Knee arthrosis (gonarthrosis)

Arthrosis of the knee joint (otherwise called gonarthrosis) is a fairly common disease that has recently been found not only in older people, but also in young people.

Pathology is one of the main reasons for the disability of patients if they refuse to seek help from a traumatologist or orthopedist.

Let us consider why patients develop gonarthrosis of the knee joint, what are its main signs, how dangerous it is, and how effective treatment of progressive destruction of the knee is carried out.

The main factors in the appearance of this pathology

The joints are constantly exposed to significant stress. The knees are especially affected: they are forced to perform significant physical work, which is why they wear out quickly. The deforming process is intensified by the fact that the legs are forced to bear the weight of the body.

This fact further contributes to the fact that the knees begin to wear out, and the cartilage tissue of the joint becomes thinner and degrades.

The following reasons can accelerate the pathological process in the joints:

1. Increased body weight of patients. In complete destruction of the joint occurs much faster and more intense. It has been proven that the disease in question in obese people occurs three times more often than in people of normal weight.
2. Intense sports, due to which the joints are constantly injured.
3. Frequent fractures, previous knee injuries contribute to the fact that the patient begins to degenerate processes of the articular cartilage from a fairly young age.
4. Anomalies in the location of the bones - the so-called valgus or varus deformity.
5. Poor development of the ligamentous apparatus of the knee leads to frequent injuries, dislocations. Due to the described damage, the patient develops arthrosis.
6. Damage to the meniscus triggers the degenerative process of destruction of the knee.
7. Constant stress leads to a deterioration in the health of the musculoskeletal system.
8. Disruption of metabolic processes in the body due to a lack of nutrients and minerals (bones suffer most from a lack of calcium).

In addition, the following people belong to the risk group:

• all athletes;
• patients, regardless of gender, who have reached the age mark of 50 years;
• women who have started menopause;
• patients suffering from varicose veins;
• persons with unfavorable heredity.

What are the degrees of the disease

The pathology in question develops gradually, very slowly. At first, it may not appear, and the patient is in no hurry to see a doctor. Nevertheless, the pathological process has already begun, and if it is not stopped in time, the functions of the lower extremities will gradually be lost, which entails the onset of disability.

So, at grade 1, the patient may notice that the leg gets tired, even if the load was small. Some limitation of the mobility of the knee joint is noticeable, and a significant crunch is heard during movement.

There are pronounced starting pains when discomfort does not give rest mainly in the morning. After the patient "disperses", the discomfort gradually subsides, again increasing after sports activities. At this stage of the development of the disease, there is no pronounced deformation of the bone tissue.

At grade 2, the pain gets worse. Walking is impaired because of this. Sometimes it becomes almost impossible for the patient to move normally, and even after a slight load, a long rest is required. As the joint gap narrows, osteophytes grow on the bones, and pathological fluid accumulates in the joint.

At grade 3, pain occurs not only during work, sports, but also in a state of complete rest. The deformity of the knee is very pronounced, which makes any movement difficult.

Common symptoms of the disease

It is necessary to pay attention to the general symptoms of arthrosis of the knee joint:

1. Pain. It does not appear suddenly, however, mild discomfort can last for almost years. More severe pain is caused by trauma.
2. Deformation of the knee (it retains its previous shape).
3. Accumulation of fluid in the intra-articular cavity. When its amount exceeds certain values, the so-called Baker's cyst develops. A tight elastic object appears on the back of the knee. It is most noticeable when the joint is extended.
4. Knee crunch is observed if the pathology is in the second, third stage. It differs significantly from what is observed in a healthy person when bending or extending the knee. The sound is felt as harsh and painful. Sometimes crunching interferes with active movements.
5. Decreased normal range of motion in the joint. Usually the patient cannot bend, unbend the affected leg. He is able to bend it at a right angle, further movements are accompanied by severe pain.
6. Knee stiffness occurs primarily in stages 3. Sometimes patients are able to walk only on bent limbs.
7. Increased pain when the weather changes.
8. Substantial thinning of the cartilage. Sometimes, in advanced cases, bone exposure is noted. X-ray of the knee shows significant accumulation of osteophytes.

Varieties of arthrosis

Depending on the origin, arthrosis is primary (proceeds as an independent disease) or secondary - a complication of existing pathologies. Depending on the place of localization, pathology is right-, left- and bilateral.

Based on the characteristics of the manifestation, the following types of the disease are distinguished.

