Knee Joint Osteoarthritis: Causes, Symptoms & Treatment

Knee joint osteoarthritis or gonarthrosis is the most common form of osteoarthritis in Germany. This chronic disease belongs to the so-called rheumatic forms. Its symptoms, the course of the disease, and options for prophylaxis and therapy will be considered below.

What is osteoarthritis of the knee joint?

Schematic diagram difference between healthy joint, arthritis and osteoarthritis. Click to enlarge. Osteoarthritis generally refers to wear and tear of the joints that is significantly greater than a level appropriate for the individual’s age. This degenerative wear and tear is treatable by conventional medicine, but is ultimately considered incurable. In knee joint arthrosis – 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 joint is increasingly restricted in its function and loses mobility. If the patellar joint is affected, retropatellar arthrosis is present. Medial gonarthrosis refers to the inner or medial parts of the femorotibial joint. And knee joint osteoarthritis in the outer femorotibial joint is called lateral gonarthrosis.

Causes

There is disagreement about causative triggers of knee joint osteoarthritis and, as a result, indicated treatment options. Alternative therapists consider osteoarthritis as a disease of civilization, which is less to be characterized with wear and tear and caused by stress and wear and tear, but rather that it stems from a sedentary lifestyle and improper diet. However, the generally high significance of a suitable diet with regard to knee joint arthrosis is undisputed in both camps. For conventional medicine, joint dysplasia, incorrect loading or overloading, for example due to increased body weight, as well as inflammatory reactions (secondary arthrosis) are considered to be classic disease triggers of knee joint arthrosis. Secondary osteoarthritis is also called osteoarthritis, whereas load-induced primary osteoarthritis is called osteoarthrosis. Drugs, namely antibiotics, can also contribute to knee joint osteoarthritis if they damage the hyaline articular cartilage. Osteoarthritis can in principle be classified according to its cause: Is there increased deposition of homogentisic acid in the joint (arthrosis alcaptonurica), is there a mechanical influence of uric acid (arthrosis urica), or is there regular bleeding (hemophilic arthrosis).

Symptoms, complaints, and signs

Osteoarthritis of the knee joint is initially manifested by the typical start-up pain and stiffness of the joints. Those affected feel an unpleasant, usually 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 periods of suffering lasting longer and longer in the course of the disease. The same applies to the morning stiffness of the joints, which usually persists for 20 to 30 minutes. If the osteoarthritis is based on rheumatoid arthritis, the joints often stiffen for several hours. The affected knee joint hurts when pressure is applied and is generally less mobile than before. This can lead to limited range of motion. Osteoarthritis can often be identified by a grinding or rubbing sound. In addition, the affected joint is slightly swollen. In some sufferers, bruising develops in the area of the knee. The signs of the disease often occur in phases, and the phases can vary greatly in intensity and duration. External conditions, such as cold and damp, often lead to an increase in symptoms, while symptoms subside with warmth and rest. In the long term, symptoms intensify. In a severe course, the knee joint may stiffen permanently and lose its function completely.

Diagnosis and course

In any case, the course of the disease is characterized by progressive damage and degradation of the knee joint cartilage. Initially, it is cracked and rough, then becomes less elastic. The synovial fluid (joint lubricant) is also no longer produced to the normal extent. Eventually, the cartilage layer between the bones shrinks. Sclerosis as well as bone growths may occur in the bone at the cartilage. Knee joint osteoarthritis usually progresses slowly. If the femur and tibia rub painfully directly against each other from the last stage, the knee joint may stiffen in the long term.Even the loss of the knee joint is possible. Knee joint osteoarthritis is a self-reinforcing disease:

Pain and loss of function draw compensation from our musculoskeletal system, muscle tension, and renewed poor posture, followed by further joint deformity and increasing discomfort, eventually even at rest. Muscles harden, shorten and atrophy. Inflammation occurs. Since cartilage tissue does not receive a direct blood supply, it regenerates only very slowly.

Complications

Due to knee joint osteoarthritis, most patients usually suffer from severe pain. This can occur in the joints and limbs. This results in severe movement restrictions and further 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 may also be swollen and bruises may form. Often the knees also hurt, which leads to an unhealthy posture. The patient’s quality of life is significantly reduced by knee joint arthrosis. As a rule, spontaneous healing does not occur, so that treatment by a physician is necessary in any case. The treatment of knee joint arthrosis does not lead to further complications. With the help of painkillers or various therapies, the pain and discomfort can be relatively well limited. Likewise, a healthy lifestyle can have a very positive effect on the life and daily routine of the affected person. The patient’s life expectancy is usually not reduced by knee joint osteoarthritis. In some cases, however, surgical intervention or prostheses may be necessary.

When should you see a doctor?

Joint pain often goes away on its own. If pain, restricted movement and the like persist for several weeks or months, a doctor should be consulted. Signs of knee joint arthrosis should always be clarified to rule out complications. Anyone who suddenly experiences pain in the knee joint or repeatedly suffers fractures should consult their family doctor or an orthopedist. If the pain suddenly changes, this is a reason for another visit to the doctor. Especially in the case of gonarthrosis, a change in symptoms may indicate that the osteoarthritis is progressing and changing. People who have osteoarthritis in other parts of the body should inform the appropriate physician if they have complaints of the knee joint. This is especially true if the symptoms rapidly become more severe. If the symptoms restrict the quality of life, a rapid clarification is indicated. Otherwise, psychological problems may be added to the physical secondary complaints, which require independent treatment. If the complaints occur in a child, the pediatrician in charge must be consulted in any case.

