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Gonarthrosis Therapy – Knee Osteoarthritis Treatment

Gonarthrosis therapy covers all treatments for knee joint cartilage degeneration. The goals are pain relief, preservation of function, and improved quality of life.

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Things worth knowing about "Gonarthrosis Therapy"

Gonarthrosis therapy covers all treatments for knee joint cartilage degeneration. The goals are pain relief, preservation of function, and improved quality of life.

What Is Gonarthrosis?

Gonarthrosis is a degenerative disease of the knee joint in which the articular cartilage gradually breaks down. This leads to pain, stiffness, and reduced mobility. It is one of the most common joint diseases and primarily affects people over the age of 50. Gonarthrosis therapy aims to relieve symptoms, slow the progression of the disease, and improve the quality of life of those affected.

Causes of Gonarthrosis

Gonarthrosis can develop for a variety of reasons:

Primary gonarthrosis: Age-related cartilage wear without a specific underlying disease
Secondary gonarthrosis: Resulting from injuries, joint malalignment (e.g., bow legs or knock knees), inflammatory conditions, or obesity
Genetic factors: A familial predisposition is well recognized
Excess body weight: Increased mechanical load on the joint accelerates cartilage breakdown

Symptoms

Typical complaints in gonarthrosis include:

Knee pain, especially during physical activity and when climbing stairs
Morning stiffness or start-up pain after periods of rest
Swelling and warmth of the knee joint
Grating or cracking sounds in the knee (crepitus)
Progressive limitation of movement

Diagnosis

The diagnosis of gonarthrosis is made through a combination of:

Clinical examination: Palpation, range-of-motion testing, and pain localization
X-ray imaging: Standard method for detecting joint space narrowing, osteophytes, and subchondral sclerosis
MRI (Magnetic Resonance Imaging): Assessment of cartilage, menisci, and soft tissue structures
Laboratory tests: To exclude inflammatory conditions such as rheumatoid arthritis

Treatment of Gonarthrosis

Gonarthrosis therapy follows a stepwise concept encompassing both conservative and surgical measures.

Conservative Treatment

In early and intermediate stages, non-surgical approaches are the primary focus:

Physiotherapy: Exercises to strengthen joint-stabilizing muscles, improve flexibility, and correct gait patterns
Weight reduction: Reducing body weight to decrease mechanical stress on the joint
Assistive devices: Orthoses, insoles, and walking aids to offload the knee joint
Physical therapy: Heat and cold therapy, electrotherapy, and ultrasound treatment
Pain management: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac for pain relief and reduction of inflammation
Intra-articular injections: Corticosteroids for short-term anti-inflammatory effect, or hyaluronic acid to improve joint lubrication
Dietary supplements: Glucosamine and chondroitin are discussed, though evidence remains inconsistent

Surgical Treatment

When conservative measures are insufficient, surgical options may be considered:

Arthroscopy: Minimally invasive joint examination for removal of loose bodies or meniscus treatment (of limited benefit in advanced stages)
Osteotomy: Correction of leg axis malalignment to reduce load on the affected compartment
Unicompartmental knee arthroplasty: Replacement of only one compartment in localized arthritis
Total knee arthroplasty (TKA): Complete joint replacement in advanced stages; associated with high long-term success rates

Complementary and Alternative Approaches

In addition to standard therapies, various complementary methods are used:

Acupuncture: May contribute to pain relief; evidence is moderate
Balneotherapy: Therapeutic baths and thermal water treatments for relaxation and pain relief
Exercise programs: Aquatic gymnastics, cycling, and walking as joint-friendly physical activities

Prognosis and Disease Course

Gonarthrosis is a chronic, progressive condition. However, consistent treatment can significantly slow its progression. Many patients can maintain a good quality of life for many years through conservative measures alone. When indicated correctly, knee joint replacement surgery provides excellent long-term outcomes in terms of pain relief and restored mobility.

References

Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC): S2k Guideline Gonarthrosis (2018, updated 2021). AWMF Registration No. 033-004.
Hochberg, M.C. et al.: American College of Rheumatology 2012 Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research, 2012.
Felson, D.T.: Osteoarthritis of the Knee. New England Journal of Medicine, 2006; 354(8): 841-848.

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