The inflammatory-degenerative process of the knee joint or gonarthrosis occurs for various reasons. It has an extremely negative impact on a person's quality of life, sometimes causing disability. How to treat arthrosis of the knee joint and avoid complications?
What is arthrosis?
About 22% of the world's population suffers from gonarthrosis, and women are more often affected. This insidious disease is characterized by rapid progression.
If treatment is not started in time, the knee joint can completely disintegrate. This leads to a violation of the function of the musculoskeletal system. Movement is possible only with crutches, or a person becomes a hostage to a wheelchair.
The knee joint is the second largest after the hip and the most complex in structure. It allows you to bend and straighten the leg in different directions, promotes the correct position of the body and coordination in space. It is a strong and stable joint that can withstand the weight of a person. Consists of 3 bones: the femur, tibia and fibula, as well as the patella or knee cap. Includes osteochondral structures, muscles, ligaments and nerve fibers.
The disease begins with a violation of blood circulation and nutrition of joint tissues. First of all, the cartilage suffers. The quality and quantity of synovial fluid, which is located in the joint capsule and contributes to the proper functioning of the knee, decreases. Friction occurs between joint parts. Gradually the cartilage cracks and breaks down. Exposed bones begin to rub against each other. There is pain and a crunching sound is heard.
Causes of the disease
It mostly affects the elderly, especially overweight women. As a result of hormonal changes, the cartilage of the knee wears down a lot. Gonarthrosis in varying degrees occurs in more than 80% of people after the age of 60.
There are other causes of knee arthrosis:
- Congenital joint pathology;
- dysplasia;
- injuries, operations;
- removal of the meniscus or part of it;
- Arthritis
- diseases of the lumbar spine;
- hormonal disorders;
- Low metabolism.
The risk of developing the disease increases in people who are engaged in repetitive physical work. This group also includes athletes, people with a sedentary lifestyle and people with unfavorable environmental conditions. Often patients are addicted to toxic substances (drugs, alcohol, smoking).
Deformation of the joints can be caused by work associated with constant hypothermia. The provoking factor is the period after menopause, when a woman develops gynecological disorders (fibroadenoma, endometriosis, uterine fibroids). Due to the lack of minerals and vitamins in the body, diet can be the cause.
Stages and symptoms
Gonarthrosis can be unilateral or bilateral. According to the nature of the manifestation, the disease is divided into degrees:
- At this stage, there are no obvious clinical signs. After a long workout, there may be slight discomfort and pain that disappears after rest. Pain is felt in the morning, disappears after some time when moving. Grade 1 arthrosis is rarely detected incidentally during a routine examination.
- Pain and stiffness in the knee increases. A person spares his leg and tries to load less. As a result, the muscles atrophy, the joint is deformed, the formation is felt and the leg does not fully extend at the knee.
- The pain is constant. The leg does not straighten or bend, and it is difficult for a person to walk. Partial or complete loss of mobility develops. The cartilage is completely destroyed, the friction between the bones of the joint increases with the formation of osteophytes.
In grades 2 and 3, in addition to pain, a creaking sound is heard in the knee. Fluid and pieces of cartilage tissue can accumulate in the joint capsule, causing swelling. In the late stage, the inflammatory process is expressed, the knee joint is deformed.
diagnosis
If you have knee pain, you can contact your local doctor who, if necessary, will refer you to an orthopedist, traumatologist, rheumatologist or endocrinologist.
To find out the causes and treatment of gonarthrosis, a comprehensive diagnosis is needed:
- general and biochemical blood test;
- rheumatic tests;
- radiography;
- Ultrasound and MRI can detect the disease at an early stage;
- Arthroscopy.
X-rays allow us to see the condition of the cartilage and bone changes in stages 2 and 3. These are narrowing of the joint space, osteophytes on the edges of the patella, changes in the periosteum. Arthroscopy provides more detailed information about the presence of meniscus, synovial membrane and fluid. This method is also used to treat the knee, to remove pieces of cartilage or meniscus.
Treatment of knee arthrosis
Therapy is long and sometimes painful. Once it occurs, the disease reminds itself throughout life. The main drugs used for treatment are non-steroidal anti-inflammatory drugs. Most often, these are drugs based on non-steroidal anti-inflammatory drugs (NSAIDs) from the group of phenylacetic acid derivatives. They eliminate inflammation and pain. Medicines are relatively cheap, but cause stomach and duodenal ulcers and erosion. Modern drugs cause fewer side effects, but are expensive.
Stage 1 treatment measures include exercise-related preventive measures. It is necessary to exercise daily, use contrast shower, swimming pool 2 times a week and fight against increased body weight.
Stage 2 requires joint fixation - using an elastic bandage, bandage or orthosis. Nonsteroidal anti-inflammatory drugs are used in the form of creams and ointments to relieve pain. To reduce the degree of destruction of cartilage, the patient is prescribed drugs from the group of chondroprotectors.
In severe cases, oral administration of non-steroidal anti-inflammatory drugs is required. Intra-articular injections of hormonal drugs - synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid and low mineralocorticosteroid activity - are indicated. In addition, painkillers are prescribed.
Hyaluronic acid solution is injected into the joint. It is a replacement of the intra-articular fluid and nourishes the cartilage. It acts as a joint shock absorber during movement. The manipulation is painful, it is carried out by the doctor after the acute period has passed. If conservative treatment is unsuccessful, endoprosthesis is performed.
Along with medical therapy, exercises using special simulators and devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered by subcutaneous or intramuscular injections, ozone-containing ointments, creams. Manipulation stimulates blood circulation, enhances the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in demand as an alternative to joint repair drugs. Exercise therapy and massage are indicated. A set of special exercises improves blood circulation and nutrition of cartilage cells, increases the elasticity of ligaments.
Complications and prevention
Destroyed cartilage tissue and deformed bones cannot be treated. Only surgery can help in this situation. No ointment or medicine can restore cartilage. Medicines can only stop the process of cartilage tissue destruction.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without proper treatment, the patient's condition deteriorates rapidly. The knee does not work, serious complications arise:
- joint deformation;
- cosmetic defect - limb curvature;
- Infection through blood or lymph flow from another body source;
- due to the weakness of the ligaments, dislocations and fractures are observed even during normal walking;
- Bone fusion (ankylosis) occurs in the joint area, making movement impossible.
Complications develop if the patient does not consult a doctor on time and the disease progresses. Regular preventive examinations and timely treatment of general diseases of the body will help prevent the deterioration of the condition and preserve the motor function of the limb.