Gonarthrosis is a pathological process in the cartilaginous tissue of the knee joint, which leads to its deformation. This process is associated with high stress on the knees, wear and salt deposits.
Myths about gonarthrosis
There are three most famous myths:
- "The diagnosis of gonarthrosis is the prerogative of a person with increased physical activity, and people with predominantly sedentary work do not suffer from it. " In fact, excessive physical exertion actually contributes to cartilage deterioration. During sedentary work there is a static effect on the knees, the blood supply is impaired. In addition, a sedentary lifestyle leads to weight gain.
- "Gonarthrosis of the knee joint is incurable, the disease progresses every day. " This disease is indeed chronic, but with proper timely treatment, cartilage deterioration can be prevented.
- "With osteoarthritis, you have to move as little as possible and lie down as much as possible. " A patient with such pathology is assigned special gymnastics that strengthens the ligament apparatus. Only a few sports are really contraindicated.
Gonarthrosis is the destruction of the articular cartilage in the knee joint and adjacent bone surfaces.
Manifestations of osteoarthritis of the knee joint
Manifestations depend on the severity of the deformity. The more pronounced, the more pronounced the symptoms.
Symptoms of gonarthrosis:
- long asymptomatic period;
- discomfort in the knee area;
- pain syndrome;
- reduced mobility;
- morning stiffness for up to half an hour;
- the presence of crunch during active movement;
- change in gait.
Bilateral gonarthrosis occurs when the knee joints of both limbs are involved in the process. This is one of the most difficult forms. It occurs in the elderly.
Gonarthrosis of the right side occurs with excessive static or dynamic physical exertion on the right limb. More common in athletes.
Gonarthrosis on the left side occurs in overweight people and in athletes with a load on the left leg.
Reasons for the development of gonarthrosis
Gonarthrosis is primary and secondary. It can occur primarily in childhood and adolescence, which is associated with irregularly shaped joints, as well as in the elderly due to the natural aging process.
Secondary occurs due to injury or pre-existing disease. Main reasons:
- fractures, bruises, sprains;
- extra pounds;
- the presence of an inflammatory process in the joint and the lack of appropriate therapy;
- metabolic diseases accompanied by salt deposition in cartilage tissue;
- operations;
- vitamin D deficiency;
- hormonal disorders;
- weightlifting;
- some sports (running, hockey, football).
Who is in danger?
The risk group includes:
- professional athletes;
- obese people;
- patients who have undergone trauma or surgery;
- persons over 45 years of age;
- patients with varicose veins;
- those who had cases of osteoarthritis in the family.
Women who wear shoes with high heels or flat thin soles are also at risk.
The exact causes of knee osteoarthritis are not known.
Degree of gonarthrosis
Radiologically, this pathology is divided into 5 stages or stages:
- Stage 0 - X-ray absence of arthrosis;
- Stage 1 - appearance of a small osteophyte;
- Stage 2 - osteophyte has clear contours, joint space is minimally altered;
- Phase 3 - narrowing of the joint space;
- Stage 4 - marked narrowing of the gap, sclerosis of the subchondral bone.
Knee gonarthrosis 1 degree
The first stage is characterized by fatigue, limited mobility is mild and crunching is heard. Pain occurs after waking up, sitting for a long time and after physical exertion.
There are no deformations at this stage yet. The radiograph shows a narrowing of the joint space.
How to treat gonarthrosis?
A special group of drugs is used for treatment - chondroprotectors. They contain chondroitin and glucosamine, which restore the structure of cartilage and increase elasticity. NSAIDs are used to relieve pain.
Primary gonarthrosis is usually bilateral. Even with the development of a unilateral form of the disease, after some time the other limb is involved in the pathological process.
The early symptoms of osteoarthritis of the knee joints are mild and uncharacteristic
Methods of treatment
In addition to drug treatment in remission, the following methods are used:
- physiotherapy;
- massages;
- leech therapy;
- ultrasound exposure;
- baths with radon and hydrogen sulfide;
- phonophoresis, electrophoresis;
- paraffin wraps;
- use of therapeutic mud.
These methods are used regardless of the stage of disease development during remission.
Is mud good for knee gonarthrosis? One of the indications for mud therapy are diseases of the musculoskeletal system. Therapeutic course is conducted twice a year. It includes 10 to 15 procedures. The method can be used at home, and dirt can be bought at the pharmacy.
In the first stage, the patient is prescribed orthopedic shoes during exacerbations to prevent the development of the deformation process. Women are recommended to wear shoes with a thick sole of at least 1 cm, a heel of 5 cm. Normalize your diet - reduce the amount of salt, spicy foods. Meat and jelly with jelly are included in the diet because they are natural chondroprotectors.
