The inflammatory-degenerative process of the knee joint or gonarthrosis occurs for various reasons. It has a very negative impact on a person's quality of life, and sometimes leads to disability. How to treat arthrosis of the knee joint and prevent complications?
What is arthrosis
About 22% of the world's population suffers from gonarthrosis, and women are more affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint may collapse completely. This leads to dysfunction of the musculoskeletal system. Movement is possible only with the help of crutches, or the person becomes a hostage of the wheelchair.
The knee joint is the second largest joint after the hip and the most complex in structure. It allows you to bend and straighten your legs in different directions, promotes proper body posture and spatial coordination. It is a strong and stable joint that can withstand the weight of a person. Consists of 3 bones: hip, calf and fibula, as well as the knee cap. Includes osteochondral structures, muscles, ligaments, and nerve fibers.
The disease begins with a violation of blood circulation and joint tissue nutrition. First of all, cartilage is affected. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the smooth functioning of the knee, decreases. Friction occurs between the joint parts. Gradually, the cartilage cracks and collapses. Unprotected bones begin to rub against each other. Pain appears and a creaking sound is heard.
Causes of disease
Older people, especially overweight women, are most often affected. As a result of hormonal changes, the cartilage in the knee wears down a lot. Gonarthrosis in varying degrees occurs in more than 80% of people after 60 years.
There are other causes of knee arthrosis:
- congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- arthritis;
- diseases of the lumbar spine;
- hormonal disorders;
- low metabolism.
People who engage in repetitive physical work are at increased risk of developing the disease. This group also includes athletes, people who lead a sedentary lifestyle, and people with adverse environmental conditions. Most patients are addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation may be permanent hypothermia associated with work. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Lack of minerals and vitamins in the body can be caused by diet.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. Depending on the nature of the manifestations, the disease is divided into degrees:
- There are no obvious clinical signs at this stage. After prolonged training, there may be slight discomfort and pain, which will disappear after rest. The pain is felt in the morning and goes away after a while when moving. Grade 1 arthrosis is rarely found incidentally during a routine check-up.
- Knee pain and stiffness increase. The person takes pity on the foot and tries to load it less. As a result, muscle atrophy, deformation of the joint, formation may be felt, and the leg does not fully extend at the knee.
- The pain is persistent. The leg does not straighten, does not bend, it is difficult for a person to walk. Partial or complete loss of mobility occurs. The cartilage is completely destroyed, the friction between the bones of the joint increases with the formation of osteophytes.
In addition to 2-3 degrees of pain, a creaking sound is heard in the knee. Fluid and pieces of cartilage can accumulate in the joint capsule, causing swelling. In the late stage, the inflammatory process is reported, the deformation of the knee joint.
Diagnostics
If you have knee pain, you can contact your local doctor, who will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist if necessary.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is necessary:
- general and biochemical blood analysis;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- arthroscopy.
An X-ray allows you to see the condition of the cartilage and bone changes in stages 2 and 3. These are the narrowing of the joint space, osteophyte along the edges of the patella, changes in the periosteum. Arthroscopy provides detailed information about the presence of meniscus, synovial membrane, and fluid. This technique is also used to treat the knee, removing parts of the cartilage or meniscus.
Treatment of knee arthrosis
Therapy is long and sometimes painful. A disease that occurs once is remembered for a lifetime. The main drugs used for treatment are non-steroidal anti-inflammatory drugs. Most often these are drugs based on nonsteroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. Medicines are relatively inexpensive, but cause ulcers and erosions in the stomach and duodenum. Modern drugs have fewer side effects, but are more expensive.
Treatment measures for stage 1 include preventive measures involving exercise. Daily exercise, use of a contrast shower, 2 times a week in the pool, and the fight against weight gain are necessary.
Stage 2 requires fixation of the joint - using an elastic bandage, a bandage or an orthosis. NSAIDs are used in the form of creams and ointments to relieve pain. To reduce the degree of cartilage damage, the patient is prescribed drugs from the group of chondroprotectors.
Severe cases require oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity. In addition, pain relievers are prescribed.
Hyaluronic acid solution is injected into the joint. It replaces the fluid in the joint and nourishes the cartilage. When moving, it acts as a shock absorber for the joint. Manipulation is painful, it is carried out by a doctor, after which the acute period subsides. If conservative treatment fails, endoprosthesis is performed.
Along with drug therapy, exercises using special simulators and devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on knee health. The substance is used externally, by subcutaneous or intramuscular injections, ozone-based oils, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern nutritional supplements are in demand as an alternative to drugs for joint repair. Exercise therapy and massage are provided. A set of special exercises improves blood circulation and nutrition of cartilage cells, increases flexibility of ligaments.
Complexity and prevention
Damaged cartilage tissue and deformed bones cannot be treated. Only surgery can help in this situation. No amount of ointments or drugs can repair cartilage. Only drugs can stop the process of cartilage tissue destruction.
Gonarthrosis develops gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition deteriorates rapidly. The knee cannot work, serious complications arise:
- joint deformation;
- cosmetic defect - curvature of the leg;
- infection by blood or lymph flow from another body source;
- due to the weakness of the ligaments, dislocations and fractures are observed, even during normal walking;
- Bone fusion (ankylosis) occurs in the joint area, making movement impossible.
If the patient does not consult a doctor on time and the disease worsens, it will become complicated. Regular preventive examinations and timely treatment of general diseases of the body will help to prevent the deterioration of the condition and maintain the motor function of the foot.