Knee osteoarthritis (gonarthrosis)

Osteoarthritis of the knee joint (also 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 disability of patients 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 the treatment of progressive destruction of the knee is carried out.

The main factors in the appearance of this pathology.

The joints are constantly exposed to significant stress. The knees are especially affected: they are forced to do important physical work, so they wear out quickly. The deformation process is intensified by the fact that the legs are forced to support 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. Increase in body weight of patients. In the complete destruction of the joint occurs much faster and more intense. The disease in question has been found to occur in obese people three times more often than in people of normal weight.
2. Intense sports, due to which the joints are constantly injured.
3. Frequent fractures, previous knee injuries contribute to the fact that the patient begins to degenerate the articular cartilage processes from a fairly early age.
4. Abnormalities in the location of the bones: the so-called valgus or varus deformity.
5. Poor development of the ligamentous apparatus of the knee leads to frequent injuries, dislocations. Due to the injuries described, the patient develops osteoarthritis.
6. Damage to the meniscus triggers the degenerative process of destruction of 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 more from a lack of calcium).

In addition, the following people belong to the risk group:

• all athletes;
• patients, regardless of gender, who have reached the age mark of 50 years;
• women who have started menopause;
• patients suffering from 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 rush to see a doctor. However, the pathological process has already begun, and if it is not stopped in time, the functions of the lower extremities will gradually be lost, which leads to the appearance of disability.

So in grade 1, the patient may notice that the leg gets tired, even if the load is small. There is some limitation of the mobility of the knee joint and a significant crunch is heard during movement.

There are pronounced starting pains when the discomfort does not give rest, mainly in the morning. After the patient "disperses", the discomfort gradually subsides, increasing again after sports activities. At this stage of the development of the disease, there is no pronounced deformation of bone tissue.

In grade 2, the pain worsens. Walking is affected by this. Sometimes it is almost impossible for the patient to move normally, and even after a light load, a long rest is required. As the joint space narrows, osteophytes grow in the bones and pathological fluid accumulates in the joint.

In grade 3, pain occurs not only during work, sports, but also in a state of complete rest. The deformity of the knee 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. Pain. It does not appear suddenly, however, mild discomfort can last for almost years. The most severe pain is caused by trauma.
2. Deformation of the knee (retains its previous shape).
3. Accumulation of fluid in the intra-articular cavity. When its amount exceeds certain values, a so-called Baker's cyst develops. A tight elastic object appears at the back of the knee. It is most noticeable when the joint is extended.
4. A knee crunch is observed if the pathology is in the second, third stage. It differs significantly from what is seen in a healthy person when bending or extending the knee. The sound feels harsh and painful. Sometimes the creaking interferes with active movements.
5. Decreased range of normal motion in the joint. Usually the patient cannot bend, bend the affected leg. He can bend it at a right angle, subsequent movements are accompanied by severe pain.
6. Knee stiffness mainly occurs in stages 3. Sometimes patients can only walk with their limbs bent.
7. Increased pain when the weather changes.
8. Substantial thinning of cartilage. Sometimes, in advanced cases, bone exposure is seen. X-ray of the knee shows a significant accumulation of osteophytes.

Varieties of osteoarthritis.

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

Based on 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 prolonged and intense physical exertion.
3. Inflammatory osteoarthritis occurs due to a prolonged untreated inflammatory process in the joints.
4. Dysplastic osteoarthritis develops due to congenital abnormalities in the structure of the knee joint.
5. Post-traumatic osteoarthritis appears as a result of frequent injuries to the musculoskeletal system.
6. Metabolic osteoarthritis occurs with gout and other metabolic disorders.
7. Post-infectious osteoarthritis occurs as a consequence of insufficiently treated inflammatory pathologies.
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 initial 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 consult a surgeon. Finally, in some clinics there is a limited specialist who deals with joint diseases - an arthrologist.

The scope of therapeutic measures depends on the progression of the disease. 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 himself, as this can contribute to further destruction of the joint. The main drugs are prescribed:

1. Non-steroidal anti-inflammatory tablets or ointments. Its 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 articular cartilage, improve normal nutrition in it.

The novocaine blockade helps relieve acute pain. The injection can be done from outside or inside the joint. The simplest and safest method is to administer the medicine from the outside. With correct manipulation, the pain goes away 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 drug, even the most effective, can have side effects and cause allergic reactions. This means that self-medication for this serious disease is categorically prohibited.

Conservative treatment can be effective, as long as the disease has not gone too far. In case of irreversible damage to the joint, a surgical operation is indicated. The implantation of a metallic prosthesis is carried out.

