exploration and cleaning This is a new and safe technique for the diagnosis and treatment of knee diseases, which makes the patient suffer less pain and complications, and has the characteristics of fast recovery and significant curative effect.
(2) Knee joint replacement
Artificial knee replacement is a surgical procedure in which the damaged knee joint is partially or completely replaced by an artificially manufactured joint component. The worn and damaged joint surface is removed and implanted like a brace to restore a normal smooth joint surface.