Arthritis of the knee

Arthritis of the knee is an inflammatory condition that affects one or both knee joints. This condition is characterized by inflammation of the internal structures of the joint, such as the joint membrane (synovium) and cartilage, which can lead to pain, swelling, limited mobility and destruction of the joint over time.

There are several types of knee arthritis, and the causes of their development can vary:

1. Osteoarthritis: This is the most common form of knee arthritis and is associated with wear and tear of the cartilage in the joint. Osteoarthritis usually develops with age, but can also be caused by injury or excessive stress on the joint.
2. Rheumatoid Arthritis: Rheumatoid arthritis is a chronic inflammatory disease that is autoimmune in nature and can affect multiple joints, including the knee joints.
3. Traumatic arthritis: Damage to the knee joint, such as a fracture, sprain, or strained tendon, can cause arthritis to develop.
4. Other forms of arthritis: There are also other types of arthritis such as gout, juvenile arthritis, and ankylosing spondylitis that can affect the knee joints.

Symptoms of knee arthritis may include pain, swelling, morning stiffness, limited range of motion, creaking or crunching when moving, and general weakness. Knee arthritis is diagnosed by a doctor based on a physical examination, medical history, x-rays and, in some cases, other additional tests.

Treatment of knee arthritis depends on its type and severity. It usually involves medication to relieve pain and inflammation, physical therapy to strengthen muscles and improve joint mobility, injections, surgery (if necessary), and lifestyle changes including controlling stress on the joint and proper nutrition. The goal of treatment is to reduce pain, improve function, and slow the deterioration of the joint.

Causes of the knee arthritis

Here are some of the major causes of knee arthritis:

1. Osteoarthritis (OA): Osteoarthritis, also known as degenerative arthritis, is the most common cause of knee arthritis. It develops as a result of wear and tear on joint cartilage, leading to pain, inflammation, and limited mobility.
2. Rheumatoid arthritis (RA): Rheumatoid arthritis is a chronic systemic inflammatory disease that can affect a variety of joints, including the knee joints. It is characterized by inflammation of the joints and destruction of joint tissues.
3. Gout: Gout is a form of arthritis caused by the accumulation of uric acid crystals in the joints. It can attack the knee joints and lead to acute attacks of pain and inflammation.
4. Infections: Infections, either bacterial or viral, can sometimes cause inflammation in the knee joints, which is called infectious arthritis.
5. Systemic inflammatory diseases: Some systemic inflammatory diseases, such as systemic lupus erythematosus and ankylosing spondylitis, may present with knee arthritis.
6. Injuriesand trauma: Injuries to the knee, including fractures, dislocations, and sprains, can lead to the development of post-traumatic arthritis.
7. Autoimmunediseases: Autoimmune diseases such as Sjögren's syndrome and systemic scleroderma may also present with arthritis.
8. Genetic predisposition: Heredity can also play a role in the development of arthritis, especially if family members have had arthritis.
9. Excess weight: Excess weight can increase stress on knee joints and contribute to arthritis.
10. Physical activity: Especially with strenuous physical activity or sports, there is an increased risk of injury and the development of arthritis.

Symptoms of the knee arthritis

Symptoms and signs of knee arthritis may include the following:

1. Pain: One of the most characteristic symptoms of knee arthritis is pain. The pain can be sharp, dull, aching, or throbbing. It can occur with movement, especially when putting stress on the knee, as well as at rest, especially at night.
2. Inflammation and swelling: The knee joint may be inflamed and swollen. Swelling is usually due to a buildup of joint fluid in the joint.
3. Warmth around the joint: A diseased knee joint may feel warm to the touch due to inflammation.
4. Creakingand cracking: You can hear the characteristic creaking and cracking sounds when you move your knee joint.
5. Limitation of movement: Arthritis can cause limitation of movement in the knee joint. Patients may have difficulty bending and extending the leg or lifting it.
6. Morning stiffness: Some patients may experience morning stiffness and stiffness in the knee joint after waking up.
7. Skin changes: In some cases, the skin in the knee area may be red or hotter to the touch.
8. Change in joint shape: In chronic knee arthritis, the joint can become deformed and change its shape.
9. Muscle weakness: Muscle weakness and atrophy may develop due to pain and restricted movement.
10. Symptoms of systemic disease: If arthritis is part of a systemic disease such as rheumatoid arthritis or juvenile idiopathic arthritis, there may be other symptoms such as fatigue, fever, rash, or inflammation in other joints.

Knee arthritis pain can vary in intensity and character depending on the type of arthritis and its severity. Here are some common characteristics of the pain that can accompany knee arthritis:

1. Pain on movement: Pain occurs when you try to move or put weight on the knee joint. This can include pain when walking, running, climbing stairs, and other activities.
2. Morning stiffness: Many people with knee arthritis notice that the joints are stiff and painful in the morning, and it takes time to straighten them out and make movements.
3. Resting pain: Pain can occur even at rest, especially when sitting or lying down for long periods of time.
4. Swelling: Inflammation associated with arthritis can lead to swelling of the joint, which can also cause pain and discomfort.
5. Crunching and clicking: When you move your joints, you may experience crunching or clicking, which can also be accompanied by pain.
6. Limitation of mobility: Arthritis can cause a decreased range of motion in the knee joint, which can cause pain when trying to perform normal movements.
7. Pain at night: Some people may experience an increase in knee joint pain at night or early in the morning.

