- Gonarthrosis: Where does it originate?
- Osteoarthritis forms in the knee
- Activated gonarthrosis
- Gonarthrosis: symptoms
- Gonarthrosis: frequency
- Gonarthrosis: diagnosis
- Gonarthrosis: therapy
- Additional information
As gonarthrosis Doctors refer to a joint wear in the knee. Mostly there is no concrete trigger for this: The knee joints were simply loaded too much. Gonarthrosis can cause knee pain. These can be treated with medication, exercises or surgery. Here you read everything important about gonarthrosis.
ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in doctor's letters or on incapacity certificates. M17
Gonarthrosis: Where does it originate?
Osteoarthritis forms in the knee
Gonarthrosis: Where does it originate?
The gonarthrosis is a joint wear (arthrosis) in the knee: The articular cartilage wears off. Later, adjacent joint areas such as bone parts are damaged.
Osteoarthritis always forms between two parts of the bone. The knee joint is formed by three bones:
- Femur (femur)
- Kneecap (patella)
- Tibia (tibia)
There is a joint connection between these bones. The tibia, with its middle (medial) and lateral (lateral) portion even two joints with the thigh. In technical terms this is called the different compartments in the knee.
Osteoarthritis forms in the knee
Osteoarthritis in the knee can affect one or more parts (compartments) of the knee joint:
- Gonarthrosis in 1 compartment (unicompartmental gonarthrosis): It exists either between kneecap and femur or between tibia and femur.
- Gonarthrosis in 2 compartments (bicompartmental gonarthrosis): The osteoarthritis affects the tibia and femur.
- Gonarthrosis in 3 compartments (tricompartimental gonarthrosis or pangonarthrosis): The joint wear affects all three parts of the knee joint.
The division into uni-, bi- and tricompartimental gonarthrosis is important if the joint wear is to be operated on.
Medial and lateral gonarthrosis
If the inner portion of the knee joint is affected by the wear, there is a medial gonarthrosis. If it is a knee osteoarthritis in the outer area, it is called a lateral gonarthrosis.
A worn joint can easily ignite. Cartilage parts come off, cells are destroyed. They accumulate in the synovial fluid and attract inflammatory cells. From a simple gonarthrosis, an activated gonarthrosis develops. The knee joint and surrounding tissue can swell painfully. The activated gonarthrosis can revert to a non-inflamed osteoarthritis in the knee joint with proper therapy.
Read more about the investigations
Knee wear does not always cause discomfort (such as pain); if so, it is called a symptomatic osteoarthritis in the knee.
Those affected report knee pain, for example when climbing stairs. In advanced gonarthrosis, persistent pain may also occur. The knee joint is less mobile. Gear insecurity can occur.
In many patients, the knee pain is also weather-dependent: they increase, for example, in cold or wet weather. The affected then report on "weather sensitivity".
More about possible symptoms of gonarthrosis (and other types of osteoarthritis) can be found in the article Osteoarthritis symptoms.
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Keep your joints fit - that's how it works
Climbing stairs, playing sports with friends or gardening - when the joints hurt, that is hardly possible. Especially problems with the knee are particularly common fault: painful knee joints limit the everyday life of some 20 million Germans partly strong. It is all the more important to keep the joints fit until old age. How to do it and what to do if you are already in pain, read here.
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Stay in motion
"Who restates rust" says a proverb. And that's right - who wants to keep his body and especially the joints fit, should move regularly. This stretches the ligaments, strengthens the muscles and promotes mobility. No top athletic performance is necessary, it is enough to walk short distances or ride a bike and leave the car to stand.
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Beware of "knee press sports"
Sport is good for the joints - but it depends on what activities you are pursuing. Especially for people with sensitive knees, it is advisable to avoid so-called "knee-press sports" such as football, tennis or skiing. Jogging also puts a heavy strain on the joints. More suitable are Nordic Walking (on soft ground), swimming or cycling.
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Onion vegetables for the joints
The right diet also helps: A study showed that garlic, onions and leek protect against joint wear. Thus, the onion vegetables apparently contain components that reduce harmful enzymes on cartilage tissue.
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82 percent of all Germans walk around in badly fitting shoes, according to the Federal Association of the German Footwear Industry. And that permanently damages the knee joints in particular. But not only shoes that do not fit properly cause problems - even high heels can cause pain. To protect the knees and back, the ladies should switch to flat and comfortable shoes.
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Too many kilos on the hips damage the joints. If overweight permanently overloads them, cartilage wear or even ligament damage may result. Because overweight not only massively damages the joints but the entire body, you should pay attention to a healthy weight.
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Painkiller in moderation
If pain limits everyday life, medications can relieve the symptoms. However, this does not solve the causes. It is better to have persistent complaints clarified by a specialist. This can, for example, show those affected exercises that contribute to the health of the joints.
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Heat or cold?
Do your joints hurt frequently? Then everything will do you good, which particularly stimulates the joint metabolism. Warming applications have proved successful, for example in the form of warm peat packs or circulation-promoting baths, for example with rosemary. In acute inflammation, on the other hand, cold is often more pleasant.
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Leech for osteoarthritis
A circulation-stimulating stimulus therapy often helps very well with pain from joint wear and tear. These include dry cupping, autologous blood treatments and leech therapy. The saliva that the animals give into the skin also has an anti-inflammatory effect.
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Beware of one-sided stress
Avoid asymmetric and monotonous strains, such as those caused by wearing heavy shoulder bags. Too long sitting or standing is not favorable for the joints: the articular cartilage is best nourished whenever the fluid in the joint remains in motion.
