Gonarthrosis is a pathological process in the cartilaginous tissue of the knee joint that leads to its deformation. This process is associated with high stress on the knees, wear and tear, and salt deposits.
Myths about knee osteoarthritis
There are 3 more famous myths:
- "The diagnosis of knee osteoarthritis is the prerogative of people with greater physical activity, and people with predominantly sedentary work do not suffer from it. "In fact, excessive physical exertion contributes to cartilage deterioration. During sedentary work, a static effect occurs on the knees, the blood supply is impeded. Also, a sedentary lifestyle leads to an increase in body weight.
- "Gonarthrosis of the knee joint is incurable, the disease progresses every day. "This disease is indeed chronic, but with proper timely treatment, cartilage deterioration can be prevented.
- "With osteoarthritis, you need to move as little as possible and lie down more. "A patient with such a pathology is assigned special gymnastics, which strengthens the ligamentous apparatus. Only a few sports are really contraindicated.
Gonarthrosis is the destruction of the articular cartilage in the knee joint and adjacent bony surfaces.
Manifestations of osteoarthritis of the knee joint.
Manifestations depend on the severity of the deformity. The more it is expressed, the more pronounced the symptoms.
Symptoms of gonarthrosis:
- long asymptomatic period;
- discomfort in the knee area;
- pain syndrome;
- decreased mobility;
- morning stiffness up to half an hour;
- the presence of a creak during active movement;
- change on the go.
Bilateral knee osteoarthritis occurs when the knee joints of both extremities are involved in the process. This is one of the most serious ways. It occurs in the elderly.
Right-sided knee osteoarthritis occurs with static or dynamic overexertion on the right limb. More often in athletes.
Left-sided gonarthrosis occurs in overweight people and in athletes with a load on the left leg.
The reasons for the development of gonarthrosis
Gonarthrosis is primary and secondary. Primary can occur in childhood and adolescence, which is associated with joint malformations, as well as in the elderly due to the natural aging process.
Secondary occurs due to an existing injury or illness. Main reasons:
- fractures, bruises, dislocations;
- overweight;
- the presence of an inflammatory process in the joint and the lack of adequate therapy;
- metabolic diseases, which are accompanied by the deposition of salts in the cartilage tissues;
- operations;
- vitamin D deficiency;
- hormonal disorders;
- lifting weights;
- some sports (running, hockey, soccer).
Who is at risk?
The risk group includes:
- professional athletes;
- obese people;
- patients who have suffered trauma or surgery;
- people over 45 years old;
- patients with varicose veins;
- those who have had cases of osteoarthritis in the family.
The risk group also includes women who wear shoes with high heels or thin flat soles.
The exact causes of knee osteoarthritis are unknown.
The degree of knee osteoarthritis.
Radiologically, this pathology is divided into 5 stages or degrees:
- Stage 0: absence of osteoarthritis by X-ray;
- Stage 1: the appearance of a small osteophyte;
- Stage 2: the osteophyte has clear contours, the joint space changes minimally;
- Stage 3: narrowing of the joint space;
- Stage 4 - pronounced narrowing of the gap, sclerosis of the subchondral bone.
Gonarthrosis of the knee 1 degree
The first degree is characterized by fatigue, limited mobility is slightly expressed, and a cracking noise is heard. The pain appears after waking up, sitting for a long time and after physical exertion.
There is still no deformation at this stage. The x-ray shows a narrowing of the joint space.
How to treat knee osteoarthritis?
For treatment, a special group of drugs is used - chondroprotectors. They contain chondroitin and glucosamine, which restore the structure of cartilage and increase elasticity. NSAIDs are used to relieve pain.
Primary gonarthrosis is usually bilateral. Even with the development of a unilateral form of the disease, after a while the second limb is also involved in the pathological process.
The first symptoms of osteoarthritis of the knee joints are mild and uncharacteristic.
Treatment methods
In addition to drug treatment in the remission phase, the following methods are used:
- physiotherapy;
- massages
- leech therapy;
- ultrasonic exposure;
- radon and hydrogen sulfide baths;
- phonophoresis, electrophoresis;
- paraffin wraps;
- the use of therapeutic mud.
These methods are used regardless of the stage of disease development during remission.
Is mud good for knee osteoarthritis? One of the indications for mud therapy is diseases of the musculoskeletal system. The course of therapy is carried out twice a year. Includes 10 to 15 procedures. The method can be used at home, and the soil can be purchased at the pharmacy.
In the first degree, the patient is prescribed orthopedic shoes during the exacerbation period to avoid the development of the deformation process. Women are advised to wear shoes with a dense sole of at least 1 cm, a heel of 5 cm. Normalize the diet: reduce the amount of salt, spicy food. Jellied meat and gelatin are included in the diet, as they are natural chondroprotectors.