1. Deforming arthrosis is characterized by a chronic course, irreversible changes in the joint.
2. Patellofemoral arthrosis develops due to prolonged intense physical exertion.
3. Inflammatory arthrosis occurs due to a prolonged untreated inflammatory process in the joints.
4. Dysplastic arthrosis develops due to congenital anomalies in the structure of the knee joint.
5. Post-traumatic arthrosis appears as a result of frequent injuries of the musculoskeletal system.
6. Metabolic arthrosis occurs with gout and other metabolic disorders.
7. Postinfectious arthrosis occurs as a consequence of insufficiently treated inflammatory pathologies.
8. The static form of the disease is detected when the knees are constantly exposed to increased pressure.
9. If the cause of the knee lesion is not established, experts talk about idiopathic arthrosis.

Features of the treatment of the disease

At the initial stages of the development of the disease, a rheumatologist and traumatologist are involved in treatment. If she has gone too far, the patient should consult a surgeon. Finally, in some clinics there is a narrow specialist dealing with joint diseases - an arthrologist.

The scope of therapeutic measures depends on how far the disease has progressed. If it is possible to eliminate the cause of the pathology in question in the early stages, then an almost permanent recovery can be achieved.

The goals of any therapy are the complete elimination of pain, the restoration of destroyed cartilage, and an increase in the range of active movements in the joint.

The course of treatment with medicines is selected exclusively by a doctor. The patient cannot prescribe them to himself, because this can contribute to further destruction of the joint. The main medications are prescribed:

1. Non-steroidal anti-inflammatory tablets or ointments. Their action is aimed at relieving pain, inflammation in the affected area. Sometimes injections into the articular cavity may be prescribed.
2. Products that improve blood circulation in the knee. These are muscle relaxants, antispasmodics. The latter relieve pain well.
3. Products that restore articular cartilage, improve normal nutrition in it.

Novocaine blockade helps to relieve acute pain. The injection can be made from the outside or inside of the joint. The simplest and safest method is to administer the medicine from the outside. With the correct manipulation, the pain goes away almost immediately.

An ointment based on potent NSAIDs also helps to cope with pain. It should be remembered that you should not use strong drugs for a long time. Any medicine, even the most effective one, can have side effects and cause allergic reactions. This means that self-medication for this serious disease is categorically not allowed.

Conservative treatment can be effective, provided that the disease has not gone too far. In case of irreversible damage to the joint, a surgical operation is indicated. The implantation of a metal prosthesis is performed.

This is currently the only way to restore knee mobility. The disadvantages of these operations are the limited service life of the prosthesis, the high price.

In arthroscopy, all surgical procedures are performed by performing microscopic punctures in the joint. During the operation, the affected cartilage fragments, clots, etc. are removed from the joint. At stage 3 of the disease, the described type of intervention is ineffective.

To reduce the load, periarticular osteotomy is used. It is shown to be done when the joint is not yet completely destroyed.

To unload the joint affected by the degenerative process, canes and orthoses are used.

The duration of treatment for the disease depends on many factors. The course of therapy with chondroprotectors can be quite long - six months or even more, since the effect of them manifests itself rather slowly. A qualified healthcare professional can determine how long to take your prescribed drugs.

The use of chondroprotectors in the treatment of arthrosis

To relieve pain, doctors prescribe non-steroidal anti-inflammatory drugs (NSAIDs).

However, even new generation NSAIDs cannot prevent the spread of the pathological process. To reduce the intensity of joint degeneration and restore its normal mobility, chondroprotectors are increasingly used.

Modern drugs in this group help to restore joint tissue. This is due to the content of chondroitin in them. It is a natural component of cartilage. The constant intake of drugs of this group helps to restore it, improve health.

Despite the wide range of drugs on offer, only a doctor can determine which one is right for a patient. The injection of chondroprotectors is not shown to everyone, the drugs themselves are diluted in special solvents.

Taking dietary supplements is indicated if the patient follows the rules of a balanced diet, takes other medications to support the joints.

The role of exercise therapy and physiotherapy in the treatment of gonarthrosis

With the described pathology, the patient is categorically contraindicated in a recumbent lifestyle. Physical activity for any disease of the musculoskeletal system is simply necessary for all categories of patients. Of course, it must be dosed; any exercise is performed exclusively under the supervision of a physician.

