Gonarthrosis is a pathological process in the cartilaginous tissue of the knee joint, which leads to its deformation. This process is associated with a large load on the knees, wear and salt deposits.
Myths about gonarthrosis
There are 3 most famous myths:
- "The diagnosis of gonarthrosis is the prerogative of people with increased physical activity, and people with mostly sedentary work do not suffer from it. " In fact, excessive physical activity actually contributes to the deterioration of cartilage. During sedentary work there is a static effect on the knees, the blood supply is impeded. 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 adequate timely treatment, cartilage deterioration can be prevented.
- "In case of osteoarthritis, you should move as little as possible and lie down more. " A patient with such pathology is prescribed special gymnastics, which 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
The manifestations depend on the severity of the deformation. The more it is expressed, the more pronounced the symptoms.
Symptoms of gonarthrosis:
- long asymptomatic period;
- knee discomfort;
- pain syndrome;
- reduced mobility;
- morning stiffness 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 severe forms. It occurs in the elderly.
Right-sided gonarthrosis is manifested by excessive static or dynamic physical exertion of the right limb. More often in athletes.
Left-sided gonarthrosis occurs in overweight people and in athletes with a strain on the left leg.
The reasons for the development of gonarthrosis
Gonarthrosis is primary and secondary. It can primarily appear in childhood and adolescence, which is associated with improperly shaped joints, as well as in the elderly due to the natural aging process.
The secondary occurs due to injury or pre-existing diseases. Main reasons:
- fractures, bruises, dislocations;
- Overweight;
- the presence of an inflammatory process in the joint and the lack of adequate therapy;
- metabolic diseases that are accompanied by salt deposition in cartilage tissues;
- operations;
- vitamin D deficiency;
- hormonal disorders;
- weight lifting;
- some sports (running, hockey, football).
Who is at risk?
The risk group includes:
- professional athletes;
- obese people;
- patients who have suffered trauma or surgery;
- people over the age of 45;
- patients with varicose veins;
- those who have had cases of osteoarthritis in the family.
The risk group also includes women who wear shoes with high heels or flat thin soles.
The exact causes of osteoarthritis of the knee are not known.
The degree of gonarthrosis
Radiologically, this pathology is divided into 5 stages or stages:
- Stage 0 - X-ray absence of arthrosis;
- Stage 1 - the appearance of a small osteophyte;
- Stage 2 - the osteophyte has clear contours, the joint space is minimally altered;
- Stage 3 - narrowing of the joint space;
- Stage 4 - marked narrowing of the cavity, sclerosis of the subchondral bone.
Gonarthrosis of the knee 1 degree
The first degree is characterized by fatigue, limited mobility is mild and a crunch is heard. The pain appears after waking up, sitting for a long time and after exercise.
At this stage there is still no deformation. Radiography shows 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 most often bilateral. Even with the development of a unilateral form of the disease, after some time the second limb also participates 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 the remission phase, the following methods are used:
- physiotherapy;
- massages;
- leech therapy;
- ultrasonic exposure;
- radon and hydrogen sulfide baths;
- phonophoresis, electrophoresis;
- paraffin wraps;
- the use of healing mud.
These methods are used regardless of the stage of development of the disease during remission.
Is mud useful in gonarthrosis of the knee? One of the indications for mud therapy are diseases of the musculoskeletal system. The course of therapy is held twice a year. It includes 10 to 15 procedures. The method can be used at home, and the dirt can be purchased at the pharmacy.
In the first stage, the patient is prescribed orthopedic shoes for the period of exacerbation to prevent the development of the deforming process. Women are advised to wear shoes with a thick sole at least 1 cm, heel 5 cm. Normalize the diet - reduce the amount of salt, spicy food. Meat and jelly are included in the diet as they are natural chondroprotectors.
Another method is weight correction. Reducing body weight to an optimal level for a patient will reduce the load on the musculoskeletal system.
