Gonarthrosis of the knee joint occupies a leading place in the group of diseases of the musculoskeletal system of degenerative-dystrophic origin.
Gonarthrosis or arthrosis of the knee joint is a disease accompanied by slow destruction of cartilage tissue of the joint, involving the entire joint in the pathological process, including ligaments, synovial membrane, subchondral bone and other elements of the joint.
Under the influence of various factors, for example, infectious diseases (colds, flu, typhus, tuberculosis, syphilis, sore throat and a number of others), injuries, functional congestion of the joint (for example, athletes, workers engaged in heavy physical labor, ballet dancers), as a result of trophism (nutrition) of cartilage tissue, cartilage thins and is destroyed, sometimes it disappears completely.
Who is at risk?First of all, women over forty are at risk of developing arthrosis of the knee joint;it happens 2 times more often in them than in the strong half of humanity.Moreover, the risk increases in women who tend to be overweight or obese.
But generally, gonarthrosis is a disease of the elderly.And there is a simple explanation for this.As you know, cartilage tissue consists of about 70-80% water, thanks to which it is well absorbed.In addition, "restorative" cells, chondrocytes, work actively at a young age.With age, the amount of moisture begins to decrease, and as a result, the cushioning ability of the joint deteriorates, the cartilage becomes dry, brittle and cracks, and the existing chondrocytes do not have time to repair the damage.In many ways, this explains the occurrence of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors include overweight, physical inactivity, chronic joint damage or systematic microtraumatization of the joint, alcohol abuse, chronic stress, previous or existing diseases of the knee joint, for example:
- knee arthritis,
- sprain, partial or complete rupture of ligaments,
- intra-articular fracture of the femur or tibia,
- metabolic disorders, such as gout and a number of other pathological conditions.
Often, it is impossible to determine any specific cause that causes gonarthrosis of the knee joint;in this case, they are talking about a combined cause, that is, gonarthrosis was the result of several diseases at once.
Also, according to the causes of occurrence, the disease is usually divided into two forms: primary and secondary.
The cause of primary arthrosis is age and related factors, such as:
- professional inclination,
- Excessive weight
- obesity,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis can be a previous injury (fracture, rupture of the ligament apparatus) in the knee, which is called post-traumatic arthrosis of the knee joint.The reason may be a previous infectious disease or inflammation of the knee joint.
Symptoms
Symptoms of arthrosis of the knee joint do not appear overnight;the development of the disease occurs gradually and often takes several months or even years.The pain that comes to the fore is constant and worsens with physical activity - walking, running, climbing or descending stairs, etc.Another characteristic symptom of this disease is the presence of crepitus in the joint, which can be a cracking or creaking sound in the knee.
There are also very common manifestations of gonarthrosis:
- an increase in local temperature (the joint is warm to the touch) or general,
- swelling of the joint,
- increase the volume,
- difficulty moving,
- deformation of the joint with subsequent curvature of the limb.
As the disease progresses, when the cartilage tissue is completely destroyed, the body has no choice but to start defending itself.This is manifested by the growth of bone tissue in the bones forming the joint in the form of "spikes" (osteophytes), and deforming arthrosis of the knee joint occurs.Exudate appears in joint spaces.
Depending on the size of the osteophytes and the degree of deformation, several degrees of gonarthrosis are distinguished:
- 1st degree gonarthrosis.Patients feel stiffness and mild pain in the joint in the morning or during prolonged sitting or standing.At this stage, there is no deformation of the joint, mobility is fully preserved.X-ray reveals a small osteophyte.
- 2nd degree gonarthrosis.Painful sensations appear not only in the morning, but also after prolonged exercise;the joint is deformed, the articular surfaces enlarge, as a result, the volume of the joint increases, it becomes difficult to bend, and a feeling of creaking is felt when making movements.An open osteophyte is visible on the X-ray, the joint space is not changed.
- Gonarthrosis 3 degrees.The manifestations are the same as the second degree, only the symptoms are brighter.The pain is constant and does not go away even during rest and sleep.Joint function is almost completely lost;patients can neither bend nor straighten their legs.As a result, lameness occurs and movement is possible only with crutches or assistance.There is a serious deformity in the knee joint.X-ray examination shows a slight narrowing of the joint space.
