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.

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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.

Osteoarthritis of the knee grade 1

Initial cartilage loss
Thickening of the bone underneath the cartilage
No narrowing of the joint line

Osteoarthritis of the knee grade 2

Measurable narrowing of the joint line
Possible irregularities of the joint surface
Onset of ossification (slight bone regeneration)

Osteoarthritis of the knee grade 3

Advanced narrowing of the joint line
Significant bone regeneration

Osteoarthritis of the knee grade 4

Significant cartilage defects
Partial/complete deterioration of the joint line
Formation of cysts and sclerosis in the bones
Tissue death

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.

Treatment of Knee Osteoarthritis

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.

Treatment with medical products

JuzoFlex Genu Xtra supports and relieves pressure on the knee joint. The knee support’s compression effect also alleviates pain during movement. This is crucial as gentle mobilisation is a particularly essential part of the healing process. Movement promotes blood flow in the knee joint and hence the supply of nutrients to the joint cartilage, which is compromised in patients with osteoarthritis of the knee. This positive effect is further amplified thanks to the friction nubs in the patella ring’s gentle massage effect which improves our perception of our body’s movement. The patella ring also ensures that the fluid which causes swelling is massaged, draining it from the tissue that surrounds the kneecap.

Orthopaedic insoles can be used to balance out static improper weight distribution.

More information about the JuzoFlex Genu Xtra

Ergotherapy and physical therapy

The ideal type of movement therapy for osteoarthritis of the knee is a personalised, multi-step exercise programme which, alongside durability and strength, will promote mobility. TENS currents, shock waves, microwaves, short waves and impulse waves can all be successfully implemented into a treatment plan.

Thermotherapy

Heat pads and hot baths can be used to treat chronic arthritis pain. However, it is better to treat acute pain with cold applications such as ice packs.

Movement

Patients should not strain the affected joint. At the same time, they should move it regularly in order to ensure there is a sufficient supply of nutrients reaching the joint cartilage.

Nutrition

An anti-inflammatory diet eases the symptoms of arthritis. Omega-3 fatty acids, which are found in linseed oil, salmon and herring, are beneficial. Meat products and other foods that originate from animals contain arachidonic acid from which pro-inflammatory messengers can form. Therefore, you should limit your intake of such foods. A mix of spices containing cumin, coriander and nutmeg will improve blood flow in the synovial membrane, relieving pain in the process. A plant-based diet supplies the body with vitamins, minerals and phytochemicals. Silicon, which is found in oats, brown rice, barley, millet and Jerusalem artichoke, has a stabilising effect on cartilage. A positive side effect of a healthy diet is weight loss, which further relieves pressure on joints.

Traditional Chinese medicine (TCM)

In recent years, acupuncture has increasingly been used to alleviate pain and improve joint function for osteoarthritis of the knee.

Medication

Ointments and painkillers can be prescribed to mitigate acute pain. Further options for a holistic arthritis therapy plan include hyaluronic acid or autologous blood component injections (platelet rich plasma, PRP) into the knee joint.

Particularly in cases where inflammation is also present, cortisone injections may also be administered.

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 stretching exercise twice on each leg.