Gonarthrosis

Definition: Gonarthrose

Gonarthrosis is a degenerative disease of the knee joint. It is associated with increasing destruction of articular cartilage, but all joint structures can be involved. These include the bones, ligaments, joint capsules and the surrounding muscles. Osteoarthritis of the knee usually progresses in phases. Inflammatory phases, in which the knee is swollen and reddened, alternate with non-inflammatory phases.

In an X-ray image, gonarthrosis shows very typical changes, which are used to classify it. However, it is important to keep in mind that not everyone with changes in the X-ray image also has symptoms.

Symptoms of gonarthrosis

The main complaint of osteoarthritis of the knee is pain . At the beginning, this is mostly movement-dependent, often occurs at the beginning of a movement and then subsides after a short time. This pain is called running-in or running -in pain . With increasing severity of the disease, however, the pain can progress to permanent pain and be accompanied by a significant reduction in the function of the joint. It can even occur at rest or at night. Due to the pain of gonarthrosis, those affected often have to resort to pain medication in order to be able to go about their everyday life.

In addition, gonarthrosis is associated with functional losses in the knee. It can lead to stiffness and restricted mobility that limit everyday life. In some cases, aids have to be used, for example to put on shoes, since bending down on the feet has become impossible.

Other possible complaints are:

• creaking noises in the knees (crepitations)
• Increased sensitivity to wet and/or cold

Causes of gonarthrosis

The exact mechanism behind the development of osteoarthritis is not yet known. What is certain is that many different factors contribute to the destruction of the affected joints. The progressive remodeling of the joint structures leads to painful functional restrictions and can affect all tissues and structures of the joint.

Central factors that play a role in the development of gonarthrosis are:

• Genetics: Osteoarthritis has a genetic component, but this varies from joint to joint.
• Age: With age, the regeneration capacity of the cartilage decreases, which promotes the development of arthrosis.
• Mechanical changes or loads on the knee
• A changed metabolic situation
• Inflammation of the knee joint

Articular cartilage is not dead tissue, but is subject to a dynamic interaction between build-up and breakdown. Incorrect stress or damage to the cartilage can, in combination with other stress factors, lead to an imbalance in the cartilage metabolism. When the cartilage’s regenerative capacity is exhausted, progressive cartilage loss can result. This causes inflammation, which in turn leads to increased cartilage degradation. A vicious circle is created that can lead to a complete loss of the cartilage layer.

In a joint, cartilage serves to form the smoothest possible surface to minimize friction during movement. In addition, it evenly distributes the pressure within the joint. When articular cartilage is damaged, new bone can form at the edge of the joint as the body tries to increase the surface area of ​​the joint to distribute weight better. Unfortunately, this new bone formation can cause additional discomfort.

How is the diagnosis “gonarthrosis” made?

In the case of the suspected diagnosis of “gonarthrosis”, examinations are used to clearly prove or rule out the presence of arthrosis in order to be able to initiate appropriate therapy.

In an individual consultation with the patient , your doctor can ask you what stresses your knees are exposed to, what previous illnesses you have or whether you may be pursuing particularly stressful leisure activities in order to assess the risk factors for osteoarthritis of the knee. In addition, it is important that you describe the pain in your knee precisely so that other knee diseases can be ruled out. The interview is followed by a physical exam and functional tests to check the mobility of your knee and whether you have a knee effusion, for example.

In some cases, it may be necessary to take a closer look at the knee with an x-ray and look for signs of osteoarthritis on the x-ray. In addition, magnetic resonance imaging (MRI) or a puncture of the joint are also possible.

When should I go to the doctor?

You should see a doctor if you experience joint pain or stiffness in your knees that won’t go away on their own.

What you can do yourself with gonarthrosis

Unfortunately, gonarthrosis is genetic in many cases, but there are a few things you can do to keep the risk as low as possible and minimize pain from an existing gonarthrosis:

• Avoid knee-straining activities in everyday life and at work.
• Avoid knee-straining sports.
• Do sports that are easy on the joints, such as swimming, cycling or water aerobics.
  One of the big misconceptions is that if you have knee pain, you should always avoid exercise. Many complaints improve with rest. If you suffer from gonarthrosis, however, it is important to move. While pain that lasts for hours after exercise is a sign that it was too much exertion, you shouldn’t give up exercise completely. Try again at a lower intensity for a few days, because muscles stabilize and protect joints, and movement provides better nutrition to cartilage. Gentle sports such as yoga or tai chi have shown good effects on arthrosis symptoms. However, you should let your teacher know in advance which joints you have problems with so that you don’t put too much strain on them.
• Maintain a healthy weight (BMI <25).
  Excess weight means extra stress on the joints that could be avoided. The joints that suffer the most from being overweight are the knees and hips.
• Heat and cold applications Both
  heat and cold can relieve pain. Heat relaxes the muscles and promotes blood circulation, while cold applications can provide relief after exercise.
• Capsaicin treatment Capsaicin is the substance that gives chili peppers their heat. Applying capsaicin patches directly to the painful area helps some people because the perceived heat leads to a decreased pain response. However, other people do not tolerate the initial burning sensation. If you want to try capsaicin ointments or patches, it is very important that you wash your hands well afterwards to avoid spreading the active ingredient and possibly getting it in your eyes, as it burns there too.

Pain therapy is of great importance in the treatment of arthrosis. Because osteoarthritis is a chronic condition, however, pain medication can quickly accumulate and lead to unwanted side effects. To keep the dose of painkillers as low as possible, creams and ointments have also been developed that you can apply directly to the affected area.

If it is necessary to take painkillers, you should be careful not to take them continuously, but only during periods of pain until the inflammation of the joint has subsided. You should discuss with your treating doctor which pain medications are suitable for you, since a combination with other medications can lead to interactions , and various organ systems can suffer from long-term use of pain medication. In addition, it may also be necessary to take a stomach protector, since many painkillers can lead to stomach ulcers.

Therapy of gonarthrosis

The major goals of therapy for gonarthrosis are:

• pain relief
• Improving the quality of life
• improvement of mobility
• improvement in walking performance
• Preventing the progression of joint damage

Even if the symptoms of osteoarthritis of the knee can be improved, it is not possible to reverse damage that has already occurred. It is therefore important to draw up an individual care plan that can be gradually escalated depending on the severity of the osteoarthritis and the symptoms.

The treatment of gonarthrosis begins conservatively, without surgery. The most important treatment is physiotherapy , which aims to relieve the symptoms and strengthen the surrounding muscles through strength, endurance and mobility training. Other options include rehabilitation, bandages, occupational therapy and many others. As a natural healing method, acupuncture has shown a good effect in the treatment of knee pain in several studies. In addition to these treatments, aids can make everyday life easier.

If non-invasive procedures do not sufficiently restore freedom from pain and mobility, surgical treatments may be necessary depending on the stage and the level of suffering.

Here’s how Med-Healths can help

If you have had knee pain for a long time and are not sure which illnesses could be behind it, you can book a consultation with a doctor via Med-Healths and get a rough classification of the possible triggers. A physical examination of the knee is of course not possible during the interview, but you can get a direct referral to a doctor on site, who can then look at the joint.