Knee joint arthrosis is the most common form of arthrosis in Germany. The information on the frequency vary greatly. The reason is that there are no uniform criteria for the diagnosis of gonarthrosis. Most diagnoses are based on the radiological signs of osteoarthritis. These are indications of joint wear in X-rays, computed tomography or magnetic resonance tomography.
With age, the likelihood of knee osteoarthritis increases. Men are more frequently affected before the age of 45. Later, more women develop a gonarthrosis.
Read more about the investigations
If there is a suspicion of gonarthrosis, the doctor will first ask the patient to give a detailed description of his symptoms. He also asks about possible injuries or illnesses that currently exist or have occurred in the past. For example, meniscal damage or joint inflammation (arthritis) may promote osteoarthritis of the knee joint.
In the next step, the doctor will examine the knee joint and check its mobility. An X-ray examination and other imaging techniques support the clarification of a gonarthrosis.
How a gonarthrosis (and other types of arthritis) are accurately diagnosed, they read in the review arthritis.
Read more about the therapies
- occupational Therapy
For gonarthrosis and other forms of osteoarthritis some general therapies apply. This includes, for example, to relieve the affected joint, but still to move regularly.
Heat applications such as heating pads or baths help against chronic arthritis pain. Acute complaints, on the other hand, can be alleviated with cold applications such as ice packs. If necessary, medications for the pain are prescribed.
You can find out more about general therapy measures for gonarthrosis and other forms of osteoarthritis in the article Osteoarthritis.
To stop the progression of the disease, people with osteoarthritis should do knee exercises. These aim to strengthen the muscles on the knee. They can thus better absorb stress, which relieves the cartilage in the knee joint.
Danger: The exercises must not harm the already damaged knee joint additionally! Therefore, body weight should not weigh on the knee during exercise. Especially suitable are therefore water aerobics and cycling.
Also useful is a special device training for people with osteoarthritis. Knee exercises, however, must always be discussed with a trained physiotherapist and must not be selected independently.
Gonarthrosis therapy: surgery without joint replacement
In knee osteoarthritis, it may be helpful to rinse the joint (lavage).In addition, rough cartilage surfaces in the joint can be smoothed (debridement). Both procedures are performed as part of a joint mirroring (arthroscopy).
Another option for gonarthrosis surgery is corrective osteotomy. The bones that build the joint are positioned differently. This should reduce the stress on the arthrosis areas.
Find out more about lavage, debridement and corrective osteotomy in the article Osteoarthritis.
Gonarthrosis therapy: surgery with joint replacement
Sometimes osteoarthritis can not adequately relieve knee discomfort caused by conservative measures or joint-preserving procedures. In case of severe gonarthrosis, the affected knee joint is sometimes replaced by a prosthesis:
If knee osteoarthritis affects only one compartment, a single-compartment endoprosthesis may be used. In a knee osteoarthritis in several compartments is a total endoprosthesis into consideration.
A so-called unicondylar prosthesis primarily supplies a moderate degree of lateral or medial gonarthrosis. The partial denture replaces only the articular surface. The joint continues to be guided through the capsule-band apparatus. Such a partial denture is also referred to as a sled prosthesis.
Patients with a partial denture often assess the functionality of joint replacement better than people with a total endoprosthesis. Besides, they are usually happier with the result of the operation. However, a sled prosthesis is not an option for every patient. If one of the following points applies, the person concerned is more likely to come to a total endoprosthesis:
- Age over 65 years
- Gonarthrosis of the kneecap
- Damage (lesion) of the joint capsule or ligaments
- relevant joint misalignments of more than 10 degrees
There are several forms of total endoprosthesis that can be used in gonarthrosis. Among other things, they differ in terms of material, structure and anchorage.
Younger patients are more likely to receive cementless prostheses. These can only be fixed in a stable bone. If necessary, they can be exchanged relatively easily.
In older patients, prostheses tend to be cemented. The reason: The bone structure is often loosened in them, and a different anchoring would be less stable.
In the case of gonarthrosis, two groups of total endoprostheses are distinguished:
- the uncoupled surface replacement
- the axle-guided prosthesis
Uncoupled surface replacement
In uncoupled surface replacement, only the articular surfaces are restored prosthetically. There is no firm connection between the prosthetic parts on the thigh and the tibia. In some cases, a so-called inlay is placed between these two parts of the prosthesis. As a result, the knee joint remains easily movable.
The prerequisite for this form of total endoprosthesis is that the natural capsule-ligament apparatus is sufficiently stable. Otherwise, an axis-guided prosthesis should be used.
Axis-guided total endoprostheses
In severe gonarthrosis with defective ligamentous apparatus, guided total endoprostheses are used. They have a firm connection between the two parts of the prosthesis on the femur and tibia. As a result, the force no longer needs to be held by the capsule or straps on the knee. However, the prosthesis is more heavily loaded and can relax more easily.
Gonarthrosis prosthesis: complications
Knee joint replacement with knee replacement, like all surgeries, involves general risks. These include, for example, bleeding or infection.
In addition, the prosthesis used can relax over time. Then usually has to be operated again. Sometimes the prosthesis has to be replaced as well.
Another danger after prosthesis insertion in gonarthrosis concerns the kneecap: it may loosen, break or cause pain. In addition, the bony structures may break around the prosthesis. Doctors call this a periprosthetic fracture. Affected gonarthrosisPatients need surgery again.
- Knee Weakness: Targeted at Pain, Injury, and Arthrosis, Kay Bartrow, 2015, TRIAS Circulation 1.
- Knee active: 100 exercises in osteoarthritis and after joint replacement, injuries, operations, Joachim Merk and Thomas Horstmann, 2013, S. Hirzel Verlag; Edition: 5