Gonarthrosis of the knee joint is the main group of diseases of the musculoskeletal system of degenerative-dystrophic origin.
Gonarthrosis or osteoarthritis of the knee joint is a disease characterized by slow destruction of the cartilage tissue of the joint, involving 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, typhoid, tuberculosis, syphilis, tonsillitis, etc. ), injuries, functional blockage of the joint (for example, in athletes, heavy manual workers, ballet dancers). There is a violation of the trophism (nutrition) of the cartilage tissue of the knee joint, as a result of which the cartilage becomes thinner and destroyed, sometimes completely disappearing.
Who is at risk? First of all, osteoarthritis of the knee joint is at risk of "winning" women over the age of forty, twice as much as the strong half of humanity. In addition, women who are overweight or obese are at increased risk.
But in general, gonarthrosis is a disease of the elderly. There is a simple explanation for this. As you know, cartilage tissue absorbs well, so it is about 70-80% water. In addition, at a young age, the cells are actively working as "restorative" chondrocytes. With age, the amount of moisture begins to decrease, and as a result, the joint's ability to soften deteriorates, cartilage dries out, becomes brittle and cracks, and existing chondrocytes do not have time to repair the damage. In many ways, this explains the formation of Gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors include overweight, physical inactivity, chronic joint injury or systemic joint microtrauma, alcohol abuse, chronic stress, and previous or existing knee joint disease:
- knee arthritis,
- torsion, partial or complete rupture of ligaments,
- intra-articular fracture of the femur or tibia,
- Metabolic diseases such as gout and a number of other pathological diseases.
It is often not possible to determine any specific cause of knee joint gonarthrosis, in which case they speak of a combined cause, ie Gonarthrosis is the result of several diseases at the same time.
In addition, the disease, depending on the cause, is generally divided into two forms: primary and secondary.
Primary osteoarthritis is caused by age and related factors:
- Professional inclination,
- Overweight,
- Obesity,
- Varicose veins of the lower extremities.
Secondary gonarthrosis can be caused by a previous knee injury (fracture, rupture of the ligament) called post-traumatic arthrosis of the knee joint. The same reason may be a previous infectious disease or inflammation of the knee joint.
symptoms
Symptoms of osteoarthritis of the knee joint do not appear overnight, the development of the disease occurs gradually and often lasts several months or even years. Persistent pain that increases with physical activity - walking, running, going up or down stairs, etc. Another symptom of this disease is the presence of crepitus in the joint, which may be a crack or crack in the knee.
The most common manifestations of gonarthrosis are:
- increase in local temperature (hot to the touch) or general,
- presence of joint swelling, By increasing the volume of
- ,
- difficulty in movement,
- deformation of the joint, followed by curvature of the joint.
When the cartilage tissue is completely destroyed as the disease progresses, the body has no choice but to begin to protect itself. This is manifested by an increase in bone tissue in the bones that form the joint in the form of "thorns" (osteophytes), there is a deformed arthrosis of the knee joint. Exudate appears in the articular cavities.
Gonarthrosis differs by several degrees depending on the size and degree of deformation of osteophytes:
- Grade 1 Gonarthrosis.Patients experience stiffness and mild pain in the joint in the morning or when sitting or standing for long periods of time. At this stage, there is no deformation of the joint, mobility is fully preserved. An X-ray reveals a small osteophyte.
- Grade 2 Gonarthrosis.Painful sensations occur not only in the morning, but also after a long period of tension, the joint deforms, the joint surfaces grow, resulting in increased joint volume, difficult flexion, and a crisis when exercising. X-ray shows a clear osteophyte, the joint space is not changed.
- Grade 3 Gonarthrosis.Manifestations are the same as in the second degree, only the symptoms are more pronounced. The pain is permanent and does not decrease at rest and sleep. The function of the joint is almost completely lost, and patients can neither bend nor straighten the leg. As a result, there is a paralysis, movement is possible only with the help of crutches or outside help. There is an obvious deformation of the knee joint. The X-ray shows a slight narrowing of the joint space.