Treatment and therapy

Osteopathy in the context of knee joint osteoarthritis. Click to enlarge. Knee joint osteoarthritis may be part of the normal aging process – if the knee joint hurts with light weight bearing, such as going down stairs, these may be the first symptoms of the disease. Once diagnosed, there are three main treatment options available: With conservative treatment, the focus is on reducing the symptoms of knee joint osteoarthritis as well as slowing the progression of the disease. This means the administration of painkillers or anti-inflammatory drugs, for example cortisone can reduce irritation. Injection of hyaluronic acid can also contribute to relief by means of improved joint lubrication. Without discomfort, the condition of the knee joint cartilage does not improve, but ligaments and muscles work without tension. To strengthen the muscles, especially the extensor muscles in the thigh, physiotherapy, adequate training, also stimulation current as well as 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. The focus on a healthy metabolism is mainly dealt with by alternative therapists. In their eyes, it is important to avoid acid-heavy foods such as meat, sausage, eggs, as well as convenience foods and cooked foods. The proportion of raw vegetables, fresh fruit and vegetables should be increased.Vital substances such as calcium, magnesium, vitamin C and vitamin D are important for building up and regenerating bone and cartilage substance. Weight control, more exercise and a change in diet stop overload and slagging and have a positive effect on the metabolism. Fasting has been proven to help osteoarthritis patients. The third and last way of treatment is arthroscopic therapy. During surgical interventions, ligaments can be regenerated, cartilage smoothed, the leg axis corrected, and the kneecap relocated. After this joint-preserving surgery of the knee that has not yet been completely destroyed, the only option is joint replacement: knee prosthesis or partial prosthesis.

Outlook and prognosis

The prognosis of knee joint osteoarthritis is described as unfavorable. It is a chronic disease with a progressive course. Without treatment, there is a steady increase in problems. Movement restrictions, pain and a decrease in physical resilience are the consequences. Eventually, the affected person needs walking aids or a wheelchair to get around. With medical and health care, further developments improve. Although there will be no cure or freedom from symptoms, doctors as well as medical professionals can delay the progress of the disease. The sooner a diagnosis is made possible, the better the options for action. The administration of medication, targeted training for optimal movement and the cooperation of the patient can alleviate existing symptoms. In addition, the course of the disease can be positively influenced. Malpositions are corrected and the muscular system is supported. Despite all efforts, the development of knee joint arthrosis cannot be stopped completely. In an advanced stage of the disease, doctors recommend surgical intervention. An implant is inserted so that the affected person’s range of motion is preserved. This results in an improvement in the overall quality of life. The surgery is associated with various risks and side effects. At the same time, the patient must learn to move around with an artificial knee joint.

Prevention

Accordingly, a healthy lifestyle with moderate, regular exercise and a diet rich in vital substances in moderation represents the best prevention against knee joint osteoarthritis. In particular, gentle exercise routines such as swimming, cycling, hiking or water gymnastics unproblematically promote the natural health maintenance of the knee: strong muscles, well-supplied and lubricated knee joints.

Aftercare

Knee joint osteoarthritis requires consistent aftercare, which is also primarily aimed at preventing or at least delaying a worsening of the condition. Aftercare is coordinated with the treating orthopedists and physiotherapists and requires the active cooperation of the patient for an optimal course. The most important aspect of aftercare is to stabilize the weakened knee through targeted muscle development. To this end, patients learn suitable exercises from the physiotherapist or in rehabilitation sports, which they then continue to perform at home or in the gym on their own. 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. Protecting the knee is nevertheless important in terms of preventing further wear and tear. This includes avoiding massive bending and twisting movements that put strain on the joint. However, light endurance movements are desirable. They promote the synovial fluid, the so-called synovia, which can improve the gliding ability in the knee joint. The doctor or physiotherapist will decide which sports are suitable for the individual case. However, sports involving dueling or jumping are absolutely unsuitable in knee osteoarthritis due to the high risk in terms of injury or further wear and tear. Stability in the knee joint can be additionally improved during sports by wearing a knee brace.

What you can do yourself

In the case of knee joint osteoarthritis, the main things that help are a healthy diet and consistent exercise. Those who exercise regularly reduce the discomfort and delay the installation of an artificial knee joint. Trigger point acupressure and stretching exercises have proven particularly effective.In conjunction with gentle sports such as swimming, the joint can be made mobile again relatively risk-free. A consistent diet also helps many osteoarthritis patients. On the one hand, a healthy and balanced diet ensures weight reduction and thus also relieves the strain on the knee joints. On the other hand, certain foods reduce the symptoms, while others intensify them. Acid-heavy foods such as meat, sausage and eggs as well as convenience foods should be avoided. A suitable diet plan is best worked out with a nutritionist. In addition, warm mud baths have an anti-inflammatory effect, loosen cramped muscles and promote metabolism. Other natural remedies that help with knee joint osteoarthritis include spice mixtures, leeches of frankincense capsules. Baths with medicinal herbs such as chamomile or lemon balm also help against joint wear. In consultation with the doctor, a therapeutic fast can also be carried out. In general, all measures should be agreed beforehand with a medical professional, so that no undesirable complications occur later.