Osteoarthritis of the knee joint (otherwise called gonarthrosis) is a fairly common disease that has recently been found not only in the elderly, but also in the young.
Pathology is one of the main reasons for patients' disabilities if they refuse to seek help from a traumatologist or orthopedist.
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 for the appearance of this pathology
The joints are constantly exposed to significant stress. The knees are particularly affected: they are forced to do significant physical work, which causes them to wear out quickly. The process of deformation is intensified by the fact that the legs are forced to bear the weight of the body.
This fact additionally contributes to the fact that the knees begin to wear out, and the cartilaginous tissue of the joint becomes thinner and degrades.
The following reasons can accelerate the pathological process in the joints:
- Increased body weight of patients. With complete destruction of the joint, it comes much faster and more intensely. It has been proven that this disease occurs three times more often in obese people than in people of normal weight.
- Intense sports, due to which the joints are constantly injured.
- Frequent fractures, previous knee injuries contribute to the fact that the patient begins to degenerate the processes of articular cartilage from a fairly young age.
- Anomalies in the position of the bones - the so-called valgus or varus deformity.
- Poor development of the ligament apparatus of the knee leads to frequent injuries, sprains. Due to the described injuries, the patient develops arthrosis.
- Damage to the meniscus triggers the degenerative process of knee destruction.
- Constant stress leads to worsening of the health of the musculoskeletal system.
- Disorder of metabolic processes in the body due to lack of nutrients and minerals (bones suffer the most from lack of calcium).
In addition, the following persons belong to the risk group:
- all athletes;
- patients, regardless of gender, who have reached the age of 50;
- women who have started menopause;
- patients suffering from varicose veins;
- persons with an unfavorable inheritance.
What are the degrees of the disease
Pathology developed gradually, very slowly. It may not appear at first, and the patient is in no hurry to see a doctor. However, the pathological process has already begun, and if it is not stopped in time, the functions of the lower extremities will be gradually lost, which leads to the emergence of disability.
Thus, in stage 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 when moving.
There are pronounced initial pains when the discomfort does not give peace, mostly in the morning. After the patient "disperses", the discomfort gradually decreases, and after sports activities, it increases again. At this stage of the disease, there is no pronounced deformation of the bone tissue.
At grade 2, the pain worsens. Walking is therefore difficult. Sometimes it is almost impossible for the patient to move normally, and even after a small load, a long rest is needed. As the joint gap narrows, osteophytes grow on the bones and pathological fluid accumulates in the joint.
In the 3rd degree, the pain occurs not only during work, sports, but also in a state of complete rest. The knee deformity is very pronounced, which makes every movement difficult.
Common symptoms of the disease
It is necessary to pay attention to the general symptoms of osteoarthritis of the knee joint:
- Pain. It does not appear suddenly, however, mild ailments can last for almost years. Severe pain is caused by trauma.
- Knee deformity (retains its previous shape).
- Accumulation of fluid in the intraarticular cavity. When its quantity exceeds certain values, the so-calledBaker's cyst. A solid elastic object appears on the back of the knee. This is most noticeable when the joint is extensive.
- Knee cracking is observed if the pathology is in the second, third stage. It differs significantly from that observed in a healthy person when bending or stretching the knee. The sound feels sharp and painful. Sometimes crunching interferes with active movements.
- Reduced normal range of motion in the joint. Usually the patient cannot bend, separate the affected leg. He is able to bend it at a right angle, further movements are accompanied by severe pain.
- Knee stiffness occurs primarily in stages 3. Sometimes patients can only walk on bent limbs.
- Increased pain when changing weather.
- Significant thinning of cartilage. Occasionally, in advanced cases, bone exposure is observed. An X-ray of the knee shows a significant accumulation of osteophytes.
Types of arthrosis
Depending on the origin, arthrosis is primary (proceeds as an independent disease) or secondary - a complication of existing pathologies. Depending on the location, the pathology is right-, left- and bilateral.
Based on the characteristics of the manifestation, the following types of diseases are distinguished.
- Deforming arthrosis is characterized by a chronic course, irreversible changes in the joint.
- Patellofemoral arthrosis develops due to long-term intense physical exertion.
