Gonarthrosis is a pathological process in the cartilage 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 osteoarthritis of the knee
There are 3 most famous myths:
- "The diagnosis of osteoarthritis of the knee is the prerogative of people with increased physical activity, and people who work mainly sedentary do not suffer from it. " In fact, excessive physical exertion even contributes to the breakdown of cartilage. When sitting down, there is a static effect on the knees, the blood circulation is hindered. In addition, a sedentary lifestyle leads to an increase in body weight.
- "Osteoarthritis of the knee joint is incurable, the disease progresses every day. " This disease is chronic, but with adequate timely treatment, cartilage breakdown can be prevented.
- "With osteoarthritis you have to move as little as possible and lie down more. " A patient with such a pathology is assigned a special exercise that strengthens the ligamentous apparatus. Few sports are really contraindicated.
Gonarthrosis is the destruction of articular cartilage in the knee joint and adjacent bone surfaces.
Manifestations of osteoarthritis of the knee joint
The manifestations depend on the severity of the deformity. The more it is expressed, the more pronounced the symptoms.
Symptoms of osteoarthritis of the knee:
- long asymptomatic period;
- Discomfort in the knee area;
- Pain syndrome;
- decreased mobility;
- morning stiffness up to half an hour;
- the presence of a crunch during active movement;
- Gear change.
Bilateral osteoarthritis of the knee occurs when the knee joints of both limbs are involved in the process. This is one of the most difficult forms. Occurs in the elderly.
Right-sided gonarthrosis occurs when there is excessive static or dynamic physical stress on the right extremity. More common in athletes.
Left-sided gonarthrosis occurs in overweight people and in athletes with stress on the left leg.
The reasons for the development of osteoarthritis of the knee
Gonarthrosis is primary and secondary. Primaries can occur in children and adolescents, which are associated with malformations of the joints, as well as in older people due to the natural aging process.
Secondary occurs due to an injury or existing illness. Main reasons:
- Fractures, bruises, dislocations;
- Obesity;
- the presence of an inflammatory process in the joint and the lack of adequate therapy;
- Metabolic diseases associated with the deposition of salts in cartilage tissue;
- Operations;
- Lack of vitamin D;
- hormonal disorders;
- Lift 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 of age;
- 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 flat, thin soles.
The exact causes of knee osteoarthritis are unknown.
The degree of osteoarthritis of the knee
Radiologically, this pathology is divided into 5 stages or grades:
- Stage 0 - absence of osteoarthritis on the X-ray;
- Stage 1 - the appearance of a small osteophyte;
- Stage 2 - the osteophyte has clear contours, the joint space is minimally changed;
- Stage 3 - narrowing of the joint space;
- Stage 4 - pronounced narrowing of the gap, sclerosis of the subchondral bone.
Knee osteoarthritis 1 degree
The first degree is characterized by tiredness, limited mobility is slightly pronounced, and a crunch can be heard. The pain occurs after waking up, sitting for a long time, and after physical exertion.
There is no deformation at this stage. The x-ray shows a narrowing of the joint space.
How do you treat osteoarthritis of the knee?
For treatment, a special group of drugs is used - chondroprotectors. They contain chondroitin and glucosamine, which restore the structure of the cartilage and increase its elasticity. NSAIDs are used to relieve pain.
Primary osteoarthritis of the knee is usually bilateral. Even with the development of a unilateral form of the disease, after a while, the second extremity is also involved in the pathological process.
Early 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:
- Physical therapy;
- Massages;
- Leech therapy;
- Ultrasonic exposure;
- Radon and hydrogen sulfide baths;
- Phonophoresis, electrophoresis;
- Paraffin packs;
- the use of healing mud.
These methods are used during remission regardless of the stage of development of the disease.
Is mud good for knee osteoarthritis? Musculoskeletal disorders are one of the indications for mud therapy. The course of therapy is carried out twice a year. It comprises 10 to 15 procedures. The method can be used at home, and the dirt can be bought at the pharmacy.
