There are many patients who come across us with the same sentences throughout the day. 'Dr. They express their problems with dozens of different sentences indicating the problem in their knees, such as 'Sir, my knee pain doesn't go away, I can't get better, I don't have enough strength to stand anymore, etc.' What is knee arthritis? What should be done?
When we talk about arthritis, our patients think that there is accumulation in the knee and that it disturbs the knee, but damage to the cartilage structure that forms the knee joint comes to the fore in the pathogenesis of the disease. In other words, what matters is not any accumulation but the destruction of the cartilage. Treatment modalities are performed accordingly.
Although reasons such as previous trauma, infection, knee surgery, and rheumatoid arthritis are frequently seen among the causes of gonarthrosis, no cause can be found in the majority of our patients. Genetic factors, obesity and weakness of the knee joint are blamed in such patients.
As can be expected, the most prominent symptom of gonarthrosis is knee pain. While this pain only occurs at an early age when going up and down stairs or with activation, in later periods patients become unable to make the slightest movements without pain.
As time goes by, the knee joint bends inward or outward (genu varum, genu valgus), which affects the patient's gait. It is a complicating factor. Again, there may be swelling in the knee in advanced stage gonarthrosis.
Diagnosis
In addition to anamnesis and physical examination, direct radiography is valuable in the diagnosis of gonarthrosis. In knee radiographs taken while standing, narrowing of the joint space in the patients' knees, destruction of the subchondral cartilage, and bone protrusions (osteophytes) in the tibia and femur are observed. MRI is not the first choice imaging method in gonarthrosis patients. However, in patients with chronic knee pain where no signs of gonarthrosis are seen on direct radiography, MRI may be requested to see the damage to the meniscal structures and cartilage. It is not a reversible disease, our aim is to prevent the progression of the disease. is to stop it. The duty of the patient is to not gain weight in order to reduce the load on the knee, to lose weight if possible, and to do physical therapy exercises regularly to strengthen the thigh and calf muscles.
In addition, the target of the recently implemented PRP (platelet reach plasma) applications. It is to ensure cartilage regeneration by multiplying the cartilage repairing (PDGF) cells in the blood and applying them to the knee. In this application, some blood is taken from the patient and the knee is applied in a suitable environment.
Surgery may be considered in patients with advanced gonarthrosis who do not benefit from all these applications. When deciding on surgery, the patient's age and the degree of gonarthrosis are taken into consideration.
An issue that our patients are curious about is complications after surgery. As with every surgery, the surgeries listed above also have complications. Clot formation and infection may occur in the early period, and prosthesis or bone fracture may occur in the late period. However, these complications were seen in only 2-4% of all cases.
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