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 leading to disability. How to treat arthrosis of the knee joint and prevent complications?
What is osteoarthritis
Approximately 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 collapse completely. This leads to impaired musculoskeletal function. Movement is possible only with the help of crutches, otherwise the person becomes a hostage of 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, favors the correct position of the body and coordination in space. This is a strong and stable joint that can withstand the weight of a person. It is made up of 3 bones: femur, tibia and fibula, as well as the patella or patella. It 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 found in the joint capsule and contributes to the proper functioning of the knee, decreases. Friction occurs between joint parts. Gradually, the cartilage breaks down and collapses. Unprotected bones begin to rub against each other. You feel pain and hear a crunching sound.
Causes of the disease
It mainly affects older people, especially overweight women. Due to hormonal changes, the knee cartilage wears out significantly. Gonarthrosis at various levels, after 60 years, occurs in more than 80% of people.
There are other reasons for the appearance of knee arthrosis:
- congenital joint pathology;
- dysplasia;
- accidents, 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 perform repetitive physical jobs. This group also includes athletes, people who lead a sedentary lifestyle and people with unfavorable environmental conditions. Often patients are people addicted to toxic substances (drugs, alcohol, smoking).
The cause of joint deformation may be 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 trigger.
Phases and symptoms
Gonarthrosis can be unilateral or bilateral. According to the nature of manifestations, the disease is divided into degrees:
- At this stage there are no obvious clinical signs. You may experience mild discomfort and pain after prolonged exercise, which disappears after rest. The pain is felt in the morning, when moving, disappears after some time. 1st degree osteoarthritis is rarely diagnosed, by chance, during a routine examination.
- Knee pain and stiffness increase. A person spares the leg and tries to load it less. As a result, the muscles atrophy, the joint is deformed, a buildup may be felt, and the leg at the knee does not fully extend.
- The pain is constant. The leg does not straighten or bend and it is difficult for the 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 addition to pain in grades 2 and 3, a crunch is heard in the knee. Fluid and pieces of cartilage tissue can build up in the joint capsule, causing swelling. At an advanced stage, the inflammatory process is pronounced, the knee joint is deformed.
Diagnostics
If you suffer from 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.
An x-ray allows you to see the state of the cartilage and changes in the bones in stages 2 and 3. This is a narrowing of the joint space, osteophytes along the edges of the kneecap, changes in the periosteum. Arthroscopy provides more detailed information about the meniscus, synovial membrane and the presence of fluid. This method is also used in knee treatment, to remove pieces of cartilage or meniscus.
Treatment of knee osteoarthritis
The therapy is long and sometimes painful. Having appeared once, the disease is remembered for the rest of your life. The main drugs used for treatment are nonsteroidal 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 lead to the formation of ulcers and erosions of the stomach and duodenum. Modern drugs cause fewer side effects, but are expensive.
Therapeutic measures for stage 1 include preventive measures related to physical exercise. Daily exercise, use of a contrast shower, swimming 2 times a week and combating body weight gain are necessary.
Phase 2 requires fixation of the joint: the use of an elastic bandage, bandage or orthosis. To relieve pain, NSAIDs are used in the form of creams and ointments. To reduce the degree of cartilage destruction, the patient is prescribed drugs from the group of chondroprotectors.
Severe severity requires oral administration of NSAIDs. Intra-articular injections of hormonal drugs are indicated: synthetic glucocorticosteroids (GCS), which have high glucocorticosteroid activity and low mineralocorticosteroid activity. Painkillers are also prescribed.
A hyaluronic acid solution is injected into the joint. It replaces intra-articular fluid and nourishes the cartilage. During movement it acts as a shock absorber for the joint. Manipulation is painful, it is carried out by a doctor after the acute period has calmed down. If conservative treatment is unsuccessful, endoprosthesis is performed.
Along with drug therapy, exercises using simulators and special devices (kinesitherapy) are prescribed. Ozone therapy has a positive effect on the condition of the knee. The substance is used externally, administered via subcutaneous or intramuscular injections, ozone ointments, creams. Manipulation stimulates blood circulation, improves the effect of chondroprotectors and glucocorticosteroids.
Modern dietary supplements are in demand as an alternative to drugs for the restoration of joints. Physical 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 healed. In this situation, only surgery will help. No ointment or medication can restore cartilage. Drugs can only stop the process of destruction of cartilage tissue.
Gonarthrosis progresses gradually, sometimes the disease lasts for years. Without adequate treatment, the patient's condition rapidly worsens. The knee cannot function, serious complications appear:
- joint deformity;
- aesthetic defect - curvature of a limb;
- infection with blood or lymph flow from another source in the body;
- 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 see a doctor in time and the disease is in an advanced stage. Regular preventive examinations and timely treatment of general diseases of the body will help prevent worsening of the condition and maintain the motor function of the limb.