At the first degree, the patient is prescribed orthopedic shoes for the duration of the exacerbation in order to prevent the development of the deformation process. Women are recommended to wear shoes with a dense sole of at least 1 cm and a heel of 5 cm. Normalize the diet - reduce the amount of salt and spicy foods. Jelly meat and jelly are included in the diet as they are natural chondroprotectors.
Another method is weight correction. Reducing the body weight to an optimal level for a particular patient reduces the strain on the musculoskeletal system.
Gonarthrosis grade 2
In the second degree, the pain intensifies, which significantly restricts movement. Long-term walking over long distances causes severe pain syndrome. The patient must rest to continue.
If treatment is not initiated (or ineffective), the osteoarthritis of the knee joint will progress.
The crunch becomes loud, lameness occurs. The affected joint is deformed. An inflammatory process occurs in the inner membrane of the joint.
A simple X-ray shows a narrowing of the joint space, the appearance of thorns on the bone (osteophytes).
treatment
Drug therapy is based on the use of NSAIDs. They have an analgesic and anti-inflammatory effect. In addition, chondroprotectors are prescribed.
After the exacerbation passes, physical therapy exercises and massages are prescribed.
Diet recommendations:
- increase the amount of vegetables;
- Include jelly and jellied meat in the diet;
- eat lean fish twice a week;
- prefer 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.
In surgical procedures, arthroscopic removal of deforming tissue is used. This method has a short-term effect of 2-3 years.
Knee osteoarthritis, symptoms and treatment grade 3
The hardest grade. The pain syndrome occurs during movement and at rest. The mobility in the knee is as limited as possible and sometimes impossible. The deformation is pronounced. There is practically no joint space on the roentgenogram.
The progressive destruction of cartilage and bone in the latter stages leads to the development of ugly deformities of the knee, which increase 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 by taking pain medication.
In stage 3, the operation is already shown - endoprosthetics. Either individual bone elements or the entire joint are replaced. Contraindication: osteoporosis.
Complications of endoprosthetics:
- marginal skin necrosis;
- Rejection of the prosthesis;
- neurovascular diseases (paresis, thrombosis).
In addition to endoprosthetics, there is arthrodesis surgery - removal of deformed tissue and joints. It is rarely used.
Osteotomy - excision of the edges of the bones to redistribute the load.
physical therapy
Exercises for gonarthrosis of the knee joint can relieve pain, strengthen the muscular system and stimulate blood circulation.
- Exercise 1. The patient lies on his back, lifts his straight leg and holds it for at least 30 seconds, then the second. The execution time should be brought to 2 minutes.
- Exercise number 2 "bicycle". Lying on your back, you imitate cycling with your feet. Repetitions 20 to 50 times.
- Exercise number 3. The patient lies on his stomach, alternately bending his legs and trying to reach the buttocks with his heel. Repetitions 20-50 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. While standing, bend over and try to reach the floor without bending your knees. Hold for 20 seconds, inhale air through your nose, exhale through your mouth.
- Exercise number 2. Sit on the floor with your legs straight and try to wrap your arms around your feet while keeping your knees straight. Hold this position for up to 30 seconds. Do 2-3 approaches. If you don't have enough flexibility to reach your feet, grab your leg by the lower leg and try to pull your body as close to your legs as possible.
- Exercise number 3. Same position as when performing the previous one. The patient takes the foot by the foot, tries to straighten it and holds it as high as possible off the ground. If the exercise is difficult, 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. The patients are forbidden to run, walk or squat for long periods of time.
After performing physical therapy exercises, it makes sense to massage the muscles of the thigh and lower leg on the affected limb. The joint itself should not be affected, this will increase inflammation.
Disease prevention
This disease is not hereditary, so it can prevent its development. For this you need:
- Avoid injuries while exercising;
- Stretching and joint gymnastics, doing yoga;
- ISS tidy;
- maintain a normal body weight;
- consult a doctor in the event of complaints in the knee area;
- drink enough water;
- prophylactically take chondroprotectors after 40 years;
- do not overcool the joints;
- in the early stages of the process and during remission, do not increase physical activity, do not walk;
- wearing orthopedic shoes;
- Use knee pads when exercising.