The diagnosis is made primarily on the basis of the symptoms described, the physical examination (e.g. frictional pain in the kneecap) and an X-ray. Typical signs such as a narrowing of the joint space, bone attachments and deformities may be visible here. However, the extent of the changes on the X-ray does not necessarily correspond to the severity of the complaints. If anything is unclear, infections and inflammatory rheumatic diseases should be excluded.
Therapy of knee arthrosis
Initially, the therapy of osteoarthritis in the knee should be started with a reduction of the load on the knee joint: Physiotherapeutic measures (see knee school arthrosis) should improve and maintain the mobility of the joints and targeted muscle building should counteract possible malpositions. Here, therapy with ultrasound waves is a good option. Depending on the condition of the patient, heat or cold can provide relief from pain.
Drugs such as: are successfully used for pain therapy. During an activated arthrosis, injections of glucocorticoids into the knee joint gap can reduce the inflammation and accelerate its subsidence. Multiple injections of hyaluronic acid into the joint space lead to improved mechanical properties of the cartilage and synovial fluid.
Depending on the patient’s level of suffering and the prospects for improvement, there are various options for surgical treatment of osteoarthritis of the knee. In addition to minor procedures (arthroscopy of the knee) such as knee joint lavage or debridement, especially in the case of minor arthrosis, there are also osteotomies and prosthetic knee joint replacement (knee prosthesis). Knee joint replacement procedures are currently the method of choice for severe arthrosis.
If the middle or outer joint space alone is affected, a unilateral (unicondylar) surface replacement (“sled prosthesis”) can be used. If pangon arthrosis is present (all surfaces of the joint are affected), a complete surface replacement, a total knee joint endoprosthesis (knee prosthesis for short) would be preferred. Depending on the condition of the ligamentous apparatus of the knee, different variants of prostheses are possible, which must be selected according to the clinical picture. – Weight Loss
- Appropriate nutrition for osteoarthritis
- Improvement of the damping (e.g. through a running analysis) and
- Sports that are easy on the joints, such as swimming, Nordic walking or crosstrainer and easy jogging (see: Sports for knee arthrosis, strengthening exercises for knee arthrosis and May one jog despite knee arthrosis)
- Cox 2 inhibitor or
- Also weak opioids
Prognosis and prophylaxis
Osteoarthritis in the knee is to be prevented above all by balanced loading in the knees. This includes: Even if all these factors are taken into account, the development of arthrosis in the course of life cannot be ruled out, as it is also decisively dependent on genetic factors. If arthrosis is present, it can only be treated symptomatically and can only be largely cured with a knee prosthesis.
It should be noted that a joint prosthesis can only approximately restore the movements and stability of the natural knee. The course of the disease can vary greatly. While some patients have only minor complaints for years and can live well under conservative therapy, there are also contrary examples where a knee prosthesis is inevitable within a few years.
and knee arthrosis, when does surgery have to be performed? Depending on the constitution of the patient, surgery may not be appropriate (e.g. osteoporosis, multimorbidity). The arthrosis in the knee can lead to such a pronounced walking disability that a wheelchair or walking aids are necessary for locomotion. – Body weight within the normal range
- Straight axis of the legs (footwear / insoles)
- Joint-gentle sport (swimming, cycling)
- Avoid additional weight load by carrying heavy objects.