ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 2 / UIF:8.2 / MODERNSCIENCE.UZ
896
OSTEOARTHRITIS OF THE KNEE JOINT
Abdulloyev Mirshod
Asian International University, teacher.
https://doi.org/10.5281/zenodo.14929750
Abstract.
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.
ОСТЕОАРТРОЗ КОЛЕННОГО СУСТАВА
Аннотация.
Остеоартроз коленного сустава (гонартроз) — патология,
поражающая хрящ, субхондральную кость и мягкие ткани. Хрящ покрывает суставные
поверхности костей и действует как амортизатор. 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.
ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 2 / UIF:8.2 / MODERNSCIENCE.UZ
897
Risk is not increased with recreational physical activity. 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
ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 2 / UIF:8.2 / MODERNSCIENCE.UZ
898
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 the end of formal treatment.
Other Nonpharmacologic Therapy Methods
Owing to insufficient benefit and data quality, guidelines recommend against massage
therapy, manual therapy (manual traction, mobilization or manipulation, or passive range of
motion), and wedge insoles. Study results are inconsistent regarding the benefit of thermal
interventions (locally applied heat or cold) and acupuncture.
Pharmacologic Therapy
Some controlled trials showed a benefit of treatment with topical nonsteroidal
antiinflammatory drugs (NSAIDs) similar to that with oral NSAIDs but with fewer adverse effects.
Their use should precede use of oral NSAIDs, although they are less practical when more
than one joint is involved. The use of topical capsaicin is not recommended, given a paucity of
high-quality data as well as small effect sizes.
If symptoms persist after the appropriate use of nonsurgical treatment, however, surgery
can be recommended. There are different types of surgical procedures to treat knee oa at various
stages and in consideration of patient related factors, such as age, level of physical activity and
risk factors.
Arthroscopic surgery
arthroscopy is widely used in the treatment of oa, despite the lack
of evidence showing it to have greater benefit than other treatments. The different arthroscopic
techniques include lavage, debridement, bone marrow stimulation of contained chondral lesions,
osteochondral transplantation, and autologous chondrocyte transplantation. as autologous
osteochondral and chondrocyte Transplantation are not indicated for knee oa, we will not discuss
them in this review. most published studies of arthroscopic procedures for knee oa are of limited
quality, owing to lack of randomization, lack of a control group, short-term follow-up, or
inconsistent assessment methods. Only three randomized trials have compared arthroscopic
surgery with a nonsurgical control procedure for knee oa.
Lavage and debridement
the rationale for arthroscopic lavage is to wash out debris and
inflammatory enzymes, consequently reducing symptoms of synovitis and pain and improving
function.
Compared improvements in womaC score following tidal irrigation, performed with a 3.4
mm wrist arthroscope, and intra-articular corticosteroid injection. Both treatments provided short-
term pain relief; however, the benefits lasted longer after irrigation.
ISSN:
2181-3906
2025
International scientific journal
«MODERN SCIENCE АND RESEARCH»
VOLUME 4 / ISSUE 2 / UIF:8.2 / MODERNSCIENCE.UZ
899
After 5 months, only 24% of patients who received corticosteroids reported continued
improvement, compared with 57% of those who underwent tidal irrigation. in both groups, the best
outcomes were reported in patients with effusion and radiographic signs of mild oa at baseline.
Joint replacement
Replacement of the entire knee joint, or total knee arthroplasty, is a safe and cost-effective
treatment for severe oa of the knee. Durable alleviation of pain and improvement of physical
function can be expected following the procedure. In addition to physician-derived data, patient-
centered outcome measurements have also become an essential component of any long-term
analysis of the success of total knee replacement. Owing to its irreversible nature, joint
replacement is recommended only in patients for whom other treatment modalities have failed.
The procedure has a remarkably higher risk of failure 15 years after implantation in patients
aged 50 years and younger 45 than in patients aged 70 years or older. Complications of joint
replacement surgery include prosthetic loosening, wearing of the polyethylene insert, infection and
periprosthetic fractures. For patients younger than 45 years, therefore, the risks and benefits of
less-invasive surgical alternatives should be thoroughly weighed against those of total knee
arthroplasty. Patients over 65 years of age are considered the best candidates for total knee
replacement. Increasingly, older patients with severe oa, as well as younger patients, are
successfully treated with total knee arthroplasty. Registers from all over the world, such as the
swedish
Knee arthroplasty register, 50 demonstrate a constant increase in joint replacement rates.
Joint replacement must be considered in patients with radiographic evidence of knee oa
who have pain and disability refractory to conservative or joint-preserving therapy. The indication
criteria for joint replacement surgery, however, might vary between countries.
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