For each patient, a traumatologist or a rehabilitation therapist individually selects special exercises. There is no need to think that different sets of classes that can be found on the Internet will suit all patients without exception.

For some, they can be really useful, while for others they will do great harm. All loads should be gentle, aimed at the fastest and most complete restoration of the functions of the affected joints.

At home, it is recommended to perform a simple exercise: while lying down, raise your leg, hold it for a few minutes and then lower it. It is harmless and can be performed even by patients with the third stage of the disease. Under the supervision of a physician, exercises are done to stretch the joint capsule. But if it causes pain, then the execution must be stopped immediately.

Physiotherapeutic methods of treating a disease include:

• massage (it is strictly forbidden to do it without a doctor's testimony);
• manual therapy (it should be as gentle as possible, not cause discomfort);
• medical laser treatment;
• impact on reflexogenic points using the finest needles;
• treatment with heat or cold (again, you do not need to perform thermal treatments at home);
• magnetic field treatment;
• phonophoresis;
• electrophoresis;
• paraffin therapy;
• ozokerite treatment;
• moxibustion with wormwood.

Nutrition for gonarthrosis

Proper nutrition is the basis for the successful treatment of degenerative diseases of the musculoskeletal system. Due to an improperly formulated diet, the patient may gain weight. The lack of vitamins, microelements aggravates the course of pathology.

All persons with gonarthrosis should increase the amount of foods fortified with vitamins and minerals in their daily diet.

Nutritionists recommend closely monitoring the calorie content of food. Fasting or extreme dieting is strictly prohibited. They can harm, body weight will increase even more.

It is imperative to ensure that the breakfast is balanced. You need to eat at least five times a day. For snacks, it is recommended to use fruits, bread.

The following foods and dishes are excluded:

• sweet soda;
• fatty meals;
• semi-finished products;
• spices;
• dishes containing flavor and odor enhancers;
• fatty meats;
• fried foods;
• White cabbage;
• tomatoes and bell peppers;
• oranges, lemons;
• chocolate;
• bananas, grapes (they are very high in calories).

Jellied meat and jelly are useful. They contain a large amount of collagen, due to which bone is restored. Jellied meat is prepared so that it contains less fat, so its calorie content will decrease.

Sources of protein for those suffering from osteoarthritis can be dairy products - cheese, cottage cheese or kefir. It is very useful to consume legumes. Be sure to include nuts in the diet.

It is necessary to observe the drinking regime. Provided that there are no associated renal diseases, it is recommended to consume about 2 liters of water.

About alternative treatment of the disease

It should be remembered that traditional methods cannot replace effective methods of official medicine. And therefore, they should be used in complex treatment, there can be no other therapy for this serious disease.

To relieve swelling of the knee, use ordinary soda. The fabric is moistened with soda gruel and wrapped around the knee. Above, to enhance the thermal effect, it is advisable to attach a plastic bag. Keep the prepared compress for the whole night.

A similar compress is made with the addition of food vinegar. In parallel with the imposition of compresses, it is necessary to take acetylsalicylic acid tablets.

Burdock leaves are very useful for the knee. Before applying the leaves, it is advisable to lubricate the knee with vegetable oil. It is necessary that there are several layers of leaves.

All this is wrapped in a plastic bag. Compresses with birch leaves are made in the same way.

Medical bile relieves inflammation, swelling and pain well. It is used in the form of warming compresses at night. Bile has virtually no side effects.

Treatment with honey is carried out in cases where the patient is not allergic to it. After the sore joint is warmed up with a heating pad, it should be lubricated with honey and a gentle massage should be done. After that, attach burdock leaves to the knee.

Prevention of gonarthrosis

Preventing a disease is much easier than curing it. Prevention measures include:

• high-quality, balanced nutrition with the use of a sufficient amount of protein, vitamins and calcium;
• eradication of bad habits;
• the fight against excess weight;
• normalization of physical activity;
• prevention of joint injury during sports or heavy physical work.

When the first symptoms of trouble appear, it is important to see a doctor right away. In a clinic consultation, it is possible to find out which doctor is treating gonarthrosis. It is advisable to undergo a comprehensive medical examination in order to find out the cause of the development of the disease.

Osteoarthritis of the knee is a serious disease: if ignored, there is a risk of disability and complete immobility. To prevent this, you need to properly treat the affected joint. Early started medical measures contribute to the almost complete remission of this pathology, help to maintain high performance, quality of life.