In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint takes the leading place.
Gonarthrosis or osteoarthritis 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 ligaments, synovium, subchondral bone and otherselements 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 hard workphysicist, 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 up to complete disappearance.
Who is at risk? First of all, osteoarthritis of the knee joint risks "earning" women over forty, they have it 2 times more often than in the strong half of humanity. Furthermore, the risk increases in those women who tend to be overweight or obese.
But in general, 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. Also, at a young age, cellular "restorative" 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, brittle and cracked, and existing chondrocytes don't have time to repair the damage. In many ways, this explains the onset of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors are excess weight, physical inactivity, chronic joint injuries or systemic joint microtrauma, alcohol abuse, chronic stress, previous or existing knee joint disease, such as:
- knee arthritis,
- sprain, partial or complete rupture of 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 specific cause of gonarthrosis of the knee joint, in this case we speak of a combined cause, that is, gonarthrosis was the result of several diseases at the same time.
Moreover, the disease, for reasons of onset, is usually divided into two forms: primary and secondary.
Primary osteoarthritis is caused by age and associated factors, such as:
- Professional preparation,
- Overweight,
- Obesity,
- Varicose veins of the lower limbs.
The cause of secondary gonarthrosis can be a previous knee injury (fracture, rupture of the ligament apparatus), called post-traumatic osteoarthritis of the knee joint. The same reason could 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 takes several months or even years. Pain that is permanent and increases with physical activity - walking, running, going down or climbing stairs and so on - come to the fore. Another characteristic symptom of this disease is the presence of crepitus in the joint, it can be a crepitus or a crunch in the knee.
Very frequent manifestations of gonarthrosis are also:
- an increase in local (the joint is warm to the touch) or general temperature,
- presence of joint swelling,
- by increasing its volume,
- difficulty moving,
- 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 "spines" (osteophytes), deforming arthrosis of the knee joint occurs. Exudate appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformation, different degrees of gonarthrosis are distinguished:
- Grade 1 gonarthrosis.Patients experience stiffness and mild pain in the joints 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 fully maintained. An x-ray reveals a small osteophyte.
- Gonarthrosis grade 2.Painful sensations appear, not only in the morning, but also after prolonged exertion, the joint is deformed, the joint surfaces are enlarged, as a result of which thevolume of the joint, flexion is difficult, a creak is heard when performing movements. 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. There is a marked deformation of the knee joint. On radiography, 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 radiography, the phenomena of sclerosis of the subchondral bone and a significant narrowing of the joint space are determined.
Treatment of osteoarthritis of the knee
To get good results from the treatment, you should seek the help of a qualified rheumatologist and, if there is not, then a therapist, as they know how to cure osteoarthritis of the knee joint. In no case should you try to treat it yourself, this can only aggravate an already no 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 long process and depends on a number of factors (the type of osteoarthritis, the cause of the osteoarthritis, the degree of the disease). Treatment is complex and includes drug and non-drug therapy and, in some cases, surgical treatment is indicated.
The medical treatment of knee osteoarthritis is aimed, first of all, at relieving the main manifestations of the disease, such as:
- Pain;
- Inflammation of the joint and periarticular tissues.
In addition to relieving the symptoms of the disease, medicines are used to:
- joint tissue repair,
- improving trophism and blood circulation,
- strengthen 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 tissues. The intra-articular insertion of the head protectors gives a good effect. In recent years, a new and effective product based on hyaluronic acid has appeared. Due to 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 joint's normal lubricating characteristics.
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 by non-pharmacological methods of treatment of gonarthrosis. The most important are magnetotherapy, acupuncture, electrophoresis and massage, traction of the apparatus (joint extension) and others. Recently, such methods as laser therapy, cryotherapy (exposure to liquid nitrogen) have entered the practice of treating arthrosis. Along with physiotherapy, physical therapy for osteoarthritis of the knee joint also gives 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 on the diseased joint should be minimized. You shouldn't jog, jump, lift weights, walk fast, squat. Exercises for osteoarthritis of the knee joint can be performed only after undergoing a course of treatment, under the supervision of the 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 the use of any effort.
When performing a gymnastic exercise, it is important to follow some rules:
- Do not exercise against pain
- If the exercise causes pain, it should be replaced by a more gentle one.
The massage for osteoarthritis of the knee 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 lymphatic flow and this, in turn, helps 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 osteoarthritis
Recently, medical specialists have discovered that there is no direct relationship between the incidence of gonarthrosis and nutrition. However, an indisputable fact is that the development of osteoarthritis is strongly 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 osteoarthritis 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 caloric, fried and high-fat foods should be excluded from the diet. Eat more vegetables, fruits, and liquids.
Prevention of osteoarthritis of the knee joint
In order for the joints to remain healthy for as long as possible, it is necessary to regularly engage in physical culture and gymnastics, but not to get too carried away by this, so that this does not lead to overload of the joints. Swimming gives the best effect and the least 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 sit still for long.
Compliance with all these simple rules, together with a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to ruin anyone's life.