What are the Symptoms of Knee Arthritis (Gonartrosia)?
It all starts with joint pains that flare up when doing certain sports, going up and down stairs, and sometimes just walking. A medical examination eliminates other knee diseases, including hip arthritis, which can cause knee pain, and determines the diagnosis. The knee is an important joint that carries weight, and therefore this disease gradually begins to affect the daily life of the patient. Exacerbations become more frequent, the pain worsens, leading to stiffness and decreased movement, thereby endangering the general mobility of the patient. Deformities may occur in the knee in the advanced stages of gonartrosis.
What is Knee Arthritis (Gonartrosis)?
It is the joint between the knee, thigh, tibia bones and kneecap. The sliding surfaces of these bones are covered with cartilage, which helps absorb shocks. Knee arthritis is the wear and tear of this cartilage. However, it is not this wear and tear that causes pain, but arthritis due to excessive friction as a result of deterioration. Knee arthritis is mostly related to the joint between the thigh and tibia bones (femorotibial osteoarthritis); it can also affect the joint between the kneecap and the femur (pathofemoral osteoarthritis) or the entire joint (total knee osteoarthritis). In most cases, it affects both knees of the patient. An X-ray will determine whether it is primary arthritis due to aging of the joint or secondary calcification caused by a trauma.
What is the Treatment of Knee Arthritis (Gonartrosis)?
In the early stages of the disease, certain lifestyle choices can help alleviate the effects. It is important to monitor your weight as excess weight is a risk factor and can worsen knee arthritis. Likewise, appropriate physical activities are highly recommended. Anti-inflammatory drugs are prescribed to relieve pain and hyaluronic acid and corticosteroid injections can be considered if necessary. Surgery can be considered as a last resort or in the later stages of the disease: an arthroscopy can be performed to cleanse the joint and remove the particles that cause inflammation. An osteotomy can be performed to realign the knee structure, which may be the cause of gonartrosis. Finally, total knee replacement (total knee arthroplasty) can be performed to replace the worn joint with a synthetic joint, thereby restoring good joint mobility and returning to a normal life.
What is Knee Arthritis (Gonartrosis)?
Disease pathology of knee osteoarthritis (OA) is characterized by degeneration of joint cartilage and associated subcondral bone. Although inflammatory processes are present at certain stages of the disease, it is traditionally classified as non-inflammatory arthritis.
Primary knee OA is thought to be caused by repetitive mechanical stress that initiates and sustains degeneration. Secondary OA is initiated by inflammatory conditions resulting in previous trauma, sepsis or joint instability, incompatibility of the joint surface and/or altered cartilage metabolism.
What are the Symptoms of Knee Arthritis (Gonartrosia)?
Symptoms of knee osteoarthritis usually appear gradually and can include any of the following:
- Pain in the knee joint – usually worse after severe activity and towards the end of the day
- Pain can spread from the affected knee up (thigh) or down (tibia)
- Stiffness of the knee joint – mainly happens in the morning or after rest, and lasts less than 30 minutes or is lightened by walking
- Swelling of the knee joint – swelling can be soft (caused by additional joint fluid) or hard (caused by bone growths called osteophytes)
- Thigh or calf muscle weakness
- Squeaking, tingling, or crackling sound as the array moves
- Knee may feel like it’s ‘locking’, ‘sticking’ or slipping during periods of activity
- The pain usually eases while resting.
How to Diagnose Knee Arthritis (Gonartrosis)?
Your doctor may ask when you first noticed pain or stiffness, whether you felt discomfort continuously or only at certain times or during certain activities, whether pain prevented you from moving your leg in certain ways, whether you heard a squeak or clicking sound during movement, whether pain or other symptoms limited your daily activities. They also want information about any previous knee injuries or knee surgery.
Your doctor carefully examines your knee during a physical examination to look for signs of osteoarthritis. To assess the flexibility and range of movement of the joint, it can gently move the knee and leg and listen to crackling or clicking sounds in the joint, called crepitus, which can be a sign of joint damage.
It can also press slightly on your knee to test sensitivity and determine if any discomfort is caused by movement in the joints. Torn soft tissue in the knee can cause similar symptoms, and our doctors can distinguish between osteoarthritis and another type of knee injury.
Knee X-rays should be taken standing up, provide clear and detailed images of the knee joint and can reveal bone protrusions or narrowing of the joint, which is the classic feature for diagnosing knee osteoarthritis. A healthy knee joint appears to have a gap between the bones in an X-ray because it acts as a pillow between cartilage, femur and tibia. X-ray examination is sufficient to diagnose knee arthritis
What are the treatment options for knee arthritis (Gonartrosis)?
Knee osteoartritis is a complex condition and there is no treatment to reverse the wear changes on the joint surface once it begins to occur. Treatment or management of knee osteoarthritis should be tailored to each individual, depending on the severity of the condition and how it affects the affected person. In the early stages of this condition, where the symptoms are mild, conservative or non-surgical treatment is usually recommended. Principles of non-surgical management focus around patient training, activity and lifestyle change, weight loss, use of physical aids and careful use of drugs to reduce or alleviate symptoms. Special exercise programs can help win over patients with patellofemoral arthritis. There is limited room for injectable treatments for knee arthritis. These measures are about making it easier to cope with symptoms (usually pain and stds) on a “daily basis”.
The operative management or surgery of knee osteoarthritis is really only indicated for the final stage of the “bone on bone” joint surfaces. In most cases, surgery for early or moderate-stage disease does not significantly improve symptoms or function. Arthroscopic surgery usually does not help in an arthritic knee unless there are significant mechanical symptoms (locking or stuttering) and a displaced meniscus tear or loose body. In patients with advanced but isolated single compartment arthritis, realignment procedures (osteotomy) or partial single compartment knee replacement surgery (UKDA) can be considered.
Total Knee Replacement (TKP) is the preferred treatment method in patients with advanced knee osteoarthritis, where 2 or 3 compartments are usually kept, incurable pain and very significant dysfunction (the ability to walk, bend and perform simple daily life activities). It should be noted that TKP is a reconciliation operation and will never be able to provide the recipient with a completely normal knee. However, TKP is usually very successful in ensuring significant relief of pain and restoration of function in a significantly impaired individual with end-stage disease.