- Inflammatory arthrosis is caused by a long untreated inflammatory process in the joints.
- Dysplastic arthrosis develops due to congenital anomalies in the structure of the knee joint.
- Post-traumatic osteoarthritis occurs as a result of frequent injuries to the musculoskeletal system.
- Metabolic arthrosis occurs in gout and other metabolic disorders.
- Postinfectious arthrosis occurs as a result of insufficiently treated inflammatory pathologies.
- A static form of the disease is detected when the knees are constantly exposed to increased pressure.
- If the cause of the knee lesion is not determined, experts talk about idiopathic arthrosis.
Characteristics of disease treatment
In the initial stages of the disease, a rheumatologist and a traumatologist are involved in the treatment. If it has gone too far, the patient should consult a surgeon. Finally, in some clinics there is a specialist who deals with joint diseases - an arthrologist.
The extent of therapeutic measures depends on how advanced the disease is. If it is possible to eliminate the cause of the pathology in question in the early stages, then almost permanent recovery can be achieved.
The goals of each therapy are complete elimination of pain, restoration of destroyed cartilage and increase of the range of active movements in the joint.
The course of drug treatment is chosen exclusively by the doctor. The patient cannot prescribe them to himself, because that can contribute to further destruction of the joint. The main drugs are prescribed:
- Non-steroidal anti-inflammatory tablets or ointments. Their action is aimed at relieving pain, inflammation in the affected area. Sometimes injections into the joint cavity may be prescribed.
- Products that improve blood circulation in the knee. These are muscle relaxants, antispasmodics. The latter alleviate pain well.
- Products that restore articular cartilage, improve normal nutrition in it.
Novocaine blockade helps relieve acute pain. The injection can be given from the outside or inside of the joint. The simplest and safest way is to give the medicine from the outside. With proper manipulation, the pain disappears almost immediately.
An ointment based on powerful NSAIDs also helps cope with pain. It should be borne in mind that you should not use strong drugs for a long time. Any drug, even the most effective, can have side effects and cause allergic reactions. This means that self-treatment of this serious disease is categorically not allowed.
Conservative treatment can be effective, provided the disease has not gone too far. In case of irreparable damage to the joint, surgery is indicated. Metal prosthesis is implanted.
This is currently the only way to restore knee mobility. The disadvantages of these operations are the limited lifespan of the prosthesis, the high cost.
In arthroscopy, all surgical procedures are performed with microscopic punctures in the joint. During the operation, the affected cartilage fragments, clots, etc. are removed from the joint. In stage 3 disease, the type of intervention described is ineffective.
Periarticular osteotomy is used to reduce the load. It has been shown to work when the joint has not yet been completely destroyed.
Rods and orthoses are used to relieve the joint affected by the degenerative process.
The duration of treatment of the disease depends on many factors. The course of therapy with chondroprotectors can be quite long - six months or even more, because their effect manifests itself rather slowly. A qualified healthcare professional can determine how long to take the prescribed medication.
Use of chondroprotectors in the treatment of osteoarthritis
To relieve pain, doctors prescribe nonsteroidal anti-inflammatory drugs (NSAIDs).
However, even new-generation nonsteroidal anti-inflammatory drugs cannot prevent the spread of the pathological process. Chondroprotectors are increasingly being used to reduce the intensity of joint degeneration and restore its normal mobility.
Modern drugs from this group help to restore joint tissue. This is due to the content of chondroitin in them. It is a natural component of cartilage. Constant intake of drugs of this group helps to restore, improve health.
Despite the wide range of medications, only a doctor can determine which one is right for a patient. Chondroprotector injection is not shown to everyone, the drugs themselves are diluted in special solvents.
Taking dietary supplements is indicated if the patient adheres to the rules of a balanced diet, taking 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 the supine lifestyle. Physical activity for any disease of the musculoskeletal system is simply necessary for all categories of patients. Of course, it must be dosed; each exercise is performed exclusively under the supervision of a physician.
For each patient, the traumatologist or rehabilitation therapist individually chooses special exercises. One should not think that the different sets of classes that can be found on the Internet will suit all patients without exception.