Gonarthrosis 2 degree
In the second degree, the pain intensifies, due to which the movement is significantly limited. Long-term long-distance walking causes severe pain syndrome. The patient must rest to continue.
If treatment is not started (or is ineffective), osteoarthritis of the knee progresses further.
The crunching becomes strong, lameness appears. The affected joint is deformed. An inflammatory process occurs in the inner membrane of the joint.
A simple X-ray reveals a narrowing of the joint space, the appearance of spines on the bone (osteophytes).
Treatment
Drug therapy is based on the use of NSAIDs. They have analgesic and anti-inflammatory effects. Chondroprotectors are also prescribed.
After the exacerbation, physiotherapy exercises and massage are prescribed.
Diet recommendations:
- increase the amount of vegetables;
- include in the diet jelly and meat jelly;
- eat lean fish twice a week;
- give preference to lean meat;
- eat bran bread.
It is also recommended to include in the diet bananas, nuts, eggs, spinach, legumes, liver, cabbage.
In addition to orthopedic shoes, special knee pads are prescribed.
Surgical interventions use arthroscopic removal of deforming tissue. This method has a short-term effect of 2-3 years.
Gonarthrosis of the knee, symptoms and treatment of grade 3
The most severe degree. The pain syndrome occurs during movement and at rest. Knee mobility is as limited as possible, and sometimes impossible. The deformation is pronounced. There is practically no space for the joints on the radiograph.
The progressive destruction of cartilage and bone in the last stages leads to the development of ugly deformities of the knee, which increases in size.
Treatment
At this stage, in addition to NSAIDs, the patient is prescribed hormonal drugs. They are injected intravenously or inside the joint. Severe pain syndrome is relieved by painkillers.
At stage 3, the operation - endoprosthesis - is already shown. Either individual bone elements or the whole joint are replaced. Contraindications: osteoporosis.
Complications of arthroplasty:
- marginal skin necrosis;
- rejection of the prosthesis;
- neurovascular disorders (paresis, thrombosis).
In addition to arthroplasty, there is arthrodesis surgery - removal of deformed tissue and joints. 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 system and stimulate blood flow to them.
- Exercise №1. The patient lies on his back, lifts his right leg up and holds it for at least 30 seconds, then the second. The execution time must be increased to 2 minutes.
- Exercise number 2 "Bicycle". Lying on your back imitates riding a bike with your feet. Repetitions 20 to 50 times.
- Exercise number 3. The patient lies on his stomach, successively bending his legs, trying to reach the back with his heel. Repetitions 20-50 times.
- Exercise number 4. It is done in the same way as the previous one, only static. That is, the patient fixes the limb in this position for 20-30 seconds.
Patients are advised to stretch:
- Exercise №1. In an upright position, bend down, trying to reach the floor without bending your knees. Hold for 20 seconds, inhaling air through the nose, exhaling through the mouth.
- Exercise number 2. Sitting on the floor with straight legs, try to wrap your arms around your legs while keeping your knees straight. Hold this position for up to 30 seconds. Perform 2-3 approaches. If the flexibility is not enough to reach the legs, they grab the legs by the lower leg and try to pull the body as close to the legs as possible.
- Exercise number 3. The same position as in the previous one. The patient grabs the leg by the leg, tries to straighten it and holds it as high as possible above the floor. If the exercise is difficult to do, then the leg is taken in the area of the lower leg. Hold the position for 10-30 seconds, then do it with the other leg.
Contraindication is the period of exacerbation and the presence of an acute inflammatory process. Patients are forbidden to run, walk for a long time and squat.
After performing physiotherapy exercises it is useful to massage the muscles of the thigh, lower leg of the affected limb. The joint itself should not be affected, this will increase the inflammation.
Disease prevention
This disease is not hereditary, so its development can be prevented. This requires:
- avoid injuries during sports;
- do stretching and joint gymnastics, yoga;
- eat right;
- maintaining a normal body weight;
- if you feel any discomfort in the knee area, consult a doctor;
- drink enough water;
- after 40 years take prophylactic 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 exercising.