- There is also a fourth stage, where there is then complete immobilization in the joint affected by deformation.X-rays reveal sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of arthrosis of the knee joint
To get good results from the treatment, you should seek help from a qualified rheumatologist, and if he is not there, you should consult a therapist, because they are the ones who know how to treat arthrosis of the knee joint.In no case should you try to treat yourself, this can only make an already bad situation worse.It is extremely important to make a correct diagnosis before starting treatment, because the correct diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a rather long process and depends on a number of factors (type of arthrosis, cause of arthrosis, degree of the disease).Treatment is complex and includes drug and non-drug therapy, and in some cases surgical treatment is indicated.
Medical treatment of arthrosis of the knee joint is primarily aimed at eliminating the main manifestations of the disease, for example:
- Pain;
- Inflammation of joint and periarticular tissues.
In addition to eliminating the symptoms of the disease, drugs are used for:
- regeneration of joint tissues,
- improve its trophism and blood circulation,
- strengthen the body's defenses,
- elimination of allergic reactions.
Various non-narcotic analgesics are used to relieve pain symptoms;rarely, narcotic pain relievers are prescribed for a short period of time.The most commonly used drugs are non-steroidal anti-inflammatory drugs.They have a combined anti-inflammatory, analgesic and antipyretic effect.
Chondroprotectors are used to restore cartilage tissue and improve joint mobility.Medicines stimulate the activity of cartilage cells - chondrocytes and help tissue regeneration.Intra-articular application of khdroprotectors gives a good effect.In recent years, a new, effective product based on hyaluronic acid has appeared.Due to its effect, this drug is called "liquid prosthesis".After being injected into the painful joint, this drug forms a protective film on the damaged cartilage and gradually restores the joint's normal lubricating properties.
Muscle relaxants are used to relieve muscle spasms;in addition to their relaxing effect, they have a positive effect on blood circulation in the affected joint.
Manual and physical therapy are widely used among the non-drug methods of treating gonarthrosis.Magnetic therapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others are of the greatest importance.Recently, the practice of treating arthrosis includes methods such as laser therapy and cryotherapy (liquid nitrogen exposure).In addition to physiotherapy, exercise therapy also has a good effect on arthrosis of the knee joint.Exercise therapy is the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the beginning of the disease, physical stress on the affected joint should be minimized.Do not run, jump, lift weights, walk fast, or squat.Exercises for arthrosis of the knee joint can be performed only after completing a course of treatment, under the supervision of your attending physician.
It is necessary to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but do not cause excessive mobility of the joint.That is, exercises should be with minimal dynamic activity.It is useful to do exercises to stretch the ligaments and joint capsules.The rules here are the same, perform the exercises gently without any effort.
When performing any gymnastic exercise, it is important to follow some rules:
- Do not exercise while relieving pain,
- If an exercise causes pain, it should be replaced by another, gentler exercise.
Massage for arthrosis of the knee joint has a beneficial effect on restoring the functions of the knee joint.At the site of impact, blood vessels expand, blood circulation improves, and metabolism accelerates.Massage procedures improve lymph flow, which in turn helps to eliminate residual inflammation.Massage strengthens the muscle system, increases oxygen flow to them, improves gas exchange, normalizes tone and increases plasticity.
Diet for arthrosis of the knee joint
Recently, medical experts have discovered that there is no direct relationship between the incidence of gonarthrosis and nutrition.However, it is an indisputable fact that the presence of excess weight in a person greatly affects the development of arthrosis.If the cause of the disease was precisely excess weight, then it is clear that nutrition for arthrosis of the knee joint is aimed at gradually reducing body weight.This will require a change in diet and a change in diet.Foods should be less caloric, fried foods and fatty foods should be excluded from the diet.Eat more vegetables, fruits and fluids.
Prevention of arthrosis of the knee joint
In order to keep the joints healthy as long as possible, it is necessary to regularly engage in physical education and gymnastics, but you should not do it too much, so as not to overload the joints.Swimming gives the best effect and minimum stress on the joints.If you play professional sports, you should wear joint protection.It is useful to replace physical activity with rest;you should not stay still for a long time.
Following all these simple rules, together with a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to destroy the life of any person.