Knee osteoarthritis, also known as gonarthrosis, is one of the most common joint diseases, affecting millions of people worldwide. This degenerative condition can cause significant pain and restricted movement, severely impacting the quality of life of those affected. In this comprehensive blog post, we will examine the causes, symptoms, and modern treatment methods for knee osteoarthritis in detail. Our goal is to provide you with a deep understanding of this condition and help you make informed decisions about your health.

Chapter 1: Introduction to Knee Osteoarthritis

1.1 Definition and Epidemiology

Knee osteoarthritis (gonarthrosis) is a chronic, degenerative disease in which the articular cartilage in the knee gradually wears away. This wear and tear leads to pain, swelling, and restricted movement. The disease predominantly affects older people, but can also occur in younger individuals, particularly after injuries or due to genetic predisposition.

1.2 Anatomy of the knee

The knee is the largest joint in the human body and consists of the thigh bone (femur), the shin bone (tibia), and the kneecap (patella). These bones are covered with cartilage, which acts as a shock absorber and allows for smooth movement. Ligaments and muscles further stabilize the joint.

Knee osteoarthritis, also known as gonarthrosis, is a chronic condition in which the cartilage in the knee joint gradually deteriorates. This leads to pain, swelling, and stiffness in the joint. Knee osteoarthritis is one of the most common causes of joint pain in older adults and affects millions of people worldwide. It is estimated that approximately 10% of men and 13% of women over the age of 60 suffer from knee osteoarthritis.

Impact on quality of life

Knee osteoarthritis (gonarthrosis) can significantly impair quality of life. The pain and restricted movement can make everyday activities such as walking, climbing stairs, and even sitting and standing difficult. This can lead to a loss of independence and a reduction in social activities, which in turn can affect mental health.

Excess weight and obesity significantly increase the stress on the knee joint, which accelerates cartilage degeneration and increases the risk of knee osteoarthritis (gonarthrosis). Obesity is one of the most modifiable risk factors for the development and progression of knee osteoarthritis.

Knee injuries, such as ligament tears or meniscus damage, as well as overuse from intensive sports activities or physical labor, can contribute to the development of knee osteoarthritis. Such injuries can lead to structural changes in the knee joint, increasing the risk of developing osteoarthritis later in life.

In the early stages of knee osteoarthritis, symptoms such as mild joint pain and stiffness can occur, especially after prolonged periods of rest or strenuous activity. The pain is often intermittent and can be relieved by rest.

As the disease progresses, the pain can become more intense and frequent. Joint stiffness may increase, and swelling and a limited range of motion may occur. Affected individuals may have difficulty performing everyday activities such as walking, climbing stairs, or rising from a seated position.

In the late stages of knee osteoarthritis (gonarthrosis), severe pain, significant joint swelling, and deformities are common. Range of motion is severely restricted, and everyday activities become increasingly difficult. Muscle atrophy around the affected joint can also occur at this stage.

The diagnosis of knee osteoarthritis (gonarthrosis) often begins with a thorough clinical examination by a doctor. This includes evaluating the symptoms, a physical examination of the knee joint, and an analysis of the patient's medical history. The doctor may perform specific tests to check the joint's mobility and stability.

X-rays are the most common imaging method used to diagnose knee osteoarthritis. They can reveal changes in the joint space and bone deformities. In some cases, MRI or CT scans may also be necessary to obtain more detailed images of the knee joint and to assess the extent of cartilage damage.

Laboratory tests are less common, but may be performed in certain cases to rule out other causes of joint pain, such as rheumatoid arthritis or gout. Blood tests can help identify inflammatory markers or other abnormalities that might indicate a systemic condition.

Physiotherapy plays an important role in the treatment of knee osteoarthritis. Specific exercises can strengthen the muscles around the knee, improve mobility, and relieve pain. Physiotherapists can also use manual techniques to improve joint function and reduce inflammation.

Pain relievers such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used to relieve pain and inflammation. In some cases, corticosteroid injections into the knee joint can also be helpful to reduce acute inflammation and relieve pain.

Weight loss and a healthy diet are crucial to reducing stress on the knee joint and slowing the progression of the disease. Regular, gentle physical activity such as swimming or cycling is recommended to maintain joint function and strengthen muscles.

Chapter 2: Causes of Knee Osteoarthritis (Gonarthrosis)

2.1 Age-related wear and tear

One of the main causes of knee osteoarthritis (gonarthrosis) is the age-related deterioration of articular cartilage. With increasing age, cartilage loses elasticity and resilience, leading to deterioration. This natural aging process is one of the most common risk factors for developing knee osteoarthritis. As we age, the cartilage's ability to regenerate decreases. This natural wear and tear process causes the cartilage to become thinner and less resistant.

