Arthrosis of the knee joint or gonarthrosis is the most common form of arthrosis in Germany. This chronic disease belongs to the so-called rheumatic group of diseases. Its symptoms, the course of the disease and options for prophylaxis and therapy will be considered below.
What is knee joint arthrosis?
Schematic representation Difference between healthy joint, arthritis and arthrosis.
Osteoarthritis is generally understood to mean wear and tear on the joints that is significantly greater than a measure corresponding to the respective age. This degenerative wear and tear can be treated by conventional medicine, but is ultimately considered incurable. See AbbreviationFinder for abbreviations related to Knee Osteoarthritis.
In osteoarthritis of the knee – also known as gonarthrosis – at least one of the three cartilaginous joint surfaces of the knee joint is affected. The joint cartilage becomes rough and loses its elasticity, so that the function of the joint is increasingly restricted and mobility is reduced.
If the kneecap joint is affected, retropatellar arthrosis is present. Medial gonarthrosis refers to the inner or medial parts of the femorotibial joint. And knee arthrosis in the external femorotibial joint is called lateral gonarthrosis.
There is disagreement about the causative triggers of osteoarthritis of the knee joint and, as a result, about the indicated treatment options. Alternative therapists regard arthrosis as a disease of civilization that is less characterized by wear and tear and is caused by stress and wear and tear than that it results from a sedentary lifestyle and poor diet.
However, the generally high importance of a suitable diet with regard to osteoarthritis of the knee joint is undisputed in both camps. Conventional medicine considers joint dysplasia, incorrect loading or overloading, for example due to increased body weight, as well as inflammatory reactions (secondary arthrosis) to be classic triggers of knee joint arthrosis. Secondary arthrosis is also called osteoarthritis, while stress-induced primary arthrosis is called osteoarthrosis.
Drugs, especially antibiotics, can also cause osteoarthritis of the knee joint if they damage the hyaline articular cartilage. Osteoarthritis can in principle be classified according to its cause: Is there increased accumulation of homogentisic acid in the joint (arthrosis alcaptonurica), is there a mechanical influence of uric acid (arthrosis urica), or is there regular bleeding (hemophilic arthritis).
Symptoms, Ailments & Signs
Osteoarthritis of the knee joint is initially manifested by the typical start -up pain and stiffening of the joints. Those affected feel an unpleasant, mostly dull pain in the affected knee in the morning after getting up or after sitting for a long time.
This subsides after a few steps, with the suffering phases lasting longer and longer as the disease progresses. The same applies to morning stiffness of the joints, which usually lasts 20 to 30 minutes. If the osteoarthritis is based on rheumatoid arthritis, the joints often stiffen for several hours. The affected knee joint is painful when pressure is applied and is generally less flexible than before.
This can lead to movement restrictions. Osteoarthritis can often be recognized by a grinding or grinding noise. In addition, the affected joint is slightly swollen. Some people develop bruising around the knee. The signs of the disease often appear in phases, whereby the phases can vary greatly in intensity and duration.
External circumstances such as cold and damp often lead to an increase in the symptoms, while the symptoms decrease with warmth and rest. In the long term, the symptoms worsen. If the course is severe, the knee joint can stiffen permanently and lose its function completely.
Diagnosis & History
In any case, the course of the disease is characterized by progressive damage and degradation of the knee cartilage. Initially it is cracked and rough, then it becomes less elastic. The synovial fluid (joint fluid) is also no longer produced to the normal extent. Eventually, the layer of cartilage between the bones shrinks. Sclerosis and bony bulges can occur in the bone on the cartilage.
Osteoarthritis of the knee joint usually progresses slowly. If the femur and tibia rub painfully directly on each other from the last stage, the knee joint can stiffen in the long term. Even the loss of the knee joint is possible. Osteoarthritis of the knee is a self-reinforcing disease:
Pain and loss of function entail compensation through our musculoskeletal system, muscle tension and renewed poor posture, followed by further joint deformation and increasing complaints, which finally also occur when we are at rest. Muscles harden, shorten and atrophy. Inflammation occurs. Since cartilage tissue is not supplied with blood directly, it only regenerates very slowly.
Osteoarthritis of the knee causes most patients to suffer from severe pain. These can occur in the joints and limbs. This leads to severe movement restrictions and other limitations in everyday life. It may also no longer be possible to carry out a professional activity as usual.
The affected regions of the body can also be swollen and bruises can form. Often the knees also hurt, which leads to an unhealthy protective posture. The quality of life of the patient is significantly reduced by knee joint arthrosis. As a rule, there is no spontaneous healing, so that treatment by a doctor is necessary in any case.
The treatment of knee arthrosis does not lead to further complications. With the help of painkillers or various therapies, the pain and discomfort can be limited relatively well. A healthy lifestyle can also have a very positive effect on the life and everyday life of those affected. The patient’s life expectancy is usually not reduced by osteoarthritis of the knee. In some cases, however, surgical interventions or prostheses may be necessary.
When should you go to the doctor?
Joint problems often go away on their own. If pain, restricted mobility and the like persist for several weeks or months, a doctor should be consulted. Signs of osteoarthritis of the knee joint should always be clarified in order to rule out complications. If you suddenly feel pain in your knee joint or suffer repeated fractures, you should see your family doctor or an orthopaedist. If the pain changes suddenly, this is a reason for another visit to the doctor.
Especially in the case of osteoarthritis of the knee, a changed symptom picture can indicate that the osteoarthritis is progressing and changing. People who have arthrosis in other parts of the body should inform the doctor responsible if they have problems with their knee joint. This is especially true if the symptoms are getting worse quickly. If the symptoms limit the quality of life, a speedy clarification is indicated. Otherwise, in addition to the physical symptoms, there may also be mental problems that require independent treatment. If the symptoms occur in a child, the responsible pediatrician must be consulted in any case.
