How is my Knee: Gonarthrosis

The knee is one of the joints in the human body that can present a greater diversity of injuries, and therefore, be more difficult to diagnose. A hard target to identify when you say  “my knee hurts”.

Among the main pathologies that a knee can present is gonarthrosis, whose word is made up of two terms; Gonu (with is knee in Greek) + osteoarthritis (degeneration of the joint’s cartilage). Gonarthrosis, then, is a degeneration of the cartilage of the knee joint that affects, in addition to the cartilage, the ligaments, menisci and periarticular muscles. 

Among the factors that can lead to the appearance of gonarthrosis, we can find:

• Age: Excessive use of a joint favors cartilage wear, so elderly people are more likely to suffer from it.
• Genetic predisposition.
• Obesity. The fact that our joint supports an excessive weight, will favor a greater wear of the cartilage.
• Sports or any activity that involves repetitive movements.
• Genu Valgo or Genu Varus (two types of knee deformities) 

The main symptoms that produce gonarthrosis are:

• Pain, that, as we progress in the injury will increase.
• Inflammation, since there is a degeneration of the cartilage, the body will try to recover it and for this it will react by inflaming itself.
• Edema, since there are some structures that are breaking down
• Decrease in joint mobility, especially in flexion, which in certain movements will generate disability.

To diagnose a knee with gonarthrosis, an anteroposterior and lateral X-ray of both knees with the patient standing will be necessary, as well as an axial X-ray of the patella and, in more severe cases, an MRI.

There are multiple therapeutic strategies for the treatment of knee osteoarthritis, however, it is very important to understand that most of the therapeutic options exclusively seek to alleviate the symptoms, the only “curative or definitive” option being the replacement of the joint with a knee prosthesis.

Regarding medical treatment, in the first place, it is advisable to modify life habits, such as modifying the type of exercise if it is practiced or starting to exercise if it was not practiced before and improving eating habits to achieve the ideal weight.

 At the pharmacological level, analgesics or anti-inflammatories only serve to control pain in the initial phases, having no effect on the rest of the symptoms.

The so-called filtrations are also used as a treatment for gonarthrosis, corticosteroids, derivatives of hyaluronic acid and different preparations of “biological” origin (platelet-rich plasma, enriched plasma, stem cells, etc.) can be injected. Its effect is mainly anti-inflammatory, but they have no effect on the osteoarthritis itself.

Undoubtedly, the treatment of choice in already established gonarthrosis is surgical intervention. In the initial phases with symptomatic joints, but radiologically little affected, if there is a limb deformity. However, when gonarthrosis is established, the only effective surgical treatment is knee arthroplasty, which can be unicompartmental or total.

Orthopedic Corner | Leon Mead MD Orthopedic Doctor | 730 Goodlette Road North, Suite 201  Naples Florida 34102 | Phone: (239) 262-1119