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, involving the entire joint in the pathological process, including the ligaments, synovial membrane, subchondral bone and other elements of the joint.
Under the influence of various factors, such as infectious diseases (colds, flu, typhoid, tuberculosis, syphilis, sore throat and many others), injuries, functional congestion of the joint (for example, athletes, workers engaged in heavy physical labor, dancers), trophism (nutrition) of the cartilaginous tissue of the knee joint is disrupted, as a result of which the cartilage becomes thinner and destroyed, sometimes until it completely disappears.
Who is at risk?First, women over forty are at risk of developing osteoarthritis of the knee joint;in them it occurs 2 times more often than in the stronger half of humanity.Furthermore, the risk increases in women who tend to be overweight or obese.
But overall gonarthrosis is a disease of the elderly.And there is a simple explanation for this.As you know, cartilaginous tissue consists of about 70-80% water, thanks to which it is absorbed well.Furthermore, at a young age, “regenerating” cells, chondrocytes, work actively.With age, the amount of moisture begins to decrease, and as a result, the cushioning capacity of the joint deteriorates, the cartilage becomes dry, brittle and cracked, and 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 include excess weight, physical inactivity, chronic joint injuries or systematic microtraumatization of the joint, alcohol abuse, chronic stress, previous or existing diseases of the knee joint, such as:
- knee arthritis,
- sprain, partial or complete tear of ligaments,
- intra-articular fracture of the femur or tibia,
- metabolic disorders, for example, gout and a number of other pathological conditions.
Very often it is not possible to establish a specific cause that caused gonarthrosis of the knee joint;in this case we are talking about a combined cause, that is, the gonarthrosis was the result of multiple diseases at the same time.
Moreover, the disease, based on the reasons for its onset, is usually divided into two forms: primary and secondary.
The cause of primary arthrosis is age and the presence of associated factors, such as:
- Professional predisposition,
- Excess weight
- Obesity,
- Varicose veins of the lower limbs.
The cause of secondary gonarthrosis may be a previous knee injury (fracture, rupture of the ligament apparatus), called post-traumatic arthrosis of the knee joint.The cause could also 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.The pain that emerges is constant and aggravated by physical activity: walking, running, going up or down stairs and so on.Another characteristic symptom of this disease is the presence of crackles in the joint, this can be a popping or creaking sound in the knee.
Also very common manifestations of gonarthrosis are:
- local (junction is hot to the touch) or general temperature increase,
- the presence of swelling of the joint,
- increasing its volume,
- difficulty moving,
- deformation of the joint resulting in 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 growth of bone tissue on the bones forming the joint in the form of "spikes" (osteophytes) and 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:
- Gonarthrosis 1st degree.Patients experience stiffness and mild pain in the joint in the morning or during prolonged periods of sitting or standing.At this stage there is no deformation of the joint, mobility is completely preserved.An x-ray reveals a small osteophyte.
- 2nd degree gonarthrosis.Painful sensations appear not only in the morning, but also after prolonged exercise;the joint is deformed, the joint surfaces widen, as a result of which the volume of the joint also increases, bending is difficult, and a creaking sensation is felt when performing movements.The radiograph shows a pronounced osteophyte, the joint space is not modified.
- Gonarthrosis 3 degrees.Manifestations are the same as in the second degree, only the symptoms become more vivid.The pain is constant and does not decrease even at rest and during sleep.The function of the joint is almost completely lost;patients can neither bend nor straighten their leg.As a result, lameness occurs and movement becomes possible only with crutches or assistance.There is severe deformation of the knee joint.An x-ray reveals slight narrowing of the joint space.
- There is also a fourth phase, in which there is complete immobilization of the affected joint with further deformation.Radiographs reveal sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of arthrosis of the knee joint
To achieve good results from treatment, you should seek help from a qualified rheumatologist, and if he is not present, from a therapist, since it is they who know how to cure arthrosis of the knee joint.Under no circumstances should you try to cure it yourself, this can only make an already bad situation worse.Before starting treatment, it is extremely important to make a correct diagnosis, as the correct diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a rather long process and depends on a number of factors (type of arthrosis, cause of arthrosis, degree of the disease).The treatment is complex and includes pharmacological and non-pharmacological therapy and in some cases surgical treatment is indicated.
Pharmacological treatment of arthrosis of the knee joint is aimed primarily at alleviating the main manifestations of the disease, such as:
- Pain;
- Inflammation of the joint and periarticular tissues.
In addition to alleviating the symptoms of the disease, drugs are used to:
- restoration of joint tissues,
- improving its trophism and blood circulation,
- strengthen the body's defenses,
- eliminating allergic reactions.
Various non-narcotic analgesics are used to relieve pain symptoms;in rare cases narcotic painkillers are prescribed for a short time.The most commonly used drugs belong to 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 restore tissues.Intra-articular administration of chodroprotectors gives a good effect.In recent years, a new and effective product based on hyaluronic acid has appeared.Because of its effect, this drug is called “liquid implant”.After injection into the painful joint, this drug forms a protective film on the damaged cartilage and gradually restores the normal lubricating characteristics of the joint.
Muscle relaxants are used to relieve muscle spasms;in addition to the relaxing effect they have a positive effect on blood circulation in the affected joint.
Among non-drug methods for the treatment of gonarthrosis, manual and physical therapy are widely used.Of great importance are magnetic therapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others.Recently, the practice of treating arthrosis has included such methods as laser therapy and cryotherapy (exposure to liquid nitrogen).Along with physiotherapy, physical therapy for arthrosis of the knee joint also gives a good effect.Physical therapy is the use of various physical exercises for therapeutic purposes.
Gymnastics for arthrosis of the knee joint
At the onset of the disease, physical stress on the affected joint should be minimized.You should not run, jump, lift weights, walk fast, or squat.Exercises for arthrosis of the knee joint can be performed only after completing a course of treatment, under the supervision of the attending physician.
It is necessary to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but do not lead to excessive mobility of the joint.That is, the exercises should have minimal dynamic activity.It is useful to perform exercises to stretch the ligaments and joint capsules.The rules here are the same, perform the exercises gently, without making any effort.
When performing gymnastic exercises, it is important to follow some rules:
- Do not perform exercises while overcoming pain,
- If an exercise causes pain, it should be replaced with a more gentle one.
Massage for arthrosis of the knee joint 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 accelerates.Massage procedures improve lymphatic flow and this, in turn, helps to eliminate residual inflammation.Massage strengthens the muscular system, increases the flow of oxygen within it, improves gas exchange, normalizes tone and increases plasticity.
Diet for arthrosis of the knee joint
Recently, medical experts have discovered that there is no direct relationship between the incidence of gonarthrosis and nutrition.However, an indisputable fact is that the development of arthrosis 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 arthrosis of the knee joint should be aimed at gradually reducing body weight.This will require a change in diet and a change in diet.Food should be low-calorie, fried foods and high-fat foods 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 for as long as possible, it is necessary to regularly engage in physical education and gymnastics, but one should not get too carried away with this, so that this does not lead to overstrain of the joints.Swimming provides the best effect and minimal stress on the joints.If you play professional sports, you must use joint protection.It is useful to alternate physical activity with rest;you should not remain still for a long time.
Compliance with all these simple rules, along with a healthy lifestyle and proper nutrition, will not allow arthrosis of the knee joint to ruin anyone's life.