- There is also a fourth stage, in which there is complete immobility in the joint affected by more deformation. X-rays show cases of sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of knee osteoarthritis
To get good results from treatment, you should seek the help of a qualified rheumatologist or a therapist because they know how to treat osteoarthritis of the knee joint. In no case do not try to treat yourself, it can aggravate an already bad situation. It is extremely important to make the right diagnosis before starting treatment, because the right diagnosis is the key to successful treatment.
Treatment of gonarthrosis is quite long and depends on a number of factors (type of osteoarthritis, cause of osteoarthritis, degree of disease). Treatment is complex and includes drug and non-drug therapy, and in some cases surgical treatment.
Drug treatment of osteoarthritis of the knee joint primarily aims to eliminate the main manifestations of the disease:
- Pain;
- Inflammation of joint and periarticular tissues.
In addition to relieving the symptoms of the disease, drugs are used for:
- repair of joint tissue,
- improve trophism and blood circulation,
- to strengthen the body's defenses,
- Elimination of allergic reactions.
Various non-narcotic analgesics are used to relieve pain symptoms, and narcotic analgesics are rarely prescribed for a short period of time. Often drugs are used in the group of non-steroidal anti-inflammatory drugs. 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 repair their tissues. Intra-articular placement of head shields has a good effect. In recent years, a new, effective product based on hyaluronic acid has emerged. Due to its action, this drug is called "liquid prosthesis". After being injected into a diseased joint, this drug forms a protective film on the damaged cartilage and gradually restores the normal lubricating properties of the joint.
Muscle relaxant is used to relieve muscle spasms, has a relaxing effect and has a positive effect on blood circulation in the affected joint.
Manual and physical therapy Non-drug treatment of gonarthrosis is widely used. The most important are magnetotherapy, acupuncture, electrophoresis and massage, traction (joint extension) and others. Recently, methods such as laser therapy and cryotherapy (exposure to liquid nitrogen) have been introduced into the practice of treating osteoarthritis. 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 onset of the disease, physical activity in the patient's joint should be minimized. You should not run, jump, lift weights, walk fast, squat. Exercises for osteoarthritis of the knee joint can be done only after a course of treatment under the supervision of your attending physician.
It is important to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but also do not lead to excessive mobility of the joint. That is, the exercises should be 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.
It is important to follow some rules when doing any gymnastics exercise:
- Don't exercise on pain
- If exercise causes pain, it should be replaced with a more subtle one.
Massage for knee osteoarthritis has a beneficial effect on the restoration of knee joint function. Blood vessels dilate in the affected area, blood circulation improves and metabolism speeds up. Massage procedures improve lymph flow, which helps eliminate residual inflammation. Massage strengthens the muscular system, increases the flow of oxygen inside, improves gas exchange, normalizes tones and increases plasticity.
Diet for knee osteoarthritis
Recently, medical experts have found no direct link between gonarthrosis and malnutrition. However, the indisputable fact is that the development of osteoarthritis is greatly affected by the presence of excess weight in a person. If the cause of the disease was completely overweight, nutrition for osteoarthritis of the knee joint should be aimed at the gradual reduction of body weight. This requires a change in diet and a change in diet. Meals should be low in calories, fried foods and fatty foods should be excluded from the diet. Eat more vegetables, fruits and liquids.
Prevention of osteoarthritis of the knee joint
To keep your joints healthy for as long as possible, you need to exercise regularly and do gymnastics, but do not be too afraid so as not to overload the joints. Swimming gives the best effect on the joints and minimal stress. When associated with professional sports, joint protection should be applied. It is useful to replace physical activity with rest, you should not remain inactive for a long time.
Following all these simple rules, combined with a healthy lifestyle and proper nutrition, will not allow osteoarthritis in the knee joint to ruin anyone's life.