Osteoarthritis of the knee (gonarthrosis)

Osteoarthritis 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 patients' disability if they refuse to seek help from a traumatologist or orthopedist.

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

The main factors in the appearance of this pathology

The joints are constantly subjected to considerable stress. The knees are especially affected - they are forced to do significant physical work, which is why they wear out quickly. The deformation 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. Weight gain of patients. In complete destruction of the joint occurs much faster and more intensively. It has been shown that the disease in question in obese people occurs three times more often than in people of normal weight.
2. Intense sports, as a result of which the joints are constantly injured.
3. Frequent fractures, previous knee injuries contribute to the fact that the patient begins to degenerate the processes of the articular cartilage from a young enough age.
4. Abnormalities in the position of the bones - the so-called valgus or varus deformity.
5. Poor development of the ligament apparatus of the knee leads to frequent injuries, dislocations. Due to the lesions described, the patient develops osteoarthritis.
6. Damage to the meniscus triggers the degenerative process of destroying 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 sex, who have reached the age threshold of 50 years;
• women who have started menopause;
• patients with varicose veins;
• people with unfavorable inheritance.

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 consult a doctor. However, the pathological process has already begun, and if it is not stopped in time, the functions of the lower limbs will gradually be lost, which leads to 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 in the mobility of the knee joint is noted and a significant crunch is heard during movement.

There are pronounced initial pains when discomfort does not give rest mainly in the morning. After the patient "disperses", the discomfort gradually subsides, increasing again after sporting activity. 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. Due to this, walking is impaired. Sometimes it becomes almost impossible for the patient to move normally, and even after a light load, a long rest is required. As the joint gap narrows, osteophytes grow on the bones and pathological fluid builds up in the joint.

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

Common symptoms of the disease

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

1. Ache. It doesn't appear suddenly, however, mild discomfort can last for nearly years. The most severe pain is caused by trauma.
2. Knee deformation (retains its previous shape).
3. Accumulation of fluid in the intra-articular cavity. When its quantity 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 heard as harsh and painful. Sometimes the crunch interferes with active movements.
5. Decreased normal range of motion in the joint. Usually the patient cannot bend, bend the affected leg. He is able to bend it at a right angle, further movements are accompanied by severe pain.
6. Knee stiffness occurs mainly 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. The knee radiograph shows a significant accumulation of osteophytes.

Variety of osteoarthritis

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

According to the characteristics of the manifestation, the following types of disease are distinguished.

1. Deforming arthrosis is characterized by a chronic course, irreversible changes in the joint.
2. Patellofemoral osteoarthritis develops due to intense and prolonged physical exertion.
3. Inflammatory osteoarthritis occurs due to an untreated prolonged inflammatory process in the joints.
4. Dysplastic osteoarthritis develops due to congenital anomalies in the structure of the knee joint.
5. Post-traumatic arthrosis appears as a consequence of frequent injuries of the musculoskeletal system.
6. Metabolic osteoarthritis occurs with gout and other metabolic disorders.
7. Postinfectious osteoarthritis occurs as a result of inadequately treated inflammatory diseases.
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 injury is not established, experts speak of idiopathic osteoarthritis.

Features of the treatment of the disease

In the early stages of the development of the disease, a rheumatologist and a traumatologist are involved in the treatment. If it has gone too far, the patient should see a surgeon. Finally, in some clinics there is a small specialist who deals with joint diseases: an arthrologist.

The extent 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, 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 drug treatment 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 drugs 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 joint 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 joint cartilage, improve normal nutrition in it.

Blocking novocaine helps relieve acute pain. The injection can be given from the outside or inside of the joint. The simplest and safest method is to administer the medicine from the outside. With proper manipulation, the pain disappears almost immediately.

An ointment based on powerful 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, 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 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 life of the prosthesis, the high price.

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

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

Canes and orthoses are used to unload the joint affected by the degenerative process.

The duration of treatment for the disease depends on many factors. The course of chondroprotector therapy can be quite long - six months or even more, since the effect of them manifests itself rather slowly. A qualified health care practitioner can determine how long to take prescribed medications.

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 disease process. To reduce the intensity of joint degeneration and restore its normal mobility, chondroprotectors are increasingly used.

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

Despite the wide range of medications on offer, 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 food supplements is indicated if the patient follows the rules of a balanced diet, takes other drugs to support the joints.

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

With the described pathology, the patient is categorically contraindicated in a 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; any exercise is performed exclusively under the supervision of a doctor.

For each patient, a traumatologist or rehabilitation therapist individually selects special exercises. It is not necessary to think that different class groups 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 hurt a lot. 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: from 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 doctor, exercises are performed to stretch the joint capsule. But if it causes pain, the execution must be stopped immediately.

Physiotherapeutic methods for treating a disease include:

• massage (it is strictly forbidden to do it without the testimony of a doctor);
• manual therapy (it should be as gentle as possible, do not cause discomfort);
• medical laser treatment;
• impact on reflex points using the finest needles;
• treatment with hot or cold (even here it is not necessary to carry out spa treatments at home);
• magnetic field treatment;
• phonophoresis;
• electrophoresis;
• paraffin therapy;
• treatment with ozokerite;
• 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 can gain weight. The lack of vitamins, microelements aggravates the course of the pathology.

All people with knee osteoarthritis should increase the amount of vitamin and mineral fortified foods in their daily diet.

Nutritionists recommend carefully monitoring the calorie content of food. Fasting or extreme dieting is strictly prohibited. They can harm, the 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 fruit, 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 peppers;
• oranges, lemons;
• chocolate;
• bananas, grapes (they are very caloric).

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

Sources of protein for osteoarthritis sufferers can be dairy products: cheese, cottage cheese or kefir. It is very useful to consume legumes. Make sure you include walnuts in your diet.

It is necessary to observe the consumption regime. Provided there is no associated kidney disease, it is recommended to consume about 2 liters of water.

Information on 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 knee swelling, use ordinary soda. The fabric is moistened with soda gruel and wrapped around the knee. Above, to enhance the thermal effect, it is recommended to attach a plastic bag. Keep the prepared compress overnight.

A similar compress is prepared 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 recommended to lubricate the knee with vegetable oil. There must be several layers of leaves.

All of 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.

Honey treatment is carried out in cases where the patient is not allergic to it. After the aching joint is heated with a heating pad, it should be lubricated with honey and a light massage should be done. Next, attach the burdock leaves to the knee.

Prevention of gonarthrosis

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

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

When the first symptoms of ailment appear, it is important to consult a doctor immediately. In a clinical consultation, it is possible to find out which doctor is treating gonarthrosis. It is recommended to undergo a comprehensive medical examination 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 avoid this, it is necessary to properly treat the affected joint. Early therapeutic measures contribute to the almost complete remission of this pathology, help to maintain high performance, quality of life.