CURRENT MODERN METHODS OF EXAMINATION OF OSTEOARTHRITIS OF THE KNEE JOINT

Аннотация

Osteoarthritis of the knee joint (gonarthrosis) is a pathology that affects cartilage, subchondral bone, and soft tissues. Cartilage covers the articular surfaces of bones and acts as a shock absorber. Synovial fluid, as a natural lubricant, prevents the cartilaginous lining from wearing out. Key words: Osteoarthrosis, cartilage, knee joint, bone, synovial fluid, elder woman, osteophyte, varus, valgus, pain. СОВРЕМЕННЫЕ МЕТОДЫ ИССЛЕДОВАНИЯ ОСТЕОАРТРОЗА КОЛЕННОГО СУСТАВА Аннотация. Остеоартроз коленного сустава (гонартроз) — патология, поражающая хрящ, субхондральную кость и мягкие ткани. Хрящ покрывает суставные поверхности костей и выполняет функцию амортизатора. Синовиальная жидкость, как естественная смазка, предотвращает износ хрящевой оболочки. Ключевые слова: остеоартроз, хрящ, коленный сустав, кость, синовиальная жидкость, пожилая женщина, остеофит, варус, вальгус, боль. Definition. Osteoarthritis is a heterogeneous condition for which the prevalence, risk factors, clinical manifestations, and prognosis vary according to the joints affected. It most commonly affects knees, hips, hands, and spinal apophyseal joints. It is characterised by focal areas of damage to the cartilage surfaces of synovial joints, and is associated with remodelling of the underlying bone, and mild synovitis. It is variously defined by a number of clinical and/or radiological features. Clinical features include pain, bony tenderness, and crepitus. When severe, there is often characteristic joint space narrowing and osteophyte formation, with visible subchondral bone changes on radiography. The symptoms and signs of knee osteoarthritis include pain, stiffness, reduced joint motion, and muscle weakness. Long- term consequences can include reduced physical activity, deconditioning, impaired sleep, fatigue, depression, and disability. Factors that have been associated with an increased risk of knee osteoarthritis include older age, female sex, overweight or obesity, knee injury, occupational factors (e.g., knee bending, heavy lifting, and squatting), and varus or valgus alignment. Risk is not increased with recreational physical activity. 1436 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 2 Pain from osteoarthritis of the knee is difficult to study longitudinally because it fluctuates and its pattern evolves. Episodic pain is predictable in early stages but becomes less predictable and more distressing in late stages. Incidence/Prevalence. Osteoarthritis is a common and important cause of pain and disability in older adults. Radiographical features are practically universal in at least some joints in people aged over 60 years, but significant clinical disease probably affects 15–25% of people. Knee disease is about twice as prevalent as hip disease in people aged over 60 years (about 12% knee v 7% hip). In a general practice setting. 2% of people aged over 45 years have a currently- recorded clinical diagnosis of knee osteoarthritis; 7% will have had the clinical diagnosis made at some point. A community-based cohort study showed that radiological features of knee osteoarthritis were very common: 15% of women aged 45–60 years developed new knee osteophytes — an incidence of 5% per year. Evaluation. A medical history and physical examination are typically sufficient to establish the diagnosis of osteoarthritis. One or both knees may be affected, with or without more generalized osteoarthritis (defined as the involvement of the hand and at least one large joint). Symptoms begin gradually, usually in men in their 40s or older and in women in perimenopause or older. The pain is often dull, involving the whole knee or more localized, increases with joint use, and abates with rest. As disease advances, pain may occur at rest and at night, interfering with sleep. Morning stiffness lasts less than 30 minutes, and stiffness occurs briefly after daytime inactivity. Findings of knee osteoarthritis include crepitus, bony enlargement, reduced knee flexion, flexion contracture, and tenderness. Treatment. In recent years, there has been a shift from primarily pharmacologic therapy to nonpharmacologic therapy, owing to the limited benefits of the former and evidence that nonpharmacologic approaches are more likely to relieve symptoms in the long term and to delay or prevent functional decline. Nonpharmacologic Therapy: Exercise and Diet Exercise is an essential component of the management of knee osteoarthritis. A systematic review of randomized trials of land-based therapeutic exercise (vs. varied comparators) in people with knee osteoarthritis showed that exercise significantly reduced pain (with a moderate effect size based on high-quality evidence from 60 trials) and improved physical function (with a moderate effect size based on moderate-quality evidence from 60 trials) and quality of life (with a small effect size based on high-quality evidence from 37 trials). Pain and function benefits were sustained at least 3 to 5 months after