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.
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, dense cartilage (sclerosis), marginal osteochondral redundancy and joint deformity.
Etiology
1, chronic strain: 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 a factor that aggravates the disease. 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 people 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 are not osteoarthritis.5. Genetic factors: The involvement of joints varies from race to race, and gender also has an impact, with the disease being more common in women.
Performance
1. Slow onset, mostly 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, more so at night with exertion, 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 may become inversion deformity.
Diagnosis
1. History of repeated strain or trauma.
2. Knee pain and stiffness, more pronounced when waking up in the morning, 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 photographs of the knee joint show lip-like osteophytes on the joint edges of the patella, femoral condyles, and tibial plateau, with the intercondylar bulge of the tibia becoming pointed, the joint space narrowing, and dense subchondral bone, and sometimes intra-articular free bodies are seen.
Treatment
1.Non-surgical treatment (conservative treatment) includes physical therapy, drugs, injection therapy and Chinese herbal medicine treatment.
2.Surgical treatment: (1). Knee arthroscopy is a safe and practical new technique for diagnosing and treating knee diseases, resulting in less pain, fewer complications, faster recovery and more effective treatment. (2). Knee joint replacement Artificial knee joint replacement is a surgical procedure that replaces part or all of the damaged knee joint with an artificially manufactured joint component. The worn and damaged joint surface is removed and implanted like braces to restore a normal smooth joint surface.
Care
1. Pay attention to warmth and cold, preferably not to be poured by rain in summer, and bring knee pads outside in winter. Use hard knee pads to protect the stability of the knee joint.
2. Avoid strenuous, prolonged exercise. Often, some elderly people experience increased symptoms of knee osteoarthritis after strenuous exercise or prolonged walking, which can be unrelieved for a long time. Try to walk on level ground, less climbing or no climbing, when you have to go up and down stairs, it is best to use your hands to hold the railing to reduce the pressure.
3, pay attention to walking and labor posture, avoid prolonged squatting, long standing, do not drag the leg walking and labor.
4, should wear thick, soft-soled flexible shoes, women should not wear high-heeled shoes.
5, both to avoid excessive exercise, but also appropriate functional exercise, swimming and walking is the best exercise; followed by sit-ups, push-ups, taut legs of the movement is also good.
6, obese people should lose weight. Reduce weight, can reduce the load on the knee joint, to avoid aggravation of the disease.
7, diet should eat more food containing protein, calcium, collagen, such as: milk, dairy products, black fungus, fish and shrimp, beef tendons, etc..
8, functional exercise, the principle of functional exercise of the knee joint is based on active non-weight-bearing activities, such as straight leg raising exercise, so as to enhance muscle strength and maintain joint stability.
Osteoarthritis care considerations
1. Avoid repetitive micro-injuries. Repetitive micro-injuries can cause cartilage damage. Repetitive micro-injuries include those associated with work-related activities such as repeated or continuous kneeling, squatting or other positions that put increased stress on the knee joint. Do not or minimize climbing hills, stairs or activities such as squatting and standing, which can increase joint torque or overload the joint surface. Wear shoes with thick and flexible soles and good shock absorption, or wedge-shaped insoles in the shoes. Make the weight caused by the pressure on the joint cartilage redistribution, reduce joint stress.
2, pay attention to weight control: excess weight will increase the stress on the joints. Studies have found that every five kilograms of weight will increase the knee joint by ten kilograms of pressure; and if you subtract twenty kilograms of weight, the knee joint will be reduced by sixty kilograms of pressure. Excessive stress can cause changes in the normal structure of the joint and aggravate osteoarthritis.
3, leg pain when not more activity: weight loss that incorporates proper exercise can be more effective in reducing pain than weight loss alone or exercise alone. However, patients with osteoarthritis of the knee in the acute pain period should reduce the amount of activity, the view that the more painful the leg should be active is incorrect, because too much activity in painful situations will aggravate the wear and tear of the joint surface. Specific exercises such as swimming, leg pressing, tai chi, slow walking, cycling or elderly tricycling, and other non-weight bearing activities for the joints are appropriate.