2.2 Genetic factors

Genetic factors also play an important role in the development of knee osteoarthritis. People with a family history of osteoarthritis have a higher risk of developing the disease. Studies have shown that certain genetic variations are associated with an increased risk of knee osteoarthritis.

2.3 Injuries and Overuse

Injuries such as ligament tears or meniscus injuries can increase the risk of knee osteoarthritis (gonarthrosis). Similarly, overuse due to repetitive, intense physical activity or work-related strain can damage the joints.

2.4 Misalignments and Overweight

Leg misalignments such as knock-knees or bowlegs put uneven stress on the knee joint and can lead to premature wear and tear. Excess weight further increases the stress on the knee joints and accelerates cartilage degeneration.

Chapter 3: Symptoms and Diagnosis of Knee Osteoarthritis (Gonarthrosis)

3.1 Early symptoms

Early signs of knee osteoarthritis (gonarthrosis) include morning stiffness and pain after prolonged periods of rest. These symptoms often improve after brief exercise.

3.2 Progressive symptoms

As the disease progresses, pain occurs even with minor exertion and at rest. Swelling and inflammation in the knee joint are common.

3.3 Diagnostic procedures

Knee osteoarthritis (gonarthrosis) is diagnosed through a combination of clinical examination, X-rays, and, if necessary, magnetic resonance imaging (MRI). The doctor assesses joint space narrowing, cartilage damage, and any bone changes.

Chapter 4: Conservative Treatment Methods

4.1 Drug therapy

Pain relievers such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used to alleviate pain. In some cases, intra-articular injections of hyaluronic acid or corticosteroids can also help.

4.2 Physiotherapy and exercise

Physiotherapy plays a central role in the treatment of knee osteoarthritis (gonarthrosis). Specific exercises strengthen the muscles, improve mobility, and reduce stress on the knee joint. Regular, gentle exercise such as swimming or cycling is recommended.

4.3 Weight reduction

Weight loss relieves stress on the knee joints and can significantly improve symptoms. A targeted nutrition and exercise program supports those affected in reducing their weight.

Chapter 5: Surgical Treatment Methods

5.1 Arthroscopic procedures

In early stages of knee osteoarthritis, arthroscopy can be performed to remove loose cartilage or bone fragments and smooth inflamed tissue.

5.2 Osteotomy

In younger patients with malalignment, an osteotomy may be considered. This procedure corrects the leg axis to shift the load to the healthy part of the knee.

5.3 Knee arthroplasty

In advanced stages of knee osteoarthritis (gonarthrosis), a total knee replacement (TKR) may be necessary. This involves replacing the damaged joint with a prosthesis. There are various types of knee prostheses, including partial and total replacements, which are selected based on the severity and location of the osteoarthritis.

Chapter 6: Postoperative Rehabilitation and Follow-up Care

6.1 Rehabilitation after total knee replacement

Intensive rehabilitation is crucial for the success of a knee replacement. Physiotherapy, exercise training, and pain management are important components of the rehabilitation program.

6.2 Long-term follow-up care

Regular check-ups with an orthopedist are necessary to monitor the condition of the prosthesis and detect any potential complications early. Patients should continue to pay attention to their weight and avoid excessive strain.

Chapter 7: Modern Technologies and Research

7.1 Advances in Imaging

Modern imaging techniques such as 3D MRI and CT scans enable more precise diagnostics and treatment planning. These technologies help to increase the success of surgeries and shorten recovery times.

7.2 Biological Therapies

New approaches such as stem cell therapy and the use of growth factors to regenerate cartilage are promising and are currently undergoing clinical trials.

7.3 Personalized Medicine

The development of personalized treatment strategies based on the genetic and physiological characteristics of the individual patient will play an increasingly important role in the future.

Chapter 8: Quality of life and prevention of knee osteoarthritis (gonarthrosis)

8.1 Importance of quality of life

Knee osteoarthritis (gonarthrosis) can significantly impair quality of life. Early diagnosis and an individually tailored treatment plan are crucial to alleviate symptoms and maintain mobility.

8.2 Prevention measures

Preventive measures such as regular exercise, a balanced diet, and avoiding excess weight can reduce the risk of knee osteoarthritis. In addition, attention should be paid to correct posture and protecting the joints.

8.3 Self-management and support

Patients can improve their quality of life through self-management measures such as pain control, exercise, and connecting with other affected individuals. Self-help groups and specialized programs offer support and information.

Knee osteoarthritis (gonarthrosis) is a complex condition that requires comprehensive and individualized treatment. Through a combination of conservative and surgical methods, as well as modern rehabilitation, patients can achieve a significant improvement in their symptoms and quality of life. Early detection, prevention, and continuous care play a crucial role in managing this widespread condition.