In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint takes the leading place.
Gonarthrosis or arthrosis of the knee joint is a disease accompanied by a slow destruction of the cartilage tissue of the joint with the involvement of the entire joint in the pathological process, including the ligaments, synovium, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (colds, flu, typhus, tuberculosis, syphilis, tonsillitis and others), injuries, functional congestion of the joint (for example, in athletes, workers engaged in hard physical labor, ballet dancers)there is a violation of the trophism (nutrition) of the cartilage tissue of the knee joint, as a result, the cartilage becomes thinner and destroyed, sometimes to complete disappearance.
Who is at risk? First of all, arthrosis of the knee joint is at risk of "earning" women over forty years old, they have it 2 times more often than in the strong half of humanity. Moreover, the risk increases in those women who tend to be overweight, or are obese.
But by and large, 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 absorbs well. In addition, at a young age, cells "restorers" chondrocytes are actively working. With age, the amount of moisture begins to decrease, and, therefore, the ability to cushion the joint worsens, the cartilage becomes dry, fragile and cracks, and the existing chondrocytes do not have time to repair damage. In many ways, this explains the occurrence of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors are excess weight, physical inactivity, chronic joint injury or systematic microtraumatization of the joint, alcohol abuse, chronic stress, previous or existing knee joint diseases, such as:
- knee arthritis,
- sprain, partial or complete rupture of the ligaments,
- intra-articular fracture of the femur or tibia,
- metabolic disorders, such as gout, and a number of other pathological conditions.
Quite often, it is not possible to establish any one specific cause of the knee joint gonarthrosis, in this case, they speak of a combined cause, that is, the gonarthrosis was the result of several diseases at once.
Also, the disease, for reasons of occurrence, is usually divided into two forms: primary and secondary.
Primary arthrosis is caused by age and associated factors, such as:
- Professional predisposition,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis can be a previous knee injury (fracture, rupture of the ligamentous apparatus), called post-traumatic arthrosis of the knee joint. The same reason may be a previous infectious disease or inflammation of the knee joint.
Signs 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. Pains that are permanent and that increase with physical activity - walking, running, descending or climbing stairs and so on - come to the fore. Another symptom characteristic of this disease is the presence of crepitus in the joint, it can be a crackle or crunch in the knee.
Also very frequent manifestations of gonarthrosis are:
- an increase in local temperature (the joint is hot to the touch) or general,
- presence of joint swelling,
- increasing its volume,
- difficulty in movement,
- deformity of the joint followed by 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 proliferation of bone tissue on the bones that form the joint in the form of "thorns" (osteophytes), there is a deforming arthrosis of the knee joint. Exudate appears in the articular cavities.
Depending on the size of the osteophytes and the degree of deformation, several degrees of gonarthrosis are distinguished:
- Grade 1 gonarthrosis.Patients feel stiffness and mild soreness in the joint in the morning or when sitting or standing for a long time. There is no deformity of the joint at this stage, the mobility is retained in full. An x-ray reveals a small osteophyte.
- Grade 2 gonarthrosis.Painful sensations appear, not only in the morning, but also after prolonged exertion, the joint is deformed, the articular surfaces are enlarged, as a result of which the volume of the joint is also increased, flexion is difficult, a crunch is felt when performing movements. X-ray shows pronounced osteophyte, the joint space is not changed.
- Grade 3 gonarthrosis.The manifestations are the same as in the second degree, only the symptoms become more pronounced. The pain is permanent, it does not subside even at rest and sleep. The function of the joint is almost completely lost, patients can neither bend the leg, nor straighten it. As a result, lameness occurs, movement becomes possible only with crutches, or outside help. There is a pronounced deformation of the knee joint. On x-ray, a slight narrowing of the joint space is determined.
- There is also a fourth stage, in which there is complete immobility in the affected joint with further deformation. On x-ray, the phenomena of sclerosis of the subchondral bone and a significant narrowing of the joint space are determined.
