Pain in the knee joint

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CME

General Description
The knee, a complex complex joint, connects the femur with the tibia bones (tibia and fibula) and the patella. Together with the muscles and ligament apparatus, it helps to perform complex movements in the lower extremity and ensures upright posture. In a healthy person, all of the surfaces that make up the joint are covered with smooth cartilage tissue. Intra-articular (synovial) fluid fills the joint cavity, reducing friction between the articular surfaces, providing nutrients to the cartilage tissue, and additionally cushioning the load

Chronic knee joint pain bothers a huge number of people, and the likelihood of its occurrence increases with age. If the pain in the knee does not go away for a long time, you should see a specialist. The doctor will help to determine the cause of the pain.

The main causes of pain in the knee joint
Osteoarthritis of the knee joint (gonarthrosis);
Arthritis of the knee joint (infectious and non-infectious);
Trauma of the joint;
Damage to the ligament apparatus or cartilage menisci of the knee joint as a result of trauma or repetitive microtrauma;
Pain after surgery;
Diseases of the blood vessels or nerves of the lower extremity.
Additional tests, such as X-rays and magnetic resonance imaging of the knee joint, are often needed to clarify the diagnosis. The most common causes of pain in the knee are traumatic ligament and meniscus injuries and knee arthritis (gonarthrosis). Gonarthrosis is usually not associated with trauma and often develops in older people as a result of “wear and tear” of the joint under increased stress.

If you have been diagnosed with knee arthritis, your doctor may suggest surgery to replace the joint with a metal or composite joint prosthesis. Such surgery is the “gold standard” in the treatment of severe forms of gonarthrosis. It allows not only an increase in the range of motion in the affected knee, but also, in most cases, eliminates painful sensations. At the same time, up to 15% of patients who have undergone arthroplasty continue to experience pain in the knee.

Sometimes arthroplasty is impossible or undesirable for a variety of reasons. For example, the risk of surgery is unacceptably high. Postponing surgery may be justified if the biomechanics of the joint are relatively intact and pain is the patient’s chief complaint. In such cases, conservative therapy may be preferred. It should not be forgotten that uncontrolled administration of pain medications, especially in the elderly, is associated with a high risk of adverse effects from the gastrointestinal tract and cardiovascular system, so it is important to choose an individual scheme of drug therapy together with the doctor. In addition to medications, a specialist may recommend and prescribe physiotherapeutic methods, specially designed exercise routines.

Pain may be eliminated or reduced by using special high-precision methods, which block the path of nerve impulses to the affected joint. This may include therapeutic blocks or radiofrequency denervation of the knee joint. These interventions do not require hospitalization and are performed under local anesthesia. They stop the transmission of pain impulses from the knee joint to the central nervous system. The morphological changes in the joint are preserved, but the intensity of pain is significantly reduced, allowing the patient to continue to lead an active life without resorting to surgery. These techniques are also indicated for patients awaiting arthroplasty. In addition to improving the quality of life in the preoperative period, it can help reduce the likelihood of chronic pain after arthroplasty. This method is also applicable in cases where pain continues to bother the patient after knee surgery.

Treatment of pain in the knee joint:
The main goal of knee pain treatment is to diagnose and eliminate the cause of the pain. However, therapy aimed at reducing the pain syndrome begins immediately.

The approach to knee pain treatment is comprehensive and involves the work of a multidisciplinary team of physicians:orthopedic trauma surgeon, rehabilitation therapist, pain management specialist, and physical therapist.

Key areas of treatment:

conservative therapy;
therapeutic exercise;
physical therapy;
manual therapy;
Therapeutic and diagnostic blocks;
Radiofrequency denervation (RFD) of the hip joint;
arthroscopy of the knee joint;
Prosthetic replacement of knee joint.
Conservative therapy.
For each patient an individual scheme of analgesic therapy is selected, based on the causes of the disease, the characteristics of pain, possible contraindications and drug interactions. Throughout treatment, the scheme of conservative therapy is adjusted depending on the clinical situation.

Radiofrequency denervation.
Radiofrequency denervation of sensitive nerves in the knee joint is a minimally invasive, modern method that allows you to safely fight