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 mobility restrictions, severely impacting the quality of life of those affected. In this comprehensive blog post, we will thoroughly examine the causes, symptoms, and modern treatment methods for knee osteoarthritis. 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 condition in which the articular cartilage in the knee is gradually worn away. This wear and tear leads to pain, swelling, and limited mobility. The condition predominantly affects older individuals but can also occur in younger people, 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 femur (thigh bone), tibia (shin bone), and patella (kneecap). These bones are covered with cartilage, which acts as a shock absorber and enables smooth movements. In addition, ligaments and muscles stabilize the joint.

Knee osteoarthritis, also referred to as gonarthrosis, is a chronic condition in which the cartilage in the knee joint is gradually broken down. 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. According to estimates, about 10% of men and 13% of women over 60 years suffer from knee osteoarthritis.

Impact on Quality of Life

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

Overweight and obesity significantly increase the stress on the knee joint, accelerating cartilage degradation and increasing the risk of knee osteoarthritis (gonarthrosis). Obesity is one of the strongest modifiable risk factors for the development and progression of knee osteoarthritis.

Injuries to the knee joint, such as ligament tears or meniscal damage, as well as overuse due to intense sporting activities or physical work, can contribute to the development of knee osteoarthritis. Such injuries can lead to structural changes in the knee joint, increasing the risk of later osteoarthritis.

In the early stages of knee arthrosis, symptoms such as mild joint pain and stiffness can occur, especially after prolonged periods of rest or intense activities. The pain is often intermittent and can be alleviated by rest.

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

In the late stage of knee osteoarthritis (gonarthrosis), severe pain, significant joint swelling, and deformities are common. The range of motion is severely limited, and everyday activities become increasingly difficult. At this stage, muscle atrophy around the affected joint can also occur.

The diagnosis of knee osteoarthritis (gonarthrosis) often begins with a thorough clinical examination by a doctor. This includes assessing symptoms, a physical examination of the knee joint, and analyzing 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 for diagnosing knee osteoarthritis. They can show changes in the joint space and bone deformities. In some cases, MRI or CT scans may also be required to obtain more detailed images of the knee joint and 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 may indicate a systemic disease.

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

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

Weight reduction and a healthy diet are crucial in reducing the strain 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 the muscles.

Chapter 2: Causes of knee osteoarthritis (gonarthrosis)

2.1 Age-related Wear

One of the main causes of knee osteoarthritis (gonarthrosis) is age-related degeneration of articular cartilage. As age increases, the cartilage loses its elasticity and resilience, leading to deterioration. This natural aging process is one of the most common risk factors for developing knee osteoarthritis. With increasing age, the cartilage's ability to regenerate decreases. The 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. Individuals 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 Overload

Injuries such as ligament tears or meniscal injuries can increase the risk of knee osteoarthritis. Similarly, overloading through repetitive, intense physical activities or occupational stresses can damage the joints.

2.4 Misalignments and Overweight

Misalignments of the legs, such as knock knees or bowlegs, unevenly stress the knee joint and can lead to premature wear. Excess weight further increases the stress on the knee joints and accelerates cartilage degradation.

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

3.1 Early Symptoms

The first signs of knee osteoarthritis (gonarthrosis) include morning stiffness and pain after longer periods of rest. These symptoms often improve after short periods of movement.

3.2 Progressive Symptoms

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

3.3 Diagnostic Procedures

The diagnosis of knee osteoarthritis (gonarthrosis) is made through a combination of clinical examination, X-rays, and possibly magnetic resonance imaging (MRI). The doctor assesses the narrowing of the joint space, cartilage damage, and possible bone changes.

Chapter 4: Conservative Treatment Methods

4.1 Medicinal Therapy

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

4.2 Physical Therapy and Exercise

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

4.3 Weight Reduction

Weight loss relieves the knee joints and can significantly improve symptoms. A targeted nutrition and exercise program helps those affected to reduce their weight.

Chapter 5: Surgical Treatment Methods

5.1 Arthroscopic Interventions

In the 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 malalignments, an osteotomy can be considered. This involves correcting 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), joint replacement (knee arthroplasty) may be necessary. The damaged joint is replaced with a prosthesis. There are various types of knee prostheses, including partial and total prostheses, 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 prosthesis. Physical therapy, exercise training, and pain management are important components of the rehabilitation program.

6.2 Long-Term Follow-Up Care

Regular check-ups with the orthopedist are necessary to monitor the condition of the prosthesis and detect possible complications early. Patients should continue to watch their weight and avoid excessive stress.

Chapter 7: Modern Technologies and Research

7.1 Advances in Imaging

Modern imaging techniques such as 3D MRI and CT 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 for cartilage regeneration are promising and are being clinically tested.

7.3 Personalized Medicine

The development of personalized treatment strategies based on the genetic and physiological characteristics of individual patients 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 concept are crucial to alleviate symptoms and maintain mobility.

8.2 Prevention Measures

Preventive measures such as regular exercise, a balanced diet, and avoiding overweight can reduce the risk of knee osteoarthritis. Additionally, correct posture and joint protection should be observed.

8.3 Self-Management and Support

Patients can improve their quality of life through self-management measures such as pain control, exercise, and exchange 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.