Psychosomatics of knee arthritis

Relates to the interaction between psychological factors and physical manifestations of the disease. The psychosomatic aspect means that psychological states, emotions and stress can influence the development, course and worsening of arthritis symptoms in the knee joints. It is important to realize that psychosomatic does not mean that arthritis is caused by psychological factors alone, but it can influence the course of the disease.

Here are some of the psychological aspects that may be associated with knee arthritis:

1. Stress: Constant stress can increase inflammation and joint pain. Stress can affect the immune system, which can make arthritis worse.
2. Depression and anxiety: Patients with arthritis often experience depression and anxiety due to pain, limitations in movement, and lifestyle changes. Emotional states can increase the sensation of pain.
3. Sleep: Psychological problems such as insomnia can be common in patients with arthritis. Lack of sleep can increase pain and inflammation.
4. Self-esteem and fear of the future: Arthritis can reduce quality of life and affect self-esteem. It can cause fear of the future and worsen emotional well-being.
5. Coping strategies: The ways in which patients cope with pain and stress can affect pain levels and overall well-being. Positive strategies such as relaxation and meditation can help reduce pain.

Arthritis of the knee in a child

It is an inflammatory condition that affects the knee joint in children. This condition can have different causes and characteristics, and it can be caused by both immune and infectious factors. It is important to note that pediatric arthritis has its own characteristics, and it should be diagnosed and treated by specialists in pediatric rheumatology or rheumatology.

Here are some key points related to knee arthritis in children:

1. Symptoms: Symptoms of knee arthritis in a child may include pain, swelling, morning stiffness, limited mobility, and inflammation around the joint. Children may also have a subfebrile or feverish temperature, fatigue, and behavioral changes.
2. Causes: Arthritis in children can be caused by a variety of things, including immune diseases such as juvenile idiopathic arthritis (formerly called juvenile rheumatoid arthritis), infectious arthritis, trauma, and other conditions.
3. Diagnosis: A diagnosis of knee arthritis in a child is made based on a physical examination, medical history, laboratory blood tests, and educational imaging of the joints. Additional investigations may include joint fluid tests.
4. Treatment: Treatment for knee arthritis in children may include medication (such as anti-inflammatory drugs and biologics), physical therapy, rehabilitation, injections, and, in some cases, surgery. Treatment should be individualized depending on the type of arthritis and its severity.
5. Support and lifestyle: It is important to provide support and understanding for a child with arthritis. Parents and professionals should help the child manage pain, teach them how to care for their joints, and provide an optimal environment for their development and activity.

Pediatric arthritis requires a comprehensive approach to diagnosis and treatment, and parents should consult with a pediatric rheumatologist or rheumatologist to best manage this condition.

Stages

The degree of knee arthritis is usually assessed by physicians based on clinical and diagnostic findings. The degree of arthritis is usually categorized as mild, moderate, or severe depending on the severity of symptoms, degree of inflammation, and functional loss. However, grading systems may vary depending on the specific method or grading scale.

The most commonly used grading system for knee arthritis is the Kellgren-Lawrence grading system, which assesses the degree of degeneration and changes in the joint on radiographs. This grading system usually includes the following steps:

1. Grade 0 (normal): No evidence of arthritis. The joint space is normal, with no signs of degeneration.
2. Grade 1 (questionable): There may be small changes in the joint, such as a small loss of joint space or small osteophytes (bone growths).
3. Grade 2 (moderate): Radiographs show more significant changes such as moderate loss of joint space, presence of osteophytes and possibly some deformity of the joint.
4. Grade 3 (medium): Moderate degeneration of the joint with visible loss of joint space, large osteophytes and more severe deformities.
5. Grade 4 (severe): Severe degeneration of the joint with maximal loss of joint space, large osteophytes and severe deformity of the joint.

This rating system helps doctors categorize the degree of arthritis and make treatment decisions. However, it is important to remember that the degree of arthritis does not always match the severity of symptoms and pain.

