Osteoarthritis of the knee, also known as gonarthrosis, is a widespread degenerative disease that affects many people in Germany and worldwide. This disease damages the articular cartilage of the knee joint and can lead to pain, limited mobility and long-term impairment. In this comprehensive guide, you will learn everything about the causes, symptoms, diagnosis and treatment of knee osteoarthritis. It also explains how you can delay or even avoid the disease through preventive measures.

What is osteoarthritis of the knee (gonarthrosis)?

Osteoarthritis is a chronic, degenerative disease of the joints characterized by the progressive breakdown of articular cartilage. In the case of gonarthrosis, it affects the knee joint, one of the most frequently stressed joints in the body. When the protective cartilage wears down, the bones rub directly against each other, causing pain and stiffness.

The knee joint – a high-performance mechanism

The knee is a complex joint consisting of the thigh bone (femur), shinbone (tibia) and the kneecap (patella). It is stabilized by ligaments, menisci and muscles and allows both twisting and bending movements. This structure makes the knee vulnerable to wear and tear and injury.

Why is the knee prone to osteoarthritis?

The knee is one of the most stressed joints in the human body. Not only does it support the entire body weight, but it is also put under a lot of strain during everyday movements such as walking, running or climbing stairs.

Causes of osteoarthritis of the knee

The development of osteoarthritis is complex and multifactorial. There are primary and secondary causes.

1. Primary knee osteoarthritis:

• Age-related wear and tear of the articular cartilage.
• Genetic predisposition.

2. Secondary knee osteoarthritis:

• Injuries: Previous meniscus tears or cruciate ligament injuries.
• Inflammatory diseases: Rheumatoid arthritis.
• Misalignments: X-legs or O-legs.
• Permanent overload: Due to occupational stress or intense sports.
• Obesity: Additional weight puts enormous strain on the knee and accelerates wear and tear.

Risk factors

• Gender: Women are more commonly affected, especially after menopause.
• Sports with high joint strain: football, skiing or jogging.
• Occupational activities: Frequent kneeling, lifting and standing.

Symptoms of osteoarthritis of the knee

Early signs:

• Pain in the knee, initially only when straining, later also at rest.
• Slight swelling or a feeling of tension in the knee area.

Advanced symptoms:

• Significant limitation of mobility, especially when climbing stairs or squatting.
• Crunching noises when moving the knee.
• Recurrent inflammation and effusions in the joint.

Late symptoms:

• Instability of the knee joint.
• Axial misalignments, such as increased X-legs or O-legs.

Diagnosis of arthrosis of the knee joint

1. Medical history: Your doctor will ask you about your symptoms, previous family illnesses and everyday stresses.

2. Clinical examination:

• Checking the mobility and stability of the knee joint.
• Identification of swelling and tenderness.

3. Imaging procedures:

• X-ray: Important for assessing the joint space and bone attachments (osteophytes).
• MRI: Provides information about the condition of the cartilage, menisci and surrounding soft tissues.
• Ultrasound: Depiction of effusions or synovitis (inflammation of the joint lining).

Treatment of arthrosis of the knee joint

The treatment of knee osteoarthritis depends on the stage of the disease and the patient's personal needs.

1. Conservative therapy:

• Medication: Painkillers such as paracetamol and NSAIDs, cortisone injections.
• Physiotherapy: The aim is to strengthen the stabilizing muscles.
• Joint protection: avoidance of excessive stress.
• Weight control: Reducing weight significantly relieves the strain on the knee.

2. Minimally invasive procedures:

• Arthroscopy to remove loose joint bodies or inflammatory tissue.
• Hyaluronic acid injections as a lubricant for the joint.

3. Surgical therapy:

• Cartilage transplant: For localized cartilage damage.
• Partial prostheses: Replacement of only the affected parts of the joint.
• Total endoprosthesis (TEP): Complete replacement of the knee joint in cases of extensive osteoarthritis.

Joint replacement of the knee joint in detail

When is knee replacement recommended for osteoarthritis?

A joint replacement is necessary if the patient suffers from permanent pain and severe restrictions on movement and conservative therapies no longer provide sufficient relief.

Types of knee replacements:

• Unicondylar prosthesis: Replaces only one half of the joint, suitable for limited osteoarthritis.
• Full prosthesis: Replaces the entire knee joint, the most common form.

