Gonarthrosis is a pathological process in the cartilage tissue of the knee joint, which 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 most famous myths:
- "The diagnosis of knee osteoarthritis is the prerogative of people with increased physical activity, and people with predominantly sedentary work do not suffer from it. " In fact, excessive physical exertion actually contributes to the deterioration of cartilage. During sedentary work, a static effect occurs on the knees, the blood supply is hampered. In addition, 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 adequate and timely treatment, deterioration of the cartilage 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 ligament apparatus. Only a few sports are really contraindicated.
Knee osteoarthritis 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 knee osteoarthritis:
- long asymptomatic period;
- knee discomfort;
- pain syndrome;
- reduced mobility;
- morning stiffness up to half an hour;
- the presence of a cracking sound during active movement;
- change of gait.
Bilateral knee osteoarthritis occurs when the knee joints of both limbs are involved in the process. It is one of the most severe forms. Occurs in the elderly.
Right knee osteoarthritis occurs with excessive static or dynamic physical exertion on the right limb. More often in athletes.
Knee osteoarthritis of the left side occurs in overweight people and in athletes with a load on the left leg.
The reasons for the development of knee osteoarthritis
Gonarthrosis is primary and secondary. Primary can occur during childhood and adolescence, which is associated with poorly formed joints, as well as in older people due to the natural aging process.
Secondary occurs due to injury or existing illnesses. Main reasons:
- fractures, contusions, 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 cartilage tissue;
- operations;
- vitamin D deficiency;
- hormonal disorders;
- lifting weights;
- certain sports (running, hockey, football).
Who is at risk?
The risk group includes:
- professional athletes;
- obese people;
- patients who have had trauma or surgery;
- people over 45;
- 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 osteoarthritis of the knee are unknown.
The degree of knee osteoarthritis
Radiologically, this pathology is divided into 5 stages or degrees:
- Stage 0 - No X-ray osteoarthritis;
- Stage 1 - the appearance of a small osteophyte;
- Stage 2 - the osteophyte has clear contours, the joint space is little changed;
- 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 sound is heard. The pain appears after waking up, prolonged sitting and after physical exertion.
There is no deformation yet 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 its elasticity. NSAIDs are used to relieve pain.
Primary knee osteoarthritis is most often bilateral. Even with the development of a one-sided form of the disease, after some time the second limb is also involved in the pathological process.
The first symptoms of osteoarthritis of the knee joints are mild and unusual
Processing methods
In addition to drug therapy in the remission phase, the following methods are used:
- physiotherapy;
- massages;
- leech therapy;
- exposure to ultrasound;
- radon and hydrogen sulphide baths;
- phonophoresis, electrophoresis;
- paraffin wraps;
- the use of therapeutic mud.
These methods are used regardless of the stage of development of the disease 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. It includes 10 to 15 procedures. The method can be used at home, and dirt can be bought at the pharmacy.
At the first degree, the patient is prescribed orthopedic shoes for the period of exacerbation in order to prevent 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. Jelly meat and jelly are included in the diet, because 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, which significantly limits movement. Long-term walking for long distances 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 crackling becomes loud, a limp appears. The affected joint is deformed. An inflammatory process occurs in the inner membrane of the joint.
On the simple x-ray, there is a narrowing of the joint space, the appearance of thorns on the bone (osteophytes).
Processing
Pharmacotherapy 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, massage are prescribed.
Dietary recommendations:
- increase the amount of vegetables;
- include jelly and jelly meat in the diet;
- eat lean fish twice a week;
- favor lean meat;
- eat bran bread.
It is also recommended to include in the diet bananas, nuts, eggs, spinach, legumes, liver, cabbage.
In addition to orthopedic shoes, special knee pads are prescribed.
From surgical interventions, arthroscopic removal of the deforming tissue is used. This method has a short-term effect of 2-3 years.
Gonarthrosis of the knee, symptoms and grade 3 treatment
The most severe degree. Pain syndrome occurs during movement and at rest. Mobility of the knee is as limited as possible, and sometimes impossible. The deformation is pronounced. There is hardly any joint space on the roentgenogram.
The gradual destruction of cartilage and bones in the later stages leads to the development of ugly deformities of the knee, which increase in size.
Processing
At this stage, in addition to NSAIDs, the patient is prescribed hormonal drugs. They are injected intravenously or inside the joint. Severe pain syndrome is relieved with pain relievers.
At stage 3, the operation is already shown - endoprosthesis. 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 stent, there is an arthrodesis operation - the removal of deformed tissues and joints. It is rarely used.
Osteotomy - excision of the edges of the bones to redistribute the load.
Physiotherapy
Exercises for knee osteoarthritis of the knee joint can relieve pain, strengthen the muscle system, and stimulate blood flow to it.
- Exercise n ° 1. The patient lies on his back, lifts his right leg and holds it for at least 30 seconds, then the second. The run time should be reduced to 2 minutes.
- Exercise number 2 "Bike". Lying on your back, imitate the bicycle with your feet. Repetitions 20 to 50 times.
- Exercise number 3. The patient is lying on his stomach, alternately bending the legs, trying to reach the buttocks with the heel. Repetitions 20-50 times.
- Exercise number 4. It is done in the same way as the previous one, only in static mode. That is, the patient fixes the limb in this position for 20-30 seconds.
Patients are advised to stretch:
- Exercise n ° 1. While standing, bend over, trying to reach the floor without bending your knees. Hold for 20 seconds, breathe in air through your nose, breathe out through your mouth.
- Exercise number 2. Sitting on the floor with your legs straight, try to wrap your arms around your feet, while keeping your knees straight. Hold this position for up to 30 seconds. Perform 2-3 approaches. If the flexibility is not enough to reach the feet, they take the leg from the bottom of the leg and try to pull the body as close to the legs as possible.
- Exercise number 3. The same position as during the execution of 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, the leg is caught in the lower part of the leg. Hold the position for 10 to 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 for long periods and squatting.
After performing physiotherapy exercises, it is useful to massage the muscles of the thigh, lower leg on the affected limb. The joint itself should not be influenced, this will increase the inflammation.
Disease prevention
This disease is not hereditary, so its development can be avoided. This requires:
- avoid injuries while playing sports;
- do stretching and joint gymnastics, yoga;
- eat properly;
- maintain normal body weight;
- if you experience any discomfort in the knee, see a doctor;
- drink enough water;
- after 40 years, take prophylactic chondroprotectors;
- do not overcool the joints;
- in the presence of the early stages of the process and during remission, do not increase physical activity, do not run;
- wear orthopedic shoes;
- use knee pads when playing sports.