Forms

Arthritis can have different forms and subtypes depending on its characteristics and causes. Here are some of the types of knee arthritis:

1. Acute: Acute develops suddenly and quickly. It can be caused by infection (sepsis), trauma (such as a fracture or sprain), or other factors such as crystalline arthritis (such as gout).
2. Chronic: Chronic arthritis is characterized by a long and slow progression of inflammation in the knee joint. Examples of chronic arthritis include rheumatoid arthritis and osteoarthritis.
3. Purulent: Purulent arthritis develops when bacteria invade the joint cavity, resulting in septic inflammation. This condition is a medical emergency and requires immediate medical attention.
4. Rheumatoid: Rheumatoid arthritis is a chronic autoimmune disease in which the immune system attacks your own joints, including the knee joint. This leads to chronic inflammation, pain, and joint degeneration.
5. Psoriatic: Psoriatic arthritis is a form of arthritis that develops in patients with psoriasis, a chronic skin disease. It can affect the knee joint and other joints.
6. Reactive: This type of arthritis usually develops as a response to an infection in another part of the body, such as the gastrointestinal tract or urinary tract. It can cause pain, swelling, redness and restricted movement in the knee joint, as well as symptoms such as conjunctivitis, urethritis and joint inflammation.
7. Psoriatic: This type of arthritis develops in some people with psoriasis, a chronic inflammatory skin disease. Symptoms may include pain, swelling and inflammation of the knee joint, as well as characteristic psoriatic rashes on the skin.
8. Deforming: This type of arthritis involves the gradual breakdown of cartilage in the knee joint and can lead to deformity of the joint. Symptoms include pain, swelling, morning stiffness, and limited mobility.
9. Infectious: This type of arthritis is caused by an infection that can enter the knee joint. It can cause severe pain, swelling, redness, and restricted movement. Treatment usually involves antibiotics.
10. Juvenile: This is a form of arthritis that develops in children and adolescents. Symptoms can vary but include pain, swelling, joint stiffness and sometimes skin rashes. Juvenile arthritis has different subtypes including joint, systemic, and enthesitis arthritis.
11. Septic: This is a form of arthritis caused by an infection of the knee joint. The infection can enter the joint through blood, trauma, surgery, or other ways. Symptoms include inflammation, pain, swelling, and limited mobility.
12. Undifferentiated: The term "undifferentiated arthritis" is used when symptoms of arthritis are present but the exact cause or type of arthritis cannot be determined. It can be a temporary condition or remain undiagnosed.
13. Allergic: This is a form of arthritis that can develop as a reaction to allergens or allergic substances. Allergies cause inflammation in the joints, resulting in pain and swelling.
14. Stress: This type of arthritis can develop as a result of overuse and wear and tear on the knee joint, usually in athletes or people involved in physical labor. It may also be called "osteoarthritis" or "osteoarthritis."
15. Traumatic: This type of arthritis can occur after an injury or trauma to the knee joint, such as a fracture or torn ligament. Traumatic arthritis may develop over time after the injury.

Diagnostics of the knee arthritis

Diagnosing knee arthritis usually involves several steps to accurately determine the type of arthritis and choose the appropriate treatment. Here are the steps in diagnosing knee arthritis:

1. PhysicalExam: The doctor will perform a physical examination of the joints, including the knee joints, to look for signs of inflammation, swelling, restriction of movement, and pain. It is important to tell the doctor about the nature and duration of the pain, as well as factors that increase or relieve symptoms.
2. MedicalHistory: The physician asks questions about the patient's medical history, including the presence of previously diagnosed arthritis, other medical conditions, and risk factors.
3. Blood tests: A general blood count and biochemical analysis may reveal signs of inflammation, such as C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR). Tests for antinuclear antibodies (ANA), rheumatoid factor, and antibodies to cyclic citrullinated peptide (anti-CCP) may also be performed to determine the type of arthritis.
4. X-rays: X-rays of the knee joints may be taken to evaluate the condition of the bones, detect degenerative changes, and rule out other possible causes of pain. X-rays may also help in determining the extent of joint damage.
5. Ultrasound (USG): Ultrasound can be used to visualize joints and evaluate the presence of joint effusion or soft tissue changes.
6. Magnetic resonance imaging (MRI): MRI provides more detailed information about the condition of the soft tissues of the joint, including cartilage and tendons.
7. Arthroscopy: If the results of other tests are equivocal or a more accurate diagnosis is needed, arthroscopy may be required. This is a surgical procedure that uses a small optical camera to view the internal structures of the joint.
8. Joint biopsy: In rare cases, if infectious arthritis or other unclear causes of inflammation are suspected, it may be necessary to take a sample of joint tissue for analysis.

Differential diagnosis

Differential diagnosis of shoulder arthritis involves identifying and distinguishing this condition from other possible causes of pain or inflammation in the shoulder joint. Here are some of the possible conditions and diagnostic methods that may be used:

1. Osteoarthritis (o steoarthritis): Osteoarthritis of the shoulder can mimic the symptoms of arthritis. Diagnosis may include X-rays to evaluate the joints and rule out signs of inflammation characteristic of arthritis.
2. Subacute/chronic synovitis: This is inflammation of the joint bag (synovial membrane) or joint sheaths. Synovial fluid tests and imaging studies (MRI or ultrasound) may be performed to evaluate the joint and synovial membrane.
3. Traumatic injury: Tra uma to the shoulder can cause symptoms similar to arthritis. X-rays and clinical examination can help determine if there is an injury or fracture.
4. Rheumatoid arthritis: This is a chronic systemic inflammatory disease that can affect the joints, including the shoulder. Diagnosis includes blood tests such as determination of rheumatoid factor and antibodies to cyclic citrullinated peptide (anti-CCP), radiography and MRI.
5. Other types of arthritis: There are many different types of arthritis, such as intra-articular arthritis, arthritis associated with other systemic diseases (e.g., systemic lupus erythematosus, ankylosing spondylitis, etc.), and others. Diagnosis may vary depending on the type of arthritis.
6. Infectious arthritis: If infectious arthritis is suspected, joint fluid tests may be performed to look for germs.
7. Tendinitis: Inflammation of the tendons in the shoulder joint can mimic the symptoms of arthritis. Ultrasound or MRI may be used to evaluate the condition of the tendons.

Arthritis and osteoarthritis are two different conditions related to the knee joint, and they have different causes, symptoms, and characteristics.

1. Arthritis of the knee:

   • Cause: Arthritis is an inflammatory disease of a joint that can be caused by immune system reactions (e.g., rheumatoid arthritis) or infection (infectious arthritis).
   • Symptoms: Arthritis is accompanied by inflammation, pain, swelling, redness and restriction of movement in the knee joint. Usually morning stiffness of the joint is a characteristic sign of rheumatoid arthritis.
   • Characteristics: Arthritis can cause destruction of joint tissues and bones due to inflammation and immune activity. It is usually a chronic condition that requires long-term treatment.

2. Osteoarthritis (osteoarthritis) of the knee joint:

   • Cause: Osteoarthritis, or osteoarthritis, is a degenerative joint disease that is caused by wear and tear of the articular cartilage. This is due to the aging process, trauma, repetitive mechanical stress and other factors.
   • Symptoms: Osteoarthritis is characterized by pain in the knee joint, especially on movement, creaking or clicking in the joint, limited mobility and morning stiffness.
   • Characteristics: Osteoarthritis is associated with gradual wear and tear of articular cartilage and changes in joint structure. It is more commonly associated with age and mechanical factors and tends to progress over time.

Treatment of the knee arthritis

Knee arthritis treatment usually involves several steps and is based on the type of arthritis, its severity, and the individual patient. Here are common knee arthritis treatment steps and protocols:

1. Diagnosis and assessment:

• In this step, the doctor performs diagnostics including a physical exam, examination of the joint, and may also require additional tests such as X-rays, MRI, CT scans, or blood tests.

2. Drug therapy:

• Depending on the type of arthritis and how severe it is, your doctor may prescribe medications including:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation.
  • Glucocorticosteroids, which may be injected into the joint to relieve inflammation.
  • Biologic drugs that modify the immune system.
  • Drugs that reduce the activity of the disease.

3. Physical therapy and exercise:

• Physical therapy includes exercises to strengthen muscles, improve mobility and reduce pain. Physical therapists may also use massage techniques and cold and heat therapy.

4. Rehabilitation:

• After physical therapy, the patient may be referred to rehabilitation to regain full functionality of the knee joint.

5. Lifestyle changes:

• It is important to maintain a healthy lifestyle, including weight control, physical activity with doctor's recommendations, proper nutrition, and adherence to a regimen.

6. Injections:

• In some cases, hyaluronic acid injections may be used to help lubricate the joint and reduce pain.

7. Surgical treatment:

• If conservative methods do not bring improvement, surgery may be necessary. Options include arthroscopy, revision arthroplasty and other surgical procedures.

8. Self-management and support:

• It is important to teach the patient to self-manage their condition and support them in monitoring symptoms and following their doctor's recommendations.

Treatment for knee arthritis is individualized and can be tailored to each patient's needs. The key is to see a doctor early to determine the type of arthritis and develop the best treatment plan.

Drug treatment

Treatment for knee arthritis includes various medications that help relieve pain, reduce inflammation, and slow the progression of the disease. Here are some of the medications that may be used in the treatment of knee arthritis:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs):

   • Ibuprofen (Advil, Motrin)
   • Diclofenac (Voltaren)
   • Naproxen (Aleve, Naprosyn)
   • Meloxicam (Mobic)

2. Glucocorticosteroids (corticosteroids):

   • Prednisolone (Prednisone)
   • Triamcinolone (Kenalog)
   • Methylprednisolone (Depo-Medrol)

3. Biological drugs (biological disease modifiers):

   • Adalimumab (Humira)
   • Etanercept (Enbrel)
   • Infliximab (Remicade)
   • Abatacept (Orencia)

4. Disease-modifying drugs (DMARDs):

   • Methotrexate (Methotrexate)
   • Leflunomide (Arava)
   • Sulfasalazine (Azulfidine)

5. Hyaluronic acid (joint injections):

   • Sodium hyaluronate (Hyalgan, Synvisc)
   • Eptozar (Euflexxa)
   • Supartz

6. Anti-inflammatory creams and gels:

   • Diclofenac creams (Voltaren Gel)
   • Ketoprofen creams (Orudis KT)

7. Analgesics:

   • Acetaminophen (Tylenol)
   • Tramadol (Ultram)

8. Immunomodulators and immunosuppressants:

   • Azathioprine (Imuran)
   • Cyclosporine (Neoral, Sandimmune)

Treatment of knee arthritis often requires an individualized approach, and the choice of medications depends on the type and severity of arthritis, as well as the patient's response to treatment.

Ointments for knee arthritis

Ointments can be used in the complex treatment of knee arthritis to relieve pain, inflammation and improve the functionality of the joint. However, the choice of ointments depends on the type of arthritis, its severity and the doctor's recommendations. Here are some of the ointments and gels that may be recommended for knee arthritis:

1. Nonsteroidal anti-inflammatory ointments (NSAIDs): Ointments containing NSAIDs, such as ibuprofen, diclofenac, or naproxen, can help reduce inflammation and relieve knee pain. These ointments are available over-the-counter and can be used for short-term relief of symptoms.
2. Capsaicinointments: Capsaicin is a natural substance that can help reduce pain and improve blood circulation in the joint area. However, capsaicin ointments can cause a burning sensation and should be used with caution.
3. Glucosamine and chondroitin ointments: These components are part of the structure of joint cartilage and can be used to improve joint health and reduce arthritis symptoms.
4. Glucocorticosteroid ointments: Glucocorticosteroid ointments such as hydrocortisone can help reduce inflammation and pain. They are usually used for short periods of time and under a doctor's supervision, as they can cause side effects.
5. Ointmentswith analgesics: Ointments containing analgesics, such as lidocaine or procaine, can help relieve pain and discomfort in the joint area.
6. Ointments with natural ingredients: Some people prefer to use ointments with natural ingredients such as arnica, boswellia or curcumin, which have anti-inflammatory properties.

Antibiotics for knee arthritis

Infectious knee arthritis is usually treated with antibiotics because it is caused by an infection. To successfully treat infectious arthritis, it is important to start antibiotics as soon as possible after diagnosis. The choice of antibiotic will depend on the type of infectious agent and sensitivity to the antibiotic. Below are some common antibiotics that can be used in the treatment of infectious knee arthritis:

1. Cephalosporins: Examples of cephalosporins that may be used include cefazolin, ceftriaxone, and cefepime. They are often used in the initial treatment of infectious arthritis.
2. Vancomycin: Vancomycin may be used when arthritis is caused by methicillin-resistant Staphylococcus aureus (MRSA) or other multiple resistant bacteria.
3. Fluoroquinolones: For example, ciprofloxacin or levofloxacin. They can be used for infections caused by gram-negative bacteria.
4. Penicillins: For example, ampicillin or amoxicillin can be used for infections caused by bacteria that are sensitive to them.
5. Other antibiotics: In rare cases where the causative agent is atypical bacteria or other microorganisms, specialized antibiotics may be used.

Analgesic drugs

Analgesic medications that may be recommended for knee arthritis pain relief include the following categories:

1. Non-opioid anti-inflammatory drugs (NSAIDs):

   • Ibuprofen (e.g., Ibuprofen, Advil)
   • Diclofenac (e.g., Diclofenac, Voltaren)
   • Naproxen (e.g., Alepran, Naprosyn)

2. Opioid analgesics (used for severe pain and with a doctor's prescription):

   • Tramadol
   • Oxycodone

3. Injectable drugs:

   • Corticosteroid injections (such as methylprednisolone) can sometimes be used to relieve inflammation and pain in the knee joint.
   • Hyaluronic acid (e.g., Synvisc, Orthovisc) may be injected into the joint to lubricate and reduce pain.
4. Anti-inflammatory biologic drugs: These drugs are usually used for rheumatoid arthritis or other forms of arthritis that do not respond to NSAIDs and other therapies.
5. Acetaminophen (paracetamol): This medicine can be used for pain and antipyretic.

Anti-inflammatory drugs

Anti-inflammatory drugs can be effective in relieving the symptoms of knee arthritis, such as pain and inflammation. Here are some of the most commonly used anti-inflammatory drugs:

1. Diclofenac: Diclofenac is an NSAID (non-steroidal anti-inflammatory drug) that can be used to reduce inflammation and relieve pain in knee arthritis. It is available in different forms including ointments, gels, tablets and injections.
2. Ibuprofen: Ibuprofen is also an NSAID and can help reduce inflammation and relieve arthritis pain. It is available as tablets, capsules, ointments, gels, and liquids.
3. Meloxicam: Meloxicam is another NSAID that can be prescribed to treat arthritis. It is usually available in tablet or capsule form.
4. Nimesil(nimesulide): Nimesil also belongs to the class of NSAIDs and can be used to relieve inflammation and pain in arthritis. It is available in different forms, including tablets and suspensions.
5. Dexamethasone: Dexamethasone is a glucocorticosteroid that can be used for arthritis as an injection into a joint. It can quickly relieve inflammation and reduce pain, but is usually used for short periods of time due to potential side effects.

