GONARTHROSIS

Gonarthrosis is a pathological condition characterized by degenerative-dystrophic processes occurring in the knee joint (osteoarthritis of the knee). Gonarthrosis of the knee is characterized by the breakdown of cartilage and deformation of the joint, accompanied by impairment of its functions. Most often, this disease affects elderly women.

CAUSES OF GONARTHROSIS

There are two types of gonarthrosis causes: primary and secondary;

• Primary – the cause of its occurrence is not yet known; bilateral gonarthrosis frequently seen in elderly patients;
• Secondary – occurs against the background of an existing injury or knee pathology at any age; unilateral gonarthrosis.

In more than 20% of cases, the pathology develops after intra-articular tibial fractures, ligament ruptures, or meniscus deformities. Generally, gonarthrosis develops 5 years after the onset of the pathology, but in rare cases, it can appear after 3 months.

The onset of the disease can be caused by a heavy load on the joint. Athletes over the age of 40 who exercise regularly in the gym are at risk. Overloading during heavy exercises can cause degenerative-dystrophic changes. Not only exercise, but also the load on joints due to excess weight can lead to similar results.

 

WHAT ARE THE SYMPTOMS AND STAGES OF GONARTHROSIS?

Common symptoms of gonarthrosis of the knee joint include:

• severe knee pain during movement;
• impaired knee function;
• swelling of the knee joint;
• limping;
• joint stiffness;
• instability in the affected joint.

The development of the pathology is slow, and in the first stage, patients notice mild pain in the joints when walking or climbing. There is tightness and stiffness in the knee area. The main symptom is acute pain when getting out of bed after a long rest or at the beginning of walking. The joint pain syndrome disappears after warming up. The disease does not manifest itself visually except for swelling due to fluid accumulation. This causes mild swelling and a change in shape.

In most cases, gonarthrosis develops gradually and progresses through four consecutive stages.

Stage I – Gonarthrosis

First-degree gonarthrosis of the knee joint is characterized by the following features:

• Vague knee pain during squatting, climbing up/down stairs.
• “Start-up” pain at the beginning of movement.
• Limitation of mobility.
• Disappearance of discomfort after the patient “walks it off”.
• Knee pain after heavy physical load.
• The knee appears strongly or slightly swollen.
• Signs of synovitis may appear (inflammation of the inner lining, which causes fluid build-up in the joint).

Stage II – Gonarthrosis

Second-degree bilateral knee joint gonarthrosis has the following features:

Pain becomes more intense.

Discomfort increases rapidly during walking and bending.

Pain is localized inside the knees and gradually disappears during rest.

The joint enlarges, and fluid begins to accumulate inside it (synovitis).

Interstitial fluid can fill the subcutaneous space on the posterior surface of the joint (Baker’s cyst).

Stiffness may pass after physical warm-up.

The shape of the legs in the knee region changes (curvature occurs).

ANATOMY AND PATHOLOGICAL CHANGES IN THE JOINT

The knee joint consists of the tibial and femoral surfaces. In the anterior region, there is the patella, which extends along the depth between the femoral condyles. In this case, the fibula does not affect the functionality of the knee joint. The thigh and tibial surfaces have a cartilage layer with a thickness of 5 mm. It absorbs shocks and reduces friction during movement.

The disease begins to form with the disruption of blood circulation in the small vessels where blood enters the cartilage tissue. Consequently, the cartilage becomes dry and thin, leading to the loss of its cushioning function. The second stage of the pathology develops against the background of compensatory changes in the bone. Subchondral sclerosis forms, and osteophytes (bone growths in the form of spikes) form at the edges of the joint.

The joint capsule and synovial membrane become dry and deformed, and the joint fluid thickens (lubrication of the joints deteriorates). Destruction occurs because nutrients are not transported to the cartilage tissue. After the breakdown of cartilage, degenerative changes accelerate, triggering the development of the third stage of the disease. In the severe phase, depressions and changes in the shape of the bone occur, leading to decreased mobility and sharp knee pain.

DIAGNOSIS OF GONARTHROSIS

Professor Dr. Erol YALNIZ, as a Professor of Orthopedics and Traumatology, guarantees you accurate diagnosis and treatment of locomotive system diseases. Diagnosis of the disease includes the patient’s history, examination of the inflamed joint, range of motion control, and mobility assessment. To confirm the diagnosis, the Professor requests an X-ray image showing changes in the joint space.

TREATMENT OF GONARTHROSIS

Access to quality healthcare is very important. Good service means a comfortable stay during treatment. In our private hospital, a highly qualified healthcare team operates, placing great emphasis on the quality and professional treatment of patients.

Today, a complete cure for gonarthrosis is not possible, but the progression of the disease can be significantly delayed. The earlier the treatment starts, the longer the development of pathological processes is postponed, and when it comes to surgical treatment, it ensures positive results in our clinic. One of the most effective surgical intervention methods is knee arthroplasty (knee joint replacement), which can be total or partial.

In knee joint replacement, damaged bones and cartilage are replaced with metal and polymer components. They are shaped to restore motion and knee function. The new artificial knee joint is called an endoprosthesis. It usually consists of two metal components mounted on the edges of the tibia and femur. A polymer component is placed between them. The metal parts are made of steel, cobalt-chromium, or titanium alloys. For contact between the metal parts, durable and wear-resistant polyethylene (plastic) components are used. For the fixation of bone components, so-called bone cement is used, or they can also be placed without cement, directly attached to the bone. Partial replacement is possible when only one part of the knee joint is affected by the disease process, and only that part of the joint is replaced. The procedure is similar to total knee replacement. Here again, parts of the femur and tibia are replaced, with a polyethylene component placed between the metal parts. A consultation is performed a week before, the day is scheduled, and on the morning of the surgery at 8:30 AM, the patient is admitted on an empty stomach. After surgical treatment, you will be given painkillers or non-steroidal anti-inflammatory drugs. On the first day after surgery, the physiotherapist will show you some exercises to perform for a faster recovery. Your hospital stay depends on many factors: your age, general condition, presence or absence of other accompanying diseases (averaging 3-7 days). Our hospital provides everything you need for your health.