Knee arthrosis: symptoms and treatment, prevention of gonarthrosis

A

Gonarthrosis or knee arthrosis is a severe degenerative-dystrophic pathology of the knee joint that causes the destruction of the structure of the cartilage tissue in the joints, which in turn leads to their deformation and loss of function. Pathology often leads to human disability.

Knee deforming gonarthrosis occupies a leading position among all arthrosis, and if it initially affects only a small part of the joint, in the absence of proper treatment, when the disease develops in the late stages of development, it all participates in the pathological process.

The disease most often develops in people over the age of 40, but in athletes at a young age (after severe joint injuries).

Women are most prone to joint deformities, but it often occurs in men and even young children. In order not to aggravate the situation, you should be able to recognize the first signs of this disease.

Varieties

The classification of gonarthrosis depