Osteoarthritis (OA), also known as degenerative osteoarthropathy, is a joint disease caused by the gradual deterioration of articular cartilage. Articular cartilage is an important tissue that protects joints, and a breach of its integrity can lead to greater stress and friction on the joints, which can cause pain and inflammation. At the same time, lesions in the subchondral bone plates at the joint margins can further exacerbate the symptoms and signs of the joint. Osteoarthritis is a chronic degenerative joint disease that progressively worsens with age.
Osteoarthritis tends to affect the knees, hips, spine, hands and other parts. Among them, the knee joint is one of the most susceptible joints, which may be related to the important position of the knee joint in the human body and the greater load it bears. Areas such as the hip joint, spine, and hands are also often affected by osteoarthritis, but it is relatively rare.
Knee osteoarthritis is the most common one, mainly due to the degeneration of the knee joint, which leads to the wear and tear of the joint cartilage, which in turn leads to pathological changes such as bone hyperplasia and synovitis. These changes can cause symptoms such as pain, swelling, and limited movement in the knee joint, which can seriously affect the patient's quality of life. In order to reduce pain and improve quality of life, patients need to be systematically administered, including medication, physics, training, etc.
In addition to the knee, hip osteoarthritis is also a common type. This condition is usually due to a combination of factors such as aging, osteoporosis, and necrosis of the femoral head. The symptoms of hip osteoarthritis include pain, stiffness, limited mobility, etc., and a variety of factors also need to be considered, including medication, physics, surgery, etc.
In conclusion, osteoarthritis is a common chronic degenerative joint disease, and the joints that are susceptible to affect include the knee joint, hip joint, spine, hand, etc. Knee arthritis accounted for 41% of these. In order to reduce pain and improve the quality of life of patients, systematic management is required. At the same time, early prevention and intervention are also very important.
Knee anatomy
Overview – Definitions
Knee arthritis, also known as knee osteoarthropathy, degenerative arthritis, proliferative arthritis or senile arthritis, is a chronic injury that begins with degeneration of cartilage. This disease not only affects the bone, but also affects joint structures such as the synovium of the joint, and is accompanied by an inflammatory process during repair, so it is also known as osteoarthritis.
Knee arthritis is a common joint disease, especially in middle-aged and elderly people. The disease can lead to joint pain and joint dysfunction, and even joint deformities. These symptoms usually manifest as joint pain, swelling, stiffness, and weakness, as well as limited joint movement. As knee arthritis is a chronic condition, it requires long-term** and management.
There are many types of knee arthritis, including age, obesity, genetic factors, lifestyle, etc. As we age, articular cartilage wears down, leading to bone growth and bone spur formation. In addition, obesity also increases the risk of knee arthritis because excess weight increases the burden on the joints. Genetics are also an important factor in knee arthritis, and some people are born with a predisposition to the disease. Lifestyle can also affect the occurrence and progression of knee arthritis, such as lack of exercise, poor posture, and overuse of certain joints.
There are many ways to treat knee arthritis, including medication, physics, surgery, etc. Medications** often include anti-inflammatory pain relievers, cartilage protectors, etc. Physical** includes hot compresses, cold compresses, electrotherapy, etc. Surgery** includes arthroscopic dissection, osteotomy, joint replacement, etc. In daily life, patients can alleviate the symptoms of knee arthritis by losing weight, strengthening exercise, changing lifestyle, etc.
In conclusion, knee arthritis is a common joint disease that requires long-term** and management. By understanding its **and **methods, we can better manage and prevent the occurrence and progression of knee arthritis.
and pathogenesisThe basic structure of joints: articular surface, articular cartilage, articular cavity, articular capsuleArticular cartilage: the thickness is about 2-7mm, the cartilage surface is smooth, and the friction coefficient is very small, so it is conducive to joint mobility. 
Key factors: With age, overuse and wear and tear on the joints, mucopolysaccharides are lost from the joints and their ability to synthesize mucopolysaccharides is diminished. 
PathologyVarious inflammatory reactions, hyperplasia, and surface exudations of the synovium. Thickening and adhesion of the joint capsule. Softening, tearing, abrasion of articular cartilage. Osteophyte formation. 
Clinical presentation.
1.The pain can be divided into five degrees according to the degree of pain from mild to severe: 1st degree: no pain 2nd degree: mild 3rd degree: moderate 4th degree: severe 5th degree: severe Most patients have mild and moderate knee pain, mostly dull pain, accompanied by heaviness, soreness, stasis, and discomfort in movement. 
2.Swelling: Some patients have swollen joints and reverse the joints. 3.Deformity: The knee joint may be varus or valgus deformity, and the bone margin of the joint may be enlarged. Some patients are unable to fully straighten the knee, and in severe cases, the knee is deformed with flexion contracture. 4.Dysfunction: abnormal motor rhythm: soft legs, snapping sounds, skeletal disorder. Decreased mobility: joint stiffness, instability, limited flexion and extension, ability to walk. 
Diagnosis
Diagnostic criteria for knee OA 1, recurrent knee pain in the past 1 month, and reduced motor function. 2. X-ray (standing or weight-bearing position) shows narrowing of the joint space, subchondral osteosclerosis, and/or cystic changes, and formation of osteophytes at the joint margin. 3. Middle-aged and elderly patients (40 years old). 4. Morning stiffness for 30 min. 5. There is a bone rub (sense) during activity. 6. The bone end of the knee joint is hypertrophied, and the local swelling is different degrees. 7. The range of motion of knee flexion and extension is reduced or limited. 8. Knee deformity changes, with knee varus deformity being the most common. Floating patella test The affected limb is straightened, the doctor holds one hand against the top of the patella, the palm of the hand is pressed against the suprapatellar capsule to allow fluid to flow into the joint cavity, and the index finger of the other hand presses the patella in a vertical direction
In the McCeyer test, the patient lies on his back, the doctor holds the foot of the affected limb with one hand, and the thumb and the remaining four fingers of the other hand touch the medial and lateral joint spaces of the knee joint respectively, first make the knee joint extremely flexed, then adduct the lower leg, externally rotate, and gradually straighten the knee joint. On the contrary, the calf is abducted and rotated, and the knee joint is gradually straightened, and if there is pain or snapping in the lateral knee joint, it means that the lateral meniscus is injured.
Drawer test The patient lies supine with the knee bent to a 90° position, the muscles are relaxed, and the doctor holds the upper end of the calf with both hands and pulls it forward and backward repeatedly. Normal lack of activity, such as sliding forward, suggests an anterior cruciate ligament injurySliding backward indicates a posterior cruciate ligament injury. In the lateral compression test, the patient is placed in a supine position, the knee joint is straightened, the physician holds the ankle joint with one hand and pushes it laterally, and the other hand is placed on the outside of the knee joint to push medially, so that the tension of the medial collateral ligament increases, if the medial knee pain is positive, it indicates the medial collateral ligament injury, if the pressure is applied in the opposite direction, the lateral knee joint pain indicates the lateral collateral ligament injury.
Grinding test This test is a method to distinguish lateral collateral ligament injury from meniscus rupture. The patient is prone with the hip straightened, the affected knee is flexed at 90°, the doctor immobilizes the thigh, holds the affected foot with both hands, squeezes the knee joint, and rotates the calfConversely, lifting the lower leg widens the knee joint space and rotates the lower leg, causing pain, which is a collateral ligament injury.
Imaging modalities.
Basic features of X-ray examination1Narrowing of the joint space: **The knee joint space is 4mm, less than 3mm is the joint space narrowing, the knee joint space is 3mm for the elderly over 60 years old, and less than 2mm is the joint space narrowing. 2.Subchondral plate sclerosis: The subchondral bone plate is dense and hardened, and cystic changes are seen in the weight-bearing subchondral bone. 3.Osteophyte formation.
Changes in articular cartilage: cartilage edema, cystic cartilage, cartilage thinning, abrasion, cartilage destruction.
Laboratory tests are usually normal. Joint synovial fluid analysis is also normal, clear, yellowish, and viscous, and the white blood cell count is often within 1000, occasionally reaching several thousand, mainly monocytes, with occasional mucin clots being solid, and sometimes red blood cells, cartilage, and fibrous debris. Differential diagnosisKnee collateral ligament injury:Fixed tenderness at the site of ligament injury, often at the upper and lower attachment points or middle of the ligament, semi-flexion of the knee, limited joint movement, positive lateral crush test. Meniscus injury of the knee:He has a history of trauma, post-injury joint pain, swelling, snapping and locking, tenderness in the internal and external space of the knee, chronic quadriceps atrophy, especially on the medial quadriceps muscle, and positive McCephala's test and grinding test.
Objective: To reduce or eliminate pain, correct deformity, restore or maintain joint function, and improve quality of life. Non-surgical**1Patient education and counseling: Patients should be encouraged to change their unhealthy lifestyle and exercise patterns and avoid inappropriate activities that may aggravate joint degeneration. 2.Proper rest and beneficial exercise: work and live within the scope of the condition, do not make the affected joint over-weight-bearing, damp, cold, overworked, and avoid sitting and standing for a long time, should not make the knee joint in a certain position for a long time, should be properly moved knee joint. Appropriate exercises, such as swimming, walking, cycling, supine straight-leg raises, or resistance training, and non-weight-bearing joint flexion and extension activities. 3.Reduce or eliminate joint strain factors: insist on riding more cars (including cycling) and walking less, especially less climbing steps and uneven roads. Obese patients should eat in moderation and lose weight. Female patients should reduce the wearing of high heels. Physics**(1) TDP irradiation, once a day, 30 minutes each time. (2) Chinese herbal fumigation**, once a day, 30 minutes each time. (3) Microwave**, once a day, 30 minutes each time. (4) Traditional Chinese medicine slump**, once a day, 30 minutes each time. (5) TCM directional dialysis **, once a day, 30 minutes each time.
