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Osteoarthritis of the knee


What is gonarthrosis/osteoarthritis of the knee?

The word gonarthrosis is formed from “gonato” – Greek for knee – and the term “arthrosis”.  It refers to a progressive deterioration of the knee joint cause by wear. The condition causes tears and degeneration of the joint cartilage, resulting in additional damage to neighbouring joint structures like the bones, ligaments and joint capsules.  

Gonarthrosis, i.e. osteoarthritis of the knee joint, is one of the most common knee conditions. You are more likely to suffer from it as you get older as it is a progressive disease and our regenerative capacity reduces with age. Some five million people suffer from osteoarthritis across Germany; around two million experience pain. Cases are highest amongst the over 60s; women in this age group are more likely to be affected.  

Effects of wear and tear and destruction of the joint cartilage include pain, stiffness in the morning, limited mobility and instability of the knee. The earlier the onset of osteoarthritis is detected, the more effective any action taken will be. Those who already take preventative measures can avoid cartilage damage by doing targeted exercises.

If you have prolonged knee pain, it is important that you seek medical advice in order to get on a treatment path as soon as possible.


Localisation of pain

  • If all three sections of the knee joint are affected, the patient is suffering from so-called pangonarthrosis.
  • If the primary area of concern is the patellofemoral joint (femoropatellar joint), the patient will be diagnosed with retropatellar arthrosis.
  • Lateral osteoarthritis of the knee refers to signs of wear that are mainly on the exterior side of the joint. If knock knees are also present, this is called valgus osteoarthritis of the knee.
  • Medial osteoarthritis of the knee occurs when the osteoarthritis is limited to the side of the joint facing the centre of the body. When this condition occurs alongside bandy legs, varus osteoarthritis of the knee is diagnosed.

Causes of osteoarthritis of the knee

Even if damage to the hyaline joint cartilage first occurs as an age-related sign of wear, there are other causes that can trigger arthritis or make it worse. In many cases, there is interplay between multiple different factors.

  • Injuries 

In the event of a knee injury such as a cruciate ligament tear, meniscus damage or a kneecap fracture, the joint cartilage may also be affected. Breaking/fracturing a bone below or above the knee has negative repercussions as it can lead to incorrect weight distribution.

 

  • Infection and inflammation of the joint

Infections of the joint due to bacteria or even chronic inflammation (e.g. rheumatoid arthritis) can attack the structures of the joint and lead to damage.

 

  • Misalignments

Hereditary misalignments such as knock knees or bandy legs can lead to intensified strain and wear to the joint.

 

  • Excessive strain

Physical activities which involve heavy use of the knees or lifting heavy objects can accelerate the onset of osteoarthritis of the knee.

 

  • Excess weight

Being overweight is also a risk factor; it can both cause osteoarthritis of the knee and make the condition worse.

 

  • Metabolic disorders

Gout is a metabolic disorder whereby increased levels of uric acid in the blood cause uric acid crystals to form in the joints. An abnormal lipid metabolism can, in turn, lead to excess weight.    

 

  • Neurological component

A lack of movement or changes to movement patterns, e.g. after nervous system diseases such as polio, paralysis following a stroke or a cruciate ligament rupture can cause osteoarthritis of the knee.


Typical warning signs and symptoms of osteoarthritis of the knee

  • Pain after a long period of inactivity  
  • Pain when climbing stairs and when walking on uneven ground  
  • Pain on exertion after heavy strain or when carrying heavy objects  
  • Pain after extended periods of sitting    
  • Intensified symptoms in cold and damp weather  
  • In advanced stages, grinding and cracking noise when moving (crepitation)

Stages of osteoarthritis of the knee

There are various methods used to classify osteoarthritis of the knee into stages of severity. The following list is the basis of the Kellgren-Lawrence scale which helps determine the severity of a case using a conventional X-ray.
A normal, healthy knee without any impairment and pain is classified as osteoarthritis of the knee grade 0.


How is osteoarthritis of the knee diagnosed?

Diagnosing osteoarthritis of the knee draws on various aspects. After the patient provides their medical history and explains their symptoms, a doctor will assess their mobility. The doctor will feel the knee in order to pinpoint exactly where the pain is.  If osteoarthritis of the knee is suspected, an X-ray or another imaging procedure (e.g. MRI) can be carried out in order to determine whether and how severely the joint is already damaged.

Patient providing their medical history

Osteoarthritis of the knee treatment  

Because wear of the joint cartilage is degenerative, it cannot be healed causally. Therefore, the objective of the therapy is to alleviate pain, keep the knee moving and stop the arthritis from getting worse.  

Alongside non-surgical therapy, operative procedures may also be carried out in order to preserve the joint. In cases of advanced osteoarthritis, an artificial joint replacement may also be required as a last resort.

Holistic treatment of osteoarthritis of the knee 

A holistic approach combines non-surgical therapy with various options such as the use of aids for relief, physical therapy, a healthy diet and medicine-based treatment involving NSAR, hyaluronic acid and analgesics.

Exercises for strong and healthy knees 

We have put together a few exercises for you to help strengthen your legs and knees, or to support rehabilitation after an injury. They are easy to do and can be incorporated into your daily routine for best results. If you are suffering from an acute injury, please consult your doctor first. Your doctor will advise you on which of the exercises are suitable for you.

Stretching
 

Repeat the stretch twice for each leg.

  • Stand on one leg. Bend the knee of the supporting leg slightly.
  • Using one hand, pull your other foot up behind you towards your buttocks.
  • Hold on to your foot with both hands.
  • Hold this position for about 20 seconds, then change legs.

 

Please note: 
Your back must remain straight during this exercise.
 

Stretching
Lunge

Strengthening - lunge
 

Do three sets of 12 lunges.

  • Stand with your legs hip-distance apart, keeping your upper body straight.
  • Tense your abdominal muscles.
  • Take one long step forwards.
  • The lower and upper parts of your front leg should form a right angle.
  • Lower your back leg, stopping just before it touches the ground.
  • Hold this position briefly, then return to the starting position.
  • Change legs after each lunge.

 

Please note: 
Your back must remain straight during this exercise.
 

Strengthening  - squat
 

Do three sets of 12 squats.

  • Stand up straight with your legs a little wider than hip-distance apart.
  • Distribute your weight equally on both legs.
  • Bend your legs slightly and push your buttocks back.
  • Squat only so far that your knees remain behind your toes.
  • Hold this position briefly, then straighten your body again.

 

Please note: 
Keep your back straight during this strengthening exercise and tense your abdominal muscles.

Kniebeuge bei Gonarthrose