Joint support and stabilization

Orthotics, bandages, and elastic bandages can be helpful for knee arthritis because they can help reduce pain, support the joint, and improve its functionality. Here's how they can be used:

1. Kneeorthoses: Knee orthoses are special medical devices that are worn on the knee and provide support and stabilization of the joint. They can help reduce pain and prevent excessive strain on the joint during movement. Orthoses are available in a variety of options, including soft and rigid. A doctor may recommend a specific type of orthosis depending on the severity of the arthritis and the individual needs of the patient.
2. Knee braces: Knee braces are soft, elasticized products that are placed on the knee and provide compression and support. They help reduce swelling, reduce pain and improve joint stability. The bandages are easy to put on and take off and can be used for everyday activities.
3. Elastic bandages: Elastic bandages can be used to hold bandages or orthoses in place and to support the joint. They usually provide extra compression and help prevent the bandage or orthosis from slipping.

Before you start using orthotics, bandages or elastic bandages, it is important to consult your doctor or orthopedist. They can help you choose the right type and size of product, as well as advise on proper wear and care.

Physiotherapy

Electrophoresis, darsonval, almag, and knee taping are various physical therapy and treatment methods that can be used for knee arthritis. However, the effectiveness of each of these methods can depend on the type and degree of arthritis, as well as the individual patient. Let's take a closer look at each of these methods:

1. Electrophoresis: This is a physical therapy procedure in which medications are injected into the body through the skin using an electric current. Electrophoresis can help administer anti-inflammatory or pain medications that can reduce inflammation and soreness in the knee joint.
2. Darsonval: A Darsonval is a device that uses high-frequency electrical impulses to treat a variety of diseases and conditions, including arthritis. It can help reduce inflammation and relieve pain.
3. Almag: Almag is a device that uses magnetotherapy to treat a variety of conditions, including arthritis. Magnetotherapy can help improve circulation and reduce inflammation in the joints.
4. Knee Taping: Knee taping is a technique in which a special medical tape (taping) is applied to the knee to support and stabilize the joint. This can help reduce pain and prevent additional damage.

It is important to emphasize that the choice of treatment method should be made by a physician who takes into account the individual needs and characteristics of the patient, as well as the extent and nature of the disease. Treatment of knee arthritis may involve a combination of different methods, including medication, physiotherapy, physical rehabilitation and surgery if necessary.

Exercises, gymnastics and massage

May be useful techniques in the holistic treatment of knee arthritis. However, before beginning any exercise or massage, be sure to consult your doctor or physical therapist to make sure they are safe for your condition. Below are some exercises and recommendations:

Exercise and gymnastics:

1. Warm-up and stretch: Start with a gentle warm-up and stretch to prepare your joints for the exercises. Rotate your legs, raise and lower them, and make circular movements with your feet.

2. Strengthening the muscles around the knee joint: Strengthening the thigh and calf muscles can reduce stress on the joint. Exercises may include:

   • Raising the leg up while lying on your side.
   • Supported squats.
   • Toe raises.

3. Increaserange of motion: Light exercises to increase knee mobility can be helpful. For example, slow and careful forward and backward movements of the leg.

4. AerobicExercise: Aerobic exercise, such as swimming or bicycling, can help strengthen the cardiovascular system and improve overall fitness.

Massage:

Massage can help relieve muscle tension and improve circulation in the knee area. It is important to have the massage performed by a professional massage therapist or physical therapist with experience working with arthritis patients. It may include light stroking, rubbing and gently strengthening the muscles around the joint.

In addition to exercise and massage, it is important to follow a proper diet, control your weight, avoid overworking your joints, and follow all of your doctor's recommendations for arthritis treatment.

Folk remedies and home methods

Some folk remedies and home methods can be used to relieve pain and reduce inflammation in knee arthritis in addition to the main treatment. The following are some of them:

1. Warm compresses: Applying warm compresses to the knee joints can help reduce pain and relax the muscles. Use a heating pad or a hot towel. However, be careful not to burn the skin.
2. Cold wraps: In the first stage of arthritis, applying cold compresses to reduce swelling and inflammation may help. Use ice or frozen vegetables wrapped in a towel.
3. Oil Massage: Gently massaging the knee joint area with an oil, such as olive oil, can help relax the muscles and improve circulation.
4. Inhalation and aromatherapy: Some aromatic oils, such as lavender and eucalyptus, can help relieve stress and reduce arthritis pain. They can be used for inhalation or added to massage oils.
5. Gels and creams with arthropathic properties: There are many gels and creams available in the market that contain natural ingredients such as menthol and camphor, which can relieve pain and inflammation when applied externally.
6. Diet: A balanced diet can help reduce inflammation. Increase your intake of antioxidants (such as vitamins C and E) and omega-3 fatty acids, which can be found in fish and nuts.
7. Physical activity: Moderate exercise appropriate for your condition can help strengthen the muscles around the joint and improve mobility. Discuss a physical activity program with your doctor.

It is important to realize that folk remedies and home methods can complement mainstream medical treatment, but do not replace it.

Compresses and heat treatments

Compresses and heat treatments can help relieve knee arthritis symptoms such as pain and burning. Warming an arthritic joint can be done using the following methods:

1. Warm compression: Using a warm, damp cloth or heating pad can help relax the muscles and improve circulation to the joint area. Apply warm compression to the sore area for 15 to 20 minutes several times a day.
2. Hot baths: Taking a hot bath with sea salt or essential oils can also relieve tension and pain in the joint. Make sure the water is not too hot to avoid burns.
3. Warm wraps: You can use warming ointments or wraps containing capsaicin or other medications that help relieve pain and inflammation.
4. Heat therapy: Applying heat devices, such as electric pillows or heating pads, to a sore joint can also provide relief. Make sure the temperature is not too high to avoid burns.

However, it is important to remember that hot compresses and heat treatments are not always suitable for all types of arthritis. For example, in rheumatoid arthritis, heat can increase inflammation and in such cases, it is better to use cold compresses. Therefore, it is important to consult your doctor or rheumatologist before starting heat treatments so that they can suggest the most appropriate method of relieving knee arthritis symptoms in your particular case.

Proper nutrition and diet

Proper diet and nutrition can have a positive impact on managing the symptoms of knee arthritis. It is important to note that diet is not a substitute for medical treatment, but it can help improve overall health and reduce inflammation. Here are some nutritional and vitamin recommendations for knee arthritis:

1. Healthy Diet: When you have arthritis, it is important to eat a diet rich in antioxidants and inflammatory food components. This includes vegetables, fruits, nuts, seeds, fish and fish oil oils.
2. Omega-3 fatty acids: Omega-3 fatty acids found in fish like salmon, tuna and mackerel may have anti-inflammatory properties and help reduce inflammation in the joints.
3. Vitamin D: Vitamin D is important for healthy bones and joints. It can be obtained from food (fish, fatty dairy products) and sunlight. If you are deficient in vitamin D, your doctor may recommend supplemental intakes.
4. Antioxidants: Include antioxidants such as vitamin C (citrus fruits, kiwi, strawberries), vitamin E (almonds, nuts, seeds) and beta-carotene (carrots, bell peppers) in your diet.
5. Curcumin: Curcumin, the active ingredient in turmeric, has anti-inflammatory properties. It can be added to food or taken as supplemental capsules (after consulting your doctor).
6. Glucosamine and chondroitin: These substances may help maintain healthy cartilage and joints. They are available in supplement form.
7. Healthy body weight: Maintain a healthy body weight, as being overweight can increase stress on your knee joints.
8. Limit inflammatory foods: Limit your intake of foods that promote inflammation, such as saturated fats, sugar, and industrially processed foods.
9. Drink: Drink enough water to keep your joints hydrated and reduce the risk of uric acid buildup (which can cause gout).

Sports and physical activity

Sports and exercise can be beneficial for knee arthritis, but it's important to choose activities that don't aggravate symptoms or damage the joints. Here are recommendations for sports and exercise for knee arthritis:

1. Walking: Walking is an excellent form of exercise for patients with knee arthritis, especially in the early stages of the disease. It is a gentle exercise that strengthens muscles and keeps joints healthy. It is important to choose soft walking surfaces to reduce impact.
2. Running: Running may not be desirable for knee arthritis, especially if the joints are severely affected. However, some people with arthritis can continue running by following some precautions:
   • Choose soft treadmills or trails.
   • Follow proper running technique to minimize stress on your knee joints.
   • Consult your doctor or physical therapist to develop an exercise plan.
3. Bicycling: Bicycling is an excellent sport for patients with knee arthritis, as it is a low-impact exercise that can strengthen the legs and improve circulation without putting a lot of stress on the joints. Bicycling can be used as a means of strengthening and maintaining joints.

It is important to remember that each case of arthritis is unique and the approach to physical activity should be individualized. Before starting any physical activity or sport for knee arthritis, you should consult your doctor or physiotherapist. They can recommend appropriate activities and develop a personalized exercise plan, taking into account the severity of your arthritis and your current condition.

Clinical Guidelines

Clinical guidelines for the treatment of knee arthritis can vary depending on the type of arthritis (e.g. Rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, etc.), its severity, the patient's age, and other factors. It is important to consult with a physician who can determine the best treatment and rehabilitation plan for your specific case. The following are general recommendations:

1. Treatment of the underlying disease (if it is rheumatoid arthritis or other systemic arthritis):

   • Use of anti-inflammatory drugs (such as NSAIDs) or biologics.
   • Modification of the course of the disease with medications such as methotrexate.
   • Physical therapy and regular exercise to maintain joint mobility.

2. Pain Management:

   • Use of pain medication such as paracetamol or low-dose oral opioids as prescribed by a doctor.
   • Glucocorticosteroid injections into the joint to relieve inflammation and pain.
   • Physical therapy, including exercises to strengthen the muscles around the joint.

3. Physical Rehabilitation:

   • Exercises to strengthen the thigh and lower leg muscles to improve knee stability.
   • Stretching and massage to improve joint mobility.
   • Use of orthotics or bandages to support the joint if necessary.