Drugs**1, intravenous administration: mannitol injection, - escin sodium injection, lornoxicam injection, Xiangdan injection, Xuesaitong, etc. 2. Oral drugs: non-steroidal drugs: ibuprofen, voltarin, fenpidex, meloxicam dispersible tablets, guigon bone pain granules, glucosamine hydrochloride, leech Zhuyu capsules. 3. External use: plasters, ointments, dressings, sprays. Other**1, acupuncture**: according to the situation, choose ordinary acupuncture or electroacupuncture main acupoints: knee eye, knee Yangguan, Yangling Spring, Zusanli, Ah is acupoint. 2. Moxibustion**: According to the condition, moxibustion is selected as a whirlwind moxibustion, warm moxibustion, septum moxibustion or paving moxibustion method 3. Traction**: Supine traction is often used, which can start from 8 kg, and the heaviest should not exceed 15 kg, 20-30 minutes each time, and 10-15 times for a course of treatment. 2.Surgical methods: osteophyte resection, loose body extraction, meniscectomy, synovectomy, arthroplasty, joint cleansing, osteotomy, artificial knee arthroplasty, arthroscopic surgery and arthroirage.
Prevention and care.
1. Try to avoid obesity. 2. Pay attention to the posture of walking and working, and do not twist your body to walk and work. 3. Don't wear high heels when walking long distances. 4. When participating in physical exercise, you should prepare for activities, gently stretch your knee joints, and then participate in strenuous exercises after your knee joints are fully mobilized. 5. When riding a bicycle, adjust the height of the saddle. 6. When the weather is cold, you should pay attention to keeping warm, and wear knee pads if necessary to prevent the knee joint from getting cold. 7. People with knee osteoarthritis should not only avoid excessive fatigue of the knee joint, but also carry out appropriate functional exercises. 8. In terms of diet, we should eat more foods containing protein, calcium, collagen and isoflavones, such as milk, dairy products, soybeans, soy products, eggs, fish and shrimp, kelp, black fungus, chicken feet, pig trotters, lamb legs, beef hoof tendons, etc., which can not only supplement protein and calcium, prevent osteoporosis, but also grow cartilage and joint lubricating fluid, and supplement estrogen, so that bones and joints can better metabolize calcium and reduce the symptoms of arthritis. Misunderstandings of knee osteoarthritis.
Myth 1: Osteoarthropathy is caused by lack of exercise and blood veins, so strengthening exercise and doing more exercise is beneficial to osteoarthropathy. The structure of adult bone and cartilage has been basically fixed, and these bones and cartilage have a certain service life, when the joint degeneration reaches a certain level, people will feel joint stiffness, swelling, pain and other discomfort. In clinical practice, it is common to see some elderly friends who love sports, climbing mountains, running parks, and climbing steps every day. While these daily exercises can improve heart and lung fitness, they also accelerate the wear and tear of joints. Therefore, for the elderly, they should exercise appropriately and avoid large amounts of exercise and long-term sports to protect their joints and delay joint degeneration. Myth 2A large loss of calcium can cause osteoporosis, which causes osteoarthropathy, so a large amount of calcium supplementation is required. Human bone is composed of 2 3 calcium and 1 3 organic matter, osteoporosis is caused by long-term loss of calcium and collagen, and the essence of osteoarthropathy is joint degeneration and excessive wear and tear of joint cartilage. Osteoporosis is a decrease in the total amount of bone and a loose bone structure like "honeycomb coal", which is manifested by increased bone fragility, prone to fractures and difficult to heal. Osteoarthropathy is caused by the degeneration, wear and tear of the cartilage on the surface of the joint after decades of use, resulting in hyperplasia, sclerosis, osteophyte formation, and cystic changes in the periarticular and subchondral bone. Osteoarthropathy and osteoporosis are two different disease states of bone, both of which can coexist. Myth 3Osteoarthritis of the knee is a foreign inflammation that requires the use of anti-inflammatory drugs. When the disease is acutely attacked, it is mostly manifested as inflammation of the synovial membrane of the joint, such as joint redness and swelling, fever, pain, etc. But it is not an inflammation caused by foreign organisms such as bacteria, viruses, pathogens, etc., and it is ineffective with antibiotics. AI assistant creation season