For some it can be really useful, while for others it will do great harm. All loads should be gentle, aimed at the fastest and most complete restoration of the functions of the affected joints.
It is recommended to perform a simple exercise at home: raise your leg while lying down, hold it for a few minutes, and then lower it. It is harmless and can be performed even by patients in the third stage of the disease. Exercises for stretching the joint capsule are performed under the supervision of a doctor. But if it causes pain, then the execution must be stopped immediately.
Physiotherapeutic methods of treating the disease include:
- massage (it is strictly forbidden to work without a doctor's testimony);
- manual therapy (should be as gentle as possible, not to cause discomfort);
- medical laser treatment;
- impact on reflexogenic points with the finest needles;
- heat or cold treatment (again, you do not have to perform thermal treatments at home);
- magnetic field treatment;
- phonophoresis;
- electrophoresis;
- paraffin therapy;
- ozokerite treatment;
- moxibustion with wormwood.
Diet for gonarthrosis
Proper nutrition is the basis for successful treatment of degenerative diseases of the musculoskeletal system. Due to improperly formulated diet, the patient may gain weight. Lack of vitamins and microelements worsens the course of pathology.
All people with gonarthrosis should increase the amount of food enriched with vitamins and minerals in their daily diet.
Nutritionists recommend careful monitoring of the caloric content of food. Fasting or extreme diets are strictly forbidden. They can hurt, body weight will increase even more.
It is necessary to ensure that breakfast is balanced. You need to eat at least five times a day. For snacks it is recommended to use fruit, bread.
The following foods and dishes are excluded:
- sweet soda;
- fatty foods;
- semi-finished products;
- spices;
- Dishes containing flavor enhancers;
- fatty meat;
- fried foods;
- White cabbage;
- tomatoes and peppers;
- oranges, lemons;
- chocolate;
- bananas, grapes (they are very caloric).
Meat and jelly jellies are useful. They contain a large amount of collagen, which is why bone is regenerated. Fir meat is prepared so that it contains less fat, so its caloric content will be reduced.
Sources of protein for osteoarthritis can be dairy products - cheese, cottage cheese or kefir. It is very useful to consume legumes. Be sure to include nuts in your diet.
It is necessary to adhere to the drinking regime. Provided that there are no associated kidney diseases, it is recommended to consume about 2 liters of water.
About alternative disease treatment
It should be borne in mind that traditional methods cannot replace effective methods of official medicine. And that is why they should be used in complex treatment, there can be no other therapy for this serious disease.
Use plain soda to relieve knee swelling. The fabric is moistened with baking soda and wrapped around the knees. Above, to improve the thermal effect, it is recommended to attach a plastic bag. Store the prepared dressing overnight.
A similar coating is made with the addition of vinegar for food. Acetylsalicylic acid tablets should be taken in parallel with the application of the dressing.
Burdock leaves are very useful for the knee. Before applying the leaves, it is recommended to lubricate the knee with vegetable oil. It is necessary to have several layers of leaves.
It's all wrapped in a plastic bag. Compresses with birch leaves are made in the same way.
Medicinal bile well relieves inflammation, swelling and pain. It is used in the form of heating pads at night. Bile has virtually no side effects.
Honey treatment is carried out in cases where the patient is not allergic to it. After the sore joint is warmed with a heating pad, it should be lubricated with honey and a gentle massage done. After that, attach the burdock leaves to the knee.
Prevention of gonarthrosis
It is much easier to prevent a disease than to cure it. Prevention measures include:
- high-quality, balanced diet with the use of sufficient amounts of protein, vitamins and calcium;
- eradicating bad habits;
- fight against excess weight;
- normalization of physical activity;
- prevention of joint injuries during sports or heavy physical work.
When the first symptoms of the problem appear, it is important to see a doctor immediately. In outpatient consultations, it is possible to find out which doctor treats gonarthrosis. It is recommended to undergo a comprehensive medical examination to determine the cause of the disease.
Osteoarthritis of the knee is a serious disease: if neglected, there is a risk of disability and complete immobility. To prevent this, it is necessary to properly treat the affected joint. Early therapeutic measures contribute to almost complete remission of this pathology, help maintain high performance, quality of life.