4. Diet and weight management:

   • Maintaining a healthy weight can reduce stress on knee joints and improve symptoms.
   • It is recommended to eat foods rich in antioxidants and vitamins, which can help reduce inflammation.

5. Surgical treatment (if necessary):

   • Arthroscopy to remove damaged tissue and part of the cartilage.
   • Total or partial knee replacement (arthroplasty) in severe cases of osteoarthritis.

6. Adherence to doctor's recommendations:

   • It is important to follow your doctor's prescriptions and make sure you take your medication regularly.
   • Have regular checkups and consultations with a rheumatologist or orthopedist.

Rehabilitation

Rehabilitation for knee arthritis plays an important role in restoring joint function, reducing pain, and improving the patient's quality of life. Effective rehabilitation involves several key aspects:

1. Physical Therapy: Physical therapy helps improve the strength and flexibility of the muscles around the knee joint. A physical therapist develops an individualized exercise program to help restore motion in the joint, strengthen muscles, and improve overall leg function.
2. Stretching exercises: Stretching the muscles and tendons around the knee can help increase joint mobility and reduce tension. It can also reduce pain.
3. Instruction on proper walking and movement: Patients may need instruction on how to walk and perform everyday movements to avoid strain and injury.
4. Use of supportive devices: In some cases of knee arthritis, the use of crutches, canes, or orthotics may be recommended to reduce stress on the joint and facilitate mobility.
5. Pharmacotherapy: Your doctor may prescribe medications to control inflammation and pain in the joint. These may include anti-inflammatory medications, pain relievers, or glucocorticosteroid injections.
6. Diet and weight management: Following a healthy diet and maintaining a healthy weight can reduce stress on the knee joint and improve its health.
7. Physical Therapy Techniques: In addition to exercises and stretching, physical therapy techniques such as electrical stimulation or cold and heat therapy can be used to reduce pain and inflammation.
8. Psychological support: Living with arthritis, patients may face psychological stressors. Support from a psychologist or group therapy can help manage these aspects of the disease.

The rehabilitation program should be individually tailored to the individual patient and their needs.

Prevention

Preventing knee arthritis and reducing your risk of developing it play an important role in maintaining healthy joints. Here are some measures and recommendations that can help you prevent or reduce your risk of developing knee arthritis:

1. Maintain a healthy lifestyle:

   • Eat a balanced diet rich in antioxidants, omega-3 fatty acids and vitamins.
   • Watch your weight and maintain a normal body mass index (BMI), as excess weight increases stress on your joints.
   • Lead an active lifestyle with regular exercise, including muscle strengthening and flexibility.

2. Avoid injuries and overexertion:

   • Use protective equipment and observe safety precautions when playing sports.
   • When lifting weights, distribute the load correctly and use supportive equipment if necessary.

3. Take care of your joints:

   • Maintain good posture and avoid long periods of immobility.
   • Encourage proper joint exercises such as stretching and mobility.

4. Avoid smoking and drink alcohol in moderation:

   • Smoking may increase your risk of developing rheumatoid arthritis.
   • Moderate alcohol consumption, especially wine, may have antioxidant properties and may have positive effects on joints.

5. Control your immune system:

   • Reduce your risk of infectious diseases and take care of your immune system.

6. Get regular medical checkups:

   • See your doctor on a regular basis to evaluate your joints and your overall health.

7. Adhere to treatment for chronic conditions:

   • If you have chronic conditions such as gout or rheumatoid arthritis, follow your doctor's recommendations and take prescribed medications.

Sick leave

A sick leave for knee arthritis is granted by a rheumatologist or orthopedist when the patient's condition requires temporary disability due to pain, inflammation and limited movement in the joint. In most cases, knee arthritis can be very painful and limit normal physical activity.

To obtain sick leave, you should see a doctor, have a consultation and discuss your condition. If the doctor recognizes that you are temporarily unable to perform normal work duties because of knee arthritis, he or she can issue you a sick leave. The length and conditions of the sick leave will depend on the severity of the condition and the responsibility of your job.

It is important to follow all doctor's recommendations, take prescribed medications, and follow rehabilitation measures to recover as quickly as possible and return to normal activities.

Arthritis of the knee and the army.

The situation regarding military service with knee arthritis may depend on several factors such as the severity of the condition, treatment, medical advice and the military service policy in a particular country. Health and physical fitness are important criteria for determining fitness for military service.

Many armed forces countries have certain medical standards that determine whether a person can be drafted or remain in the military based on their physical condition. If you have knee arthritis, you will probably need a medical evaluation to determine how much this condition affects your ability to perform military duties.

Usually, the decision about whether you can serve in the military with knee arthritis is made by medical doctors and military services based on medical records and tests. If the arthritis severely limits your ability to move or requires regular treatment and monitoring, it may affect your fitness for military service.

Literature

• Kotelnikov, G. P. Traumatology / edited by Kotelnikov G. P.., Mironov S. P. - Moscow : GEOTAR-Media, 2018.
• Pavel Evdokimenko: Arthritis. Getting rid of joint pain, World and Education, 2017.