Another method is weight correction. Reducing body weight to an optimal level for a given patient will reduce the load on the musculoskeletal system.
Grade 2 gonarthrosis
In the second degree, the pain intensifies, so movement is significantly limited. Long-term walking causes severe pain syndrome. The patient needs to rest to continue.
If treatment is not started (or is ineffective), osteoarthritis of the knee joint progresses further.
The creaking becomes loud, the limp appears. The affected joint is deformed. An inflammatory process occurs in the inner membrane of the joint.
On plain radiography, a narrowing of the joint space is found, the appearance of spines on the bone (osteophytes).
Treatment
Drug therapy is based on the use of NSAIDs. They have analgesic and anti-inflammatory effects. In addition, chondroprotectors are prescribed.
After the exacerbation has passed, physiotherapy exercises, massages are prescribed.
Diet Recommendations:
- increase the amount of vegetables;
- include gelatin and jellied meat in the diet;
- eat lean fish twice a week;
- give preference to lean meat;
- eat bran bread.
It is also recommended to include bananas, nuts, eggs, spinach, legumes, liver, and cabbage in the diet.
In addition to orthopedic shoes, special knee pads are prescribed.
Of surgical interventions, arthroscopic removal of deformed tissue is used. This method has a short-term effect of 2-3 years.
Gonarthrosis of the knee, symptoms and treatment of grade 3.
The most severe degree. Pain syndrome occurs during movement and at rest. Knee mobility is as limited as possible and sometimes impossible. The deformation is pronounced. There is practically no joint space on the radiograph.
The progressive destruction of cartilage and bones in the later stages leads to the development of unsightly deformities of the knee, which increases in size.
Treatment
At this stage, in addition to NSAIDs, the patient is prescribed hormonal drugs. They are injected intravenously or into the joint. Severe pain syndrome is relieved with pain relievers.
At stage 3, the operation is already shown - endoprosthesis. The individual bone elements or the entire joint are replaced. Contraindication: osteoporosis.
Complications of arthroplasty:
- marginal skin necrosis;
- rejection of the prosthesis;
- neurovascular disorders (paresis, thrombosis).
In addition to the endoprosthesis, there is an arthrodesis operation: removal of deformed tissue and joint. It is rarely used.
Osteotomy: excision of the edges of the bones to redistribute the load.
Physiotherapy
Exercises for gonarthrosis of the knee joint can relieve pain, strengthen the muscular apparatus, and stimulate blood flow to them.
- Exercise 1. The patient lies on his back, lifts the straight leg and holds it for at least 30 seconds, then the second. Run time should take 2 minutes.
- Exercise number 2 "Bicycle". Lying on your back, mimic cycling with your feet. Repetitions 20 to 50 times.
- Exercise number 3. The patient lies face down, alternately bends the legs, trying to reach the buttocks with the heel. Repetitions 20 to 50 times.
- Exercise number 4. It is done in the same way as the previous one, only statically. That is, the patient fixes the limb in this position for 20-30 seconds.
Patients are advised to stretch:
- Exercise 1. In a standing position, lean forward, trying to reach the floor without bending your knees. Hold for 20 seconds, inhaling air through your nose and exhaling through your mouth.
- Exercise number 2. Sitting on the floor with your legs straight, try to wrap your feet around your arms, while keeping your knees straight. Hold this position for up to 30 seconds. Take 2-3 approaches. If the flexibility is not enough to reach the feet, they take the leg at the bottom of the leg and try to bring the body as close to the legs as possible.
- Exercise number 3. The same position as in the previous one. The patient takes the foot by the foot, tries to straighten it, and holds it as high as possible above the ground. If the exercise is difficult to do, then the leg is taken in the lower leg area. Hold the position for 10-30 seconds, then do it with the other leg.
Contraindication is the period of exacerbations and the presence of an acute inflammatory process. Patients are prohibited from running, walking a lot, and squatting.
After doing physical therapy exercises, it is helpful to massage the muscles of the thigh, the lower leg on the affected limb. The joint itself should not be affected, this will increase inflammation.
Disease prevention
This disease is not inherited, so its development can be prevented. This requires:
- avoid injuries while playing sports;
- doing stretching and joint gymnastics, yoga;
- eat properly;
- maintain a normal body weight;
- if you experience any discomfort in the knee area, consult a doctor;
- drink enough water;
- after 40 years, take chondroprotectors prophylactically;
- do not overcool the joints;
- in the presence of early stages of the process and during remission, do not increase physical activity, do not run;
- wear orthopedic shoes;
- wear knee pads when playing sports.