Treatment & Therapy
Osteopathy in the context of arthrosis of the knee joint. Click to enlarge.
Arthrosis of the knee joint may be part of the normal aging process – if the knee joint hurts under light strain, for example walking down stairs, this can be the first symptoms of the disease. After the diagnosis, there are essentially three treatment options: With conservative treatment, the focus is on reducing the symptoms of osteoarthritis of the knee and slowing down the progression of the disease. That means administration of painkillers or anti-inflammatories, for example cortisone can reduce the irritation.
Injecting hyaluronic acid can also provide relief by improving joint lubrication. The condition of the knee joint cartilage does not improve without symptoms, but the ligaments and muscles work without cramping. To strengthen the muscles, especially the extensor muscles in the thighs, physiotherapy, adequate training, electrical stimulation and electrical muscle stimulation are helpful. Regular exercise promotes the natural stabilization of the knee joint because it stimulates the metabolism, promotes the supply of nutrients and at the same time the removal of harmful waste products.
It is mainly alternative therapists who focus on a healthy metabolism. In her eyes, it is important to avoid acidic foods such as meat, sausages and eggs, as well as convenience foods and cooked foods. The proportion of raw food, fresh fruit and vegetables should be increased. Vital substances such as calcium, magnesium, vitamin C and vitamin D are important for building or regenerating bone and cartilage substance. Weight control, more exercise and a change in diet stop overloading and waste products and have a positive effect on the metabolism. Therapeutic fasting has been proven to help arthrosis patients.
The third and final treatment option is arthroscopic therapy. During surgical procedures, ligaments can be regenerated, cartilage smoothed, the leg axis corrected and the kneecap relocated. After this joint-preserving operation on the knee that has not yet been completely destroyed, the only option left is the joint replacement: knee prosthesis or partial prostheses.
Outlook & Forecast
The prognosis of knee arthrosis is described as unfavorable. It is a chronic disease with a progressive disease course. Without treatment, the problems will continue to escalate. The consequences are restricted movement, pain and a decrease in physical resilience. Ultimately, the affected person needs walking aids or a wheelchair in order to be able to move around.
With medical and medical care, further developments improve. Although there will be no cure or freedom from symptoms, doctors and medical professionals can delay the progression of the disease. The sooner a diagnosis can be made, the better the options for action are. By administering medication, targeted training for optimal movement and the cooperation of the patient, an alleviation of existing complaints is achieved. In addition, the course of the disease can be positively influenced. Poor posture is corrected and the muscular system is supported.
Despite all efforts, the development of osteoarthritis of the knee joint cannot be stopped completely. In an advanced stage of the disease, doctors recommend surgical intervention. An implant is inserted so that the patient’s ability to move is preserved. This improves the general quality of life. The surgery is associated with various risks and side effects. At the same time, the patient must learn to be able to move with an artificial knee joint.
A healthy lifestyle with moderate, regular exercise and a moderate diet rich in vital substances is the best way to prevent osteoarthritis of the knee joint. In particular, gentle movement sequences such as swimming, cycling, hiking or water aerobics promote the natural health of the knee without any problems: strong muscles, well-supplied and lubricated knee joints.
Osteoarthritis of the knee requires consistent follow-up care, which above all aims to prevent or at least delay the deterioration of the findings. Follow-up care is coordinated with the treating orthopedist and physiotherapist and requires the patient’s active cooperation to ensure that the process goes as smoothly as possible.
As part of the aftercare, it is particularly important to stabilize the weakened knee through targeted muscle building. For this purpose, patients learn suitable exercises from the physiotherapist or in rehabilitation sports, which are then carried out on their own at home or in the gym. The muscles then hold the knee joint like a corset during many movements and often prevent further damage. There are also exercises that maintain or promote mobility in the knee.
Protection of the knee is nevertheless important in order to prevent further wear and tear. This includes avoiding massive bending and twisting movements that put a strain on the joint. However, light endurance movements are desired. They promote the synovial fluid, the so-called synovia, which can improve the gliding ability in the knee joint.
The doctor or physiotherapist decides which sports are suitable for the individual case. However, sport with duels or jumps is absolutely unsuitable for knee arthrosis due to the high risk of injury or further wear and tear. Stability in the knee joint can be additionally improved during sports by wearing a knee bandage.
You can do that yourself
In the case of osteoarthritis of the knee, a healthy diet and consistent exercise are the main things that help. Those who exercise regularly reduce the symptoms and delay the installation of an artificial knee joint. Trigger point acupressure and stretching exercises have proven particularly effective. In connection with gentle sports such as swimming, the joint can be made mobile again relatively risk-free.
A consistent diet also helps many arthrosis patients. On the one hand, a healthy and balanced diet reduces weight and thus also relieves the strain on the knee joints. On the other hand, certain foods reduce the symptoms while others increase them. Acidic foods such as meat, sausage and eggs as well as convenience foods should be avoided. A suitable nutrition plan is best developed with a nutritionist. In addition, warm mud baths have an anti-inflammatory effect, relax cramped muscles and stimulate the metabolism.
Other natural remedies that help with osteoarthritis of the knee are, for example, spice mixtures, leeches of incense capsules. Bathing in a tub with medicinal herbs such as chamomile or lemon balm also helps against joint wear and tear. In consultation with the doctor, a therapeutic fasting can also be carried out. In general, all measures should be discussed with a doctor beforehand so that no undesirable complications occur later.