Knee arthrosis treatment
In order to achieve good results from treatment, you should seek help from a qualified rheumatologist, and if not, then a therapist, since they know how to cure arthrosis of the knee joint. In no case should you try to treat it yourself, this can only aggravate an already not better situation. Before starting treatment, it is extremely important to make the correct diagnosis, as correct diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a rather lengthy process and depends on a number of factors (type of arthrosis, the cause of the arthrosis, the degree of the disease). Treatment is complex and includes drug and non-drug therapy, and in some cases, surgical treatment is indicated.
Drug treatment of arthrosis of the knee joint is aimed primarily at relieving the main manifestations of the disease, such as:
- Inflammation of the joint and periarticular tissues.
In addition to relieving symptoms of the disease, drugs are used for:
- joint tissue repair,
- improving its trophism and blood circulation,
- strengthening the body's defenses,
- elimination of allergic reactions.
Various non-narcotic analgesics are used to relieve pain symptoms, in rare cases, narcotic analgesics are prescribed for a short time. Most often, drugs are used from the group of 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. The drugs stimulate the activity of cartilage cells - chondrocytes, and help them repair tissue. Intra-articular insertion of head protectors gives a good effect. In recent years, a new, effective product based on hyaluronic acid has appeared. For its action, this drug is called "liquid prosthesis". Once injected into a diseased joint, this drug forms a protective film on the damaged cartilage and gradually restores the normal lubrication characteristics of the joint.
Muscle relaxants are used to relieve muscle spasms, in addition to a relaxing effect, they have a positive effect on blood circulation in the affected joint.
Manual and physical therapy is widely used from non-drug methods of treatment of gonarthrosis. The most important are magnetotherapy, acupuncture, electrophoresis and massage, apparatus traction (joint extension) and others. Recently, methods such as laser therapy, cryotherapy (exposure to liquid nitrogen) have entered the practice of treating arthrosis. Along with physiotherapy, exercise therapy for arthrosis of the knee joint also gives a good effect. Lfk is the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the onset of the disease, physical activity on the diseased joint should be minimized. You should not go jogging, jumping, lifting weights, walking fast, squatting. Exercises for arthrosis of the knee joint can be performed only after undergoing a course of treatment, under the supervision of your doctor.
It is necessary to choose exercises that help to strengthen the muscles and ligaments of the affected knee joint, but at the same time do not lead the joint to excessive mobility. That is, exercises should be with minimal dynamic activity. It is useful to do exercises to stretch the ligaments and joint capsules. The rules are the same, the exercises are performed gently, without the use of any effort.
When performing any gymnastic exercise, it is important to follow some rules:
- Do not exercise over pain
- If the exercise causes pain, then it should be replaced by another more gentle one.
Massage for knee arthrosis has a beneficial effect on the restoration of the functions of the knee joint. At the site of exposure, blood vessels expand, blood circulation improves and metabolism is accelerated. Massage procedures improve lymph flow, and this, in turn, helps to eliminate residual inflammation. Massage strengthens the muscular system, increases the flow of oxygen in them, improves gas exchange, normalizes their tone, and increases plasticity.
Diet for knee arthrosis
Recently, medical specialists have found that there is no direct relationship between the incidence of gonarthrosis and nutrition. However, the undeniable fact is that the development of arthrosis is greatly influenced by the presence of excess weight in a person. If the cause of the disease was precisely excess weight, then it is obvious that nutrition for arthrosis of the knee joint should be aimed at a gradual decrease in body weight. This will require a change in diet and a change in diet. Food should be less high-calorie, fried foods and foods high in fat should be excluded from the diet. Eat more vegetables, fruits and liquids.
Prevention of arthrosis of the knee joint
In order for the joints to remain healthy as long as possible, it is necessary to regularly engage in physical culture and gymnastics, but do not get too carried away with this, so that this does not lead to overloading of the joints. Swimming gives the best effect and minimal stress on the joints. If professional sports are involved, joint protection should be used. It is useful to alternate physical activity with rest, you should not stay still for a long time.
Compliance with all these simple rules, together with a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to ruin the life of any person.