Main focus trauma surgery / orthopaedics - knee joint arthrosis
Knee joint
The knee joint carries our entire body weight and sometimes a lot more.
On average, a human being takes about 1.5 million steps a year and carries out numerous other movements. To make all this possible for us, the knee joint is composed of an open joint which is made up of the long femur, the shinbone (fibia) and the kneecap and stabilised by ligaments and muscles. A layer of cartilage and the so-called synovial fluid keeps the bones apart from each other and so ensures almost perfect movement free of pain.
Knee joint arthrosis
Knee joint arthrosis is a painful deteriorative illness with a progressive and non-curable loss of articular cartilage and a pathological alteration of the neighbouring bone often spanning many decades. In addition to hip joint arthrosis, this is the most common degenerative illness affecting the extremities. In Germany, this affects 15 percent of all 65-year old people; whereby women are taken ill more often than men. The average age at the outset of the illness is between 65 and 70 years.
Development of knee joint arthrosis
Many factors are involved in the development of an arthrosis; whereby genetic make-up certainly plays an important role. Despite nature's excellent protective measures - such as a high strength of our hyaline cartilage, synovial fluid as well as the buffer function of the menisci - each joint is naturally exposed to normal deterioration during the course of a lifetime. This applies in particular for the hip joint and the knee joint which have to carry the full force coming from the body. The smooth cartilage layer of tissue becomes damaged and rough from abrasion during the course of one's life due to strains incurred during work and leisure time. Small furrows and tears occur, cartilage cells die off. Small cartilage fragments have the effect of sand in an engine and irritate the knee's inner skin and cause an inflammatory reaction which, in turn, can then damage the cartilage that is still intact. The result is the development of effusion and pain. Adults are no longer able to develop our body's innate hyaline cartilage. The joint is permanently damaged.
Risk factors
Risk factors for arthrosis are considered to be:
- age
- overweight
- female gender
- strain caused by heavy physical work such as frequently carrying heavy weights, in particular from a squatting position or many years of work using a jackhammer
- axial malpositions of the legs such as knock knees or bandy legs
- lack of exercise
- gout
- diabetes
- malnutrition such as insufficient vitamin C and D
- earlier damage to the cartilage caused by bacterial joint infections
- damage caused by accidents such as broken bones with joint involvement, cartilage damage, meniscus damage,
- ligament instabilities such as cruciate ligament rupture
- degenerative meniscus damages
separation
The following illnesses also cause pain in the knees and must be separated from knee joint arthrosis:
- diseases of the rheumatic form circle
- infections
- tumours
- gout-psoriasis-arthritis
- meniscus damage
- diseases of the hips and spine
- fresh injuries to the knee joint's cartilage, bone and ligament apparatus
Diagnostics
- Careful assessment of the patient's medical history
- Physical examination of the knee joint by a specialist X-ray examinations of the knee joint Standard: two levels and kneecap axial If necessary, further special examinations such as magnetic resonance imaging (MRI), laboratory tests and knee joint puncture
Golden rules
- avoid carry heavy things and ensure a balanced weight distribution - a rucksack is better than a [hand]bag
- relieve the strain on your joint by using a walking stick for longer journeys
- avoid climbing stairs too often
- avoid long walks on uneven surfaces
- avoid standing and kneeling for longer periods
- be sure to have a healthy diet
- avoid becoming overweight or reduce your weight In sports, avoid sharp sudden change of directions, jumping or lifting heavy items in sports activities Wear good shoes with a soft sole to cushion your steps
Recommended sports:
- Swimming
- Walking
- Hiking
- Cross-country skiing
- Cycling
- Sailing
Recommended sports with certain restrictions:
- Golf
- Bowling / playing skittles
- Tennis
- Table tennis
- Dancing
- Aerobics
Unsuitable sports:
- Alpine skiing
- Soccer
- Handball
- Volleyball
- Basketball
- Riding
- Squash
Operative therapy
In the event of an advanced arthrosis, and where conservative treatment methods fail,
help can only be achieved by operative therapy. According to the results, the option is either joint preserving processes or
an artificial knee joint.
