In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a leading place.
Gonarthrosis or arthrosis of the knee joint is a disease accompanied by the slow destruction of the cartilaginous tissue of the joint with the involvement of the entire joint in the pathological process, including ligaments, synovium, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (cold, flu, typhus, tuberculosis, syphilis, tonsillitis and others), injuries, functional congestion of the joint (for example, in athletes, workers engaged in heavy physical work, ballet dancers) there is a violation of the trophism (nutrition) of the cartilaginous tissue of the knee joint, which results in the cartilage becoming thinner and destroyed, sometimes to complete disappearance.
Who is in danger? First of all, osteoarthritis of the knee risk to "earn" women older than forty, have it 2 times more often than in the strong half of humanity. Moreover, the risk increases in women who are overweight or obese.
But gonarthrosis is a disease of the elderly. And there is a simple explanation for that. As you know, cartilage tissue makes up approximately 70-80% of water, which is why it is well absorbed. In addition, at a young age chondrocytes "renew" the cells actively working. With age, the amount of moisture begins to decline, and thus the ability to soften the joint deteriorates, the cartilage becomes dry, brittle and cracked, and existing chondrocytes do not have time to repair the damage. This explains the occurrence of gonarthrosis of the knee joint in many ways.
Causes of the disease
Predisposing factors are overweight, physical inactivity, chronic joint injury or systemic joint microtraumatization, alcohol abuse, chronic stress, previous or existing knee joint diseases, such as:
- knee arthritis,
- sprain, partial or complete rupture of ligaments,
- intraarticular fracture of the femur or tibia,
- metabolic disorders, such as gout and a number of other pathological conditions.
It is often not possible to determine any specific cause of gonarthrosis of the knee joint, in this case they are talking about a combined cause, ie gonarthrosis was the result of several diseases at once.
Also, the cause of the disease is usually divided into two forms: primary and secondary.
Primary osteoarthritis is caused by age and related factors, such as:
- Professional predisposition,
- Overweight,
- Obesity,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis can be a previous knee injury (fracture, rupture of the ligament apparatus), which is called post-traumatic osteoarthritis of the knee joint. The same reason may be a previous infectious disease or inflammation of the knee joint.
Symptoms
Signs of osteoarthritis of the knee joint do not appear overnight, the development of the disease occurs gradually and often lasts for several months or even years. Pains that are permanent and that are intensified by physical activity - walking, running, descending or climbing stairs and so on - come to the fore. The next symptom characteristic of this disease is the presence of crepitus in the joint, it can be cracking or crunching in the knee.
Also very common manifestations of gonarthrosis are:
- increase in local temperature (the joint is hot to the touch) or in general,
- presence of joint swelling,
- increasing its volume,
- difficulty moving,
- joint deformity followed by limb curvature.
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 make up the joint in the form of "thorns" (osteophytes), there is a deforming arthrosis of the knee joint. Exudate appears in the joint cavities.
Depending on the size of the osteophyte and the degree of deformation, there are several degrees of gonarthrosis:
- Grade 1 gonarthrosis.Patients feel stiffness and slight joint pain in the morning or when they sit or stand for a long time. At this stage, there is no deformation of the joint, mobility is completely retained. An X-ray reveals a small osteophyte.
- Grade 2 gonarthrosis.Painful sensations appear, not only in the morning, but also after a long effort, the joint deforms, the joint surfaces increase, as a result of which the volume of the joint increases, bending is difficult, crunch is felt when performing the movement. X-ray shows a 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. Deformation of the knee joint is pronounced. An X-ray shows a slight narrowing of the joint space.
- There is also a fourth phase, in which there is complete immobility of the affected joint with further deformation. X-rays show the phenomena of sclerosis of the subchondral bone and a significant narrowing of the joint space.
Treatment of knee osteoarthritis
To achieve good treatment results, you need to seek the help of a qualified rheumatologist, and if not, then a therapist, because they know how to cure osteoarthritis of the knee. In no case do not try to treat yourself, it can only make the already better situation worse. Before starting treatment, it is extremely important to make the correct diagnosis, because an accurate diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a rather lengthy process and depends on a number of factors (type of osteoarthritis, cause of osteoarthritis, degree of disease). Treatment is complex and includes drug and drug-free therapy, and in some cases, surgical treatment is indicated.
Treatment of osteoarthritis of the knee is aimed primarily at alleviating the main manifestations of the disease, such as:
- Bol;
- Inflammation of joints and periarticular tissues.
In addition to relieving the symptoms of the disease, drugs are also used to:
- joint tissue repair,
- improving your 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 briefly. The most commonly used drugs are from the group of nonsteroidal 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 to regenerate tissues. Intra-articular insertion of the head guard gives a good effect. In recent years, a new, effective product based on hyaluronic acid has appeared. Due to its action, this drug is called a "liquid prosthesis". Once injected into the diseased joint, this drug creates a protective film on the damaged cartilage and gradually restores the normal lubrication characteristics of the joint.
Muscle relaxants are used to relieve muscle cramps, in addition to having a relaxing effect on blood circulation in the affected joint.
Manual and physical therapy is widely used by non-medical methods of treating gonarthrosis. The most important are magnetotherapy, acupuncture, electrophoresis and massage, traction apparatus (joint extension) and others. Recently, methods such as laser therapy, cryotherapy (exposure to liquid nitrogen) have entered the practice of treating arthrosis. In addition to physiotherapy, exercise therapy for osteoarthritis of the knee joint also has a good effect. Lfk is the use of various physical exercises for therapeutic purposes.
Gymnastics for osteoarthritis of the knee joint
At the beginning of the disease, physical activity on the diseased joint should be reduced. You should not run, jump, lift weights, walk fast, squat. Exercises for osteoarthritis of the knee joint can be performed only after you have undergone a course of treatment, under the supervision of your doctor.
It is necessary to choose exercises that help 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, the 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 any effort.
When performing any gymnastic exercise, it is important to follow some rules:
- Don't exercise for pain
- If exercise causes pain, it should be replaced with another gentler one.
Massage for osteoarthritis of the knee has a beneficial effect on restoring the functions of the knee joint. At the site of exposure, blood vessels dilate, blood circulation improves, and metabolism speeds up. Massage procedures improve lymph flow, which in turn helps to remove residual inflammation. Massage strengthens the muscular system, increases the flow of oxygen in them, improves gas exchange, normalizes their tone and increases plasticity.
Diet against knee osteoarthritis
Recently, medical experts have discovered that there is no direct link between the incidence of gonarthrosis and diet. However, it is an indisputable fact that the development of osteoarthritis is greatly influenced by the presence of excess weight in a person. If the cause of the disease is just being overweight, then it is obvious that the diet for osteoarthritis of the knee joint should be aimed at gradually reducing weight. This will require a change in diet and a change in diet. Foods should be less caloric, fried foods and foods high in fat should be excluded from the diet. Eat more vegetables, fruits and fluids.
Prevention of osteoarthritis of the knee joint
In order for the joints to stay healthy for as long as possible, it is necessary to engage in physical culture and gymnastics on a regular basis, but do not get too carried away so that this does not lead to joint overload. 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 calm for long.
Following all these simple rules, along with a healthy lifestyle and proper diet, will not allow osteoarthritis of the knee to ruin any person’s life.