In the group of diseases of the musculoskeletal system of degenerative-dystrophic origin, gonarthrosis of the knee joint occupies a prominent place.
Gonarthrosis or osteoarthritis of the knee joint is a disease accompanied by a slow destruction of the cartilaginous tissue of the joint, involving the entire joint in the pathological process, including the ligaments, the synovial membrane, the 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 performing heavy physical labor, ballet dancers), the trophism (nutrition) of the cartilaginous tissue of the knee joint is disturbed, as a result of which the cartilage becomes thinner and destroyed, sometimes to the point of complete disappearance.
Who is at risk?First of all, women over forty years of age are at risk of developing osteoarthritis of the knee joint;It occurs in them 2 times more often than in the stronger half of humanity.Additionally, the risk increases in those women prone to being overweight or obese.
But, in general, gonarthrosis is a disease of older people.And there is a simple explanation for this.As you know, cartilage tissue is made up of approximately 70-80% water, so it is well absorbed.In addition, at a young age, "regenerating" cells - chondrocytes - actively work.With age, the amount of moisture begins to decrease and, consequently, the cushioning ability of the joint deteriorates, the cartilage becomes dry, brittle and cracked, and the existing chondrocytes do not have time to repair the damage.In many ways, this explains the appearance of gonarthrosis of the knee joint.
Causes of the disease
Predisposing factors include excess weight, physical inactivity, chronic joint injury 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 any specific cause that caused 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.
In addition, the disease, depending on the causes of its appearance, is usually divided into two forms: primary and secondary.
The cause of primary osteoarthritis is age and the presence of associated factors, such as:
- Professional predisposition,
- overweight
- obesity,
- Varicose veins of the lower extremities.
The cause of secondary gonarthrosis may be a previous injury to the knee (fracture, rupture of the ligamentous apparatus), called post-traumatic osteoarthritis of the knee joint.The cause may 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 appears is constant and worsens with physical activity: walking, running, going up or down stairs, etc.Another characteristic symptom of this disease is the presence of crepitus in the joint, this can be a cracking or cracking sound in the knee.
They are also very common manifestations of gonarthrosis:
- increased local temperature (the joint is hot to the touch) or general,
- the presence of swelling of the joint,
- increasing its volume,
- difficulty moving,
- deformation of the joint with subsequent 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 in the bones that form the joint in the form of "spikes" (osteophytes) and a deforming osteoarthritis of the knee joint occurs.Exudate appears in the joint cavities.
Depending on the size of the osteophytes and the degree of deformation, several degrees of gonarthrosis are distinguished:
- 1st degree gonarthrosis.Patients feel stiffness and mild pain in the joint in the morning or when sitting or standing for a long time.At this stage there is no deformation of the joint, mobility is completely preserved.An x-ray reveals a small osteophyte.
- Second degree gonarthrosis.Painful sensations appear not only in the morning, but also after prolonged exercise;the joint is deformed, the articular surfaces increase, as a result of which the volume of the joint also increases, it is difficult to bend, and a crunching sensation is felt when performing movements.The x-ray shows a pronounced osteophyte, the joint space does not change.
- Gonarthrosis 3 degrees.The manifestations are the same as in the second degree, only the symptoms become more vivid.The pain is constant and does not subside even with rest and sleep.The function of the joint is almost completely lost;Patients cannot bend or straighten their leg.As a result, lameness occurs and movement is only possible with crutches or assistance.There is a severe deformation of the knee joint.An x-ray reveals a slight narrowing of the joint space.
- There is also a fourth stage., in which there is complete immobilization of the affected joint with increased deformation.Radiographs reveal sclerosis of the subchondral bone and significant narrowing of the joint space.
Treatment of osteoarthritis of the knee joint.
To achieve good treatment results, it is advisable to seek the help of a qualified rheumatologist, and if not available, a therapist, since they are the ones who know how to cure osteoarthritis of the knee joint.Under no circumstances try to treat it yourself, this can only make an already bad situation worse.Before starting treatment, it is extremely important to make a correct diagnosis, since a correct diagnosis is the key to successful treatment.
Treatment of gonarthrosis is a fairly long process and depends on several factors (type of osteoarthritis, cause of osteoarthritis, degree of the disease).Treatment is complex and includes pharmacological and non-pharmacological therapy, with surgical treatment being indicated in some cases.
The main objective of pharmacological treatment of osteoarthritis of the knee joint is to alleviate 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, medications are used to:
- restoration of joint tissues,
- improving your 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 pain relievers are prescribed for a short period.The most 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 tissue.Intra-articular administration of chondroprotectors gives a good effect.In recent years, a new and effective product based on hyaluronic acid has appeared.Due to its effect, this drug is called a “liquid prosthesis.”After injection into a painful joint, this medication forms a protective film over the damaged cartilage and gradually restores the normal lubrication characteristics of the joint.
Muscle relaxants are used to relieve muscle spasms;In addition to their relaxing effect, they have a positive effect on blood circulation in the affected joint.
Among non-drug methods of treating gonarthrosis, physiotherapy and physiotherapy are widely used.The most important ones are magnetotherapy, acupuncture, electrophoresis and massage, hardware traction (joint traction) and others.Recently, the practice of treating osteoarthritis has included methods such as laser therapy and cryotherapy (exposure to liquid nitrogen).Along with physiotherapy, exercise therapy for osteoarthritis of the knee joint also gives a good effect.Physiotherapy is the use of various physical exercises for therapeutic purposes.
Gymnastics for osteoarthritis of the knee joint.
At the onset of the disease, physical stress on the affected joint should be reduced to a minimum.You should not run, jump, lift weights, walk fast or squat.Exercises for osteoarthritis of the knee joint can be performed only after completing treatment, under the supervision of your doctor.
It is necessary to choose exercises that help strengthen the muscles and ligaments of the affected knee joint, but do not cause excessive mobility of the joint.That is, the exercises should be performed with 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 applying any effort.
When performing any gymnastic exercise, it is important to follow some rules:
- Do not exercise while you are overcoming pain,
- If an exercise causes pain, then it should be replaced with a gentler exercise.
Massage for osteoarthritis 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 eliminate residual inflammation.Massage strengthens the muscular system, increases the flow of oxygen to them, improves gas exchange, normalizes their tone and increases plasticity.
Diet for osteoarthritis 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 osteoarthritis is greatly 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 gradually reducing body weight.This will require a change in diet and a change in diet.Food should be low in calories, fried foods 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 as long as possible, it is necessary to regularly practice physical education and gymnastics, but you should not get carried away with this, so that this does not lead to overload of the joints.Swimming provides the best effect and minimal stress on the joints.If you play professional sports, you should wear joint protection.It is useful to alternate physical activity with rest;You should not remain still for too long.
Compliance with all these simple rules, along with a healthy lifestyle and proper nutrition, will not allow osteoarthritis of the knee joint to ruin any person's life.