Currently, this is the only way to restore mobility to the knee. The disadvantages of these operations are the limited service life of the prosthesis, the high price.

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

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

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

The duration of treatment of the disease depends on many factors. The course of therapy with chondroprotectors can be quite long - six months or even more, since the effect of them manifests itself rather slowly. A qualified healthcare professional can determine how long to take your prescription medications.

The use of chondroprotectors in the treatment of osteoarthritis.

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 normal mobility, more and more chondroprotectors are being used.

Modern drugs of this group help to restore joint tissue. This is due to the content of chondroitin in them. It is a natural component of cartilage. The constant intake of drugs from 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. Injection of chondroprotectors is not shown to everyone, the drugs themselves are diluted in special solvents.

The intake of dietary supplements is indicated if the patient follows the rules of a balanced diet, takes other medications to support the joints.

The role of exercise therapy and physical therapy in the treatment of knee osteoarthritis.

With the described pathology, the patient is categorically contraindicated in a reclined 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 physician.

For each patient, a traumatologist or a rehabilitation therapist individually selects special exercises. There is no need to think that the different sets of classes 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 cause great harm. All loads should be gentle, aimed at the fastest and most complete restoration of the functions of the affected joints.

At home, a simple exercise is recommended: while 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 should 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, not cause discomfort);
• medical laser treatment;
• impact on the reflexogenic points using the finest needles;
• heat or cold treatment (again, it is not necessary to perform heat treatments at home);
• magnetic field treatment;
• phonophoresis;
• electrophoresis;
• paraffin therapy;
• ozokerite treatment;
• moxibustion with wormwood.

Nutrition for knee osteoarthritis

Proper nutrition is the basis for the successful treatment of degenerative diseases of the musculoskeletal system. Due to a poorly formulated diet, the patient can gain weight. The lack of vitamins, microelements aggravates the course of pathology.

All people with gonarthrosis should increase the amount of foods enriched with vitamins and minerals in their daily diet.

Nutritionists recommend closely monitoring the caloric content of foods. Fasting or extreme dieting is strictly prohibited. They can harm, body weight will increase even more.

It is imperative to ensure that breakfast is balanced. You need to eat at least five times a day. For sandwiches, it is recommended to use fruits, bread.

The following foods and dishes are excluded:

• sweet soda
• fatty food;
• semi-finished products;
• spices
• dishes containing flavor and odor enhancers;
• fatty meats;
• fried food;
• White cabbage;
• tomatoes and bell peppers;
• oranges, lemons;
• chocolate;
• bananas, grapes (they are very rich in calories).

Jellied meat and gelatin are helpful. They contain a large amount of collagen, so the bone is restored. Jellied meat is prepared to contain less fat, so its caloric content will decrease.

Protein sources for those with osteoarthritis can be dairy products: cheese, cottage cheese, or kefir. It is very useful to consume legumes. Make sure to include walnuts in your diet.

It is necessary to observe the drinking regime. As long as there are no associated kidney diseases, it is recommended to consume about 2 liters of water.

About the alternative treatment of the disease.

It should be remembered that traditional methods cannot replace the effective methods of official medicine. And therefore they must be used in complex treatments, there can be no other therapy for this serious disease.

To relieve knee swelling, use regular soda. The cloth is moistened with soda atole and wrapped around the knee. Above, to enhance the thermal effect, it is advisable to attach a plastic bag. Keep the compress ready overnight.

A similar compress is made 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 advisable to lubricate the knee with vegetable oil. There needs to be several layers of sheets.

All of this is wrapped in a plastic bag. Birch leaf compresses are made in the same way.

Medical bile relieves inflammation, swelling, and pain well. It is used in the form of warm compresses at night. Bile has practically no side effects.

Honey treatment is carried out in cases where the patient is not allergic to it. After warming the sore joint with a heating pad, it should be lubricated with honey and gently massaged. After that, put burdock leaves on the knee.

Prevention of gonarthrosis

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

• high-quality balanced nutrition with the use of a sufficient amount of protein, 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 problems appear, it is important to see a doctor immediately. In a clinical consultation, it is possible to find out which doctor is treating knee osteoarthritis. It is advisable to undergo a full medical examination to find out the cause of the development of the disease.

Knee osteoarthritis is a serious disease: if ignored, there is a risk of disability and total immobility. To prevent this, you need to properly treat the affected joint. The therapeutic measures started early contribute to the almost complete remission of this pathology, help to maintain a high performance and quality of life.