Another method is weight correction. Reducing body weight to the optimal level for a particular patient will reduce the load on the musculoskeletal system.
Grade 2 gonarthrosis
In the second stage, the pain intensifies, due to which the movement is significantly limited. Prolonged walking over long distances causes severe pain syndrome. The patient must rest to continue.
If treatment is not started (or is ineffective), osteoarthritis of the knee joint progresses further.
The crunch becomes loud, lameness appears. The damaged joint is deformed. The inflammatory process occurs in the inner membrane of the joint.
An ordinary X-ray shows a narrowing of the joint space, the appearance of spines on the bones (osteophytes).
Treatment
Drug therapy is based on the use of nonsteroidal anti-inflammatory drugs. They have analgesic and anti-inflammatory effect. Furthermore, chondroprotectors are prescribed.
After the deterioration has passed, physiotherapeutic exercises and massage are prescribed.
Dietary recommendations:
- increase the amount of vegetables;
- include jellies and jelly meats in your diet;
- eat lean fish twice a week;
- give preference to lean meat;
- eat bran bread.
It is also recommended to include bananas, nuts, eggs, spinach, legumes, liver, cabbage in the diet.
In addition to orthopedic shoes, special knee pads are prescribed.
Arthroscopic removal of deforming tissue is used as a surgical intervention. This method has a short-term effect of 2-3 years.
Knee gonarthrosis, symptoms and treatment of grade 3
The most difficult degree. Pain syndrome occurs during movement and at rest. Knee mobility is as limited and sometimes impossible as possible. The deformation is pronounced. There is practically no place in the joint on the radiograph.
Progressive destruction of cartilage and bone in the later stages leads to the development of ugly knee deformities that increase.
Treatment
At this stage, in addition to nonsteroidal anti-inflammatory drugs, the patient is prescribed hormonal drugs. They are injected intravenously or inside the joint. Severe pain syndrome is alleviated by pain medications.
In the third phase, the operation - endoprosthesis - has already been shown. Either individual bone elements or the entire joint are replaced. Contraindications: osteoporosis.
Complications of arthroplasty:
- marginal skin necrosis;
- prosthesis rejection;
- neurovascular disorders (paresis, thrombosis).
In addition to endoprosthetics, there is also arthrodesis surgery - removal of deformed tissue and joints. It is rarely used.
Osteotomy - cutting the edges of the bones to redistribute the load.
Physiotherapy
Exercises for gonarthrosis of the knee joint can relieve pain, strengthen the muscular apparatus and stimulate blood flow to them.
- Exercise # 1. The patient lies on his back, lifts a straight leg up and holds it for at least 30 seconds, then the other. Execution time should be increased to 2 minutes.
- Exercise number 2 "Bicycle". Lying on your back you imitate cycling with your feet. It is repeated 20 to 50 times.
- Exercise number 3. The patient lies on his stomach, alternately bending his legs, trying to reach the buttocks with his heel. Repeats 20-50 times.
- Exercise number 4. It is done in the same way as the previous one, only statically. That is, the patient fixes the limb in this position for 20-30 seconds.
Stretching is recommended for patients:
- Exercise # 1. In a standing position, bend over, trying to reach the floor without bending your knees. Hold for 20 seconds, inhaling air through your nose, exhaling through your mouth.
- Exercise number 2. Sit on the floor with straight legs, try to wrap your arms around your feet, and keep your knees straight. Hold this position for up to 30 seconds. Perform 2-3 approaches. If the flexibility is not enough to reach the feet, they take the foot by the shin and try to draw the body as close to the feet as possible.
- Exercise number 3. The same position as when performing the previous one. The patient grabs foot by foot, tries to straighten it and holds it as high as possible above the floor. If the exercise is difficult to perform, then the leg is taken in the lower leg area. Hold the position for 10-30 seconds, then do it with the other leg.
Contraindication is a period of exacerbation and the presence of an acute inflammatory process. Patients are prohibited from running, long walks and squats.
After performing physiotherapeutic exercises, it is useful to massage the muscles of the upper leg, lower leg on the affected limb. The joint itself should not be affected, it will increase the inflammation.
Disease prevention
This disease is not hereditary so its development can be prevented. This requires:
- avoid injuries while playing sports;
- do joint stretching and gymnastics, yoga;
- eat properly;
- maintain a normal body weight;
- if you feel discomfort in the knee area, consult a doctor;
- drink enough water;
- after 40 years prophylactically take chondroprotectors;
- do not overcool the joints;
- in the presence of early stages of the process and during remission, do not increase physical activity, do not run;
- wear orthopedic shoes;
- use knee pads when playing sports.