Related articles: Gonarthrosis
Definition
Gonarthrosis (or osteoarthritis of the knee) is a chronic-degenerative disease characterized by the destruction and potential loss of the articular cartilage of the knee. Over time, this process causes progressive damage to the joint and a significant limitation of movements.
Gonarthrosis is a pathology typical of old age (over 60 years), but can also occur in younger subjects (40-50 years).
The wear of the articular heads is often due to deviations of the femoral axis with the tibia (varus and valgus knee) and problems of overweight. Gonarthrosis can also result from a previous morbid condition, such as fracture outcomes, previous joint infections and osteonecrosis. In rare cases, gonarthrosis recognizes systemic causes, such as some dysmetabolic diseases.
Osteoarthritis of the knee can be spread to the whole joint, involving only the medial or lateral femoral tibial compartment (unicompartmental arthrosis) or exclusively affecting the patellofemoral joint.
Most common symptoms and signs *
- Knee pain
- Articolar pains
- Muscle pains
- Sore legs
- Swollen legs
- Legs tired, heavy legs
- Joint swelling
- Nodule
- osteophytes
- Joint stiffness
- Articular noises
Further indications
Gonarthrosis manifests itself with pain in the knee area (gonalgia), exacerbated by maximum flexion. Initially, this symptom is occasional, it is accused after prolonged efforts (eg long walk, climbing a few flights of stairs etc.) and is readily relieved by rest; over time, however, the frequency of pain can increase, eventually becoming persistent and even disturbing sleep.
Excessive production of synovial fluid from the inflamed capsule creates swelling, a feeling of tension or pressure. Gradually, gonarthrosis can lead to poor joint function and difficult walking (lameness).
In advanced stages, joint wear tends to determine or aggravate an axial deviation in varus or valgus of the knee. The growth of osteophytes (small bony growths due to erosive or chronic irritative pathological processes) is associated with an increase in flexion-extension noise (articular bursts). With the worsening of the disease, the ligamentous apparatus also suffers damage and causes sensations of joint failure and instability.
The diagnosis of gonarthrosis involves carrying out an X-ray in load (ie in an upright position) in the anteroposterior and lateral projections, to evaluate cartilage wear when the weight of the body weighs on the joint. This examination also allows us to highlight the fundamental radiological signs of arthrosis, namely reduction of the articular rima (caused by the consumption of cartilage), thickening of the bone below the worn or suffering cartilage (bone sclerosis), geodes (areas of bone gap) and osteophytes.
Following the diagnosis, the specialist can decide whether the problem can be controlled with the aid of supports (such as a stick), intra-articular infiltrations of hyaluronic acid preparations (local viscosupplementation), weight loss and rehabilitation exercises.
Other therapeutic approaches that may prove useful are specific dietary supplements (preparations based on glucosamine, chondroitin sulphate and similar compounds), analgesics, cortisone infiltration and physical therapies (such as lasers, ultrasounds and electrophoresis).
In the initial forms, it is possible to perform corrective interventions (osteotomies) which, realigning the limb, arrest or slow down the joint degeneration. If the disorder is more serious, however, surgery may be necessary, which may include the implantation of total or partial prostheses.