Chances of success: Modern knee arthroplasty offers high satisfaction rates when the indication is correct. The durability of a prosthesis today is probably 20-30 years, depending on the load.

Modern developments: Minimally invasive surgical techniques and individual prostheses that are perfectly adapted to the patient's anatomy using 3D printing.

Living with osteoarthritis of the knee joint

Exercise despite osteoarthritis: Regular moderate exercise such as swimming or cycling helps to maintain joint function.

Diet: An anti-inflammatory diet containing omega-3 fatty acids and antioxidants can slow the progression of the disease.

Aids: Orthopedic shoes or knee braces can make everyday life easier.

Prevention of osteoarthritis of the knee joint

Preventing knee osteoarthritis plays a crucial role in maintaining joint health and minimizing the risk of future problems. By taking appropriate measures, you can protect your knees from excessive wear and delay possible attacks of osteoarthritis. Here are the key strategies:

Regular exercise

Moderate, joint-friendly activities can improve cartilage supply and strengthen the muscles around the knee joint.

• Recommended sports: cycling, swimming and Nordic walking.
• Benefits: Exercise stimulates synovial fluid, which is important for providing nutrients to cartilage.

Weight control

Being overweight significantly increases the pressure on the knee joints. Even moderate weight loss can significantly reduce the burden.

• Strategy: Achieve a calorie deficit through a balanced diet and increased energy consumption.
• Long-term benefit: reduction of micro-injuries and inflammation in the joint.

Avoiding overload

• Gentle handling: No abrupt peaks in load caused by heavy weights or sudden movements.
• Workplace design: Ergonomic measures to avoid monotonous stress in everyday working life.

Prophylactic physiotherapy

Regular training can help correct poor posture and improve the interaction of muscles and joints.

• Goals: Improve stability, mobility and muscle coordination.

Early treatment of injuries

Untreated knee injuries increase the risk of secondary development of osteoarthritis.

• Recommendation: See a specialist immediately if pain or swelling occurs.

Future developments in the treatment of knee osteoarthritis

Research into the treatment of knee osteoarthritis is constantly evolving. New technologies and therapies promise to be even more effective in the future.

Biological treatments

• Stem cell therapy: The use of stem cells to regenerate damaged cartilage is the focus of research.
• Current status: Initial clinical studies show promising results.
• Gene therapy: The aim is to transfer anti-inflammatory genes directly into the knee joint.

Digital therapeutic approaches

• Wearables: Sensors for monitoring joint movement and stress in everyday life.
• Advantage: Early detection of incorrect loading.
• Apps for telemedicine: Patients can receive individually tailored training plans via digital platforms.

Advances in endoprosthetics

• Customized implants: 3D printing and personalized prostheses could improve the fit and durability of knee prostheses.
• Minimally invasive techniques: gentler surgeries with faster recovery times.

Frequently asked questions about knee osteoarthritis

1. How can I tell if I have knee osteoarthritis?

Typical symptoms include pain, stiffness and swelling in the knee joint. A visit to the doctor with a comprehensive medical history and imaging is crucial to the diagnosis.

2. Can osteoarthritis of the knee be cured?

No, osteoarthritis cannot be cured. However, with the right therapies, the progression can be slowed down and quality of life improved.

3. Should I avoid exercise if I have osteoarthritis of the knee joint?

No, gentle movement is essential to maintain joint function and relieve pain. However, avoid overloading and abrupt stop-and-go.

4. When is joint replacement inevitable for knee osteoarthritis?

A knee joint replacement is recommended when conservative measures no longer help and the pain and restricted mobility severely impair everyday life.

5. Can a healthy diet affect knee osteoarthritis?

Yes, an anti-inflammatory diet with omega-3 fatty acids, antioxidants and low sugar can help reduce inflammation in the joint. This has a positive effect on the progression of osteoarthritis of the knee joint.

Conclusion

Osteoarthritis of the knee (gonarthrosis) is a serious disease that can severely affect the quality of life. However, thanks to modern therapy options and a holistic approach, there are many ways to positively influence the course. Preventive measures such as weight control, gentle exercise and a healthy diet are crucial. If symptoms persist despite conservative treatment, innovative surgical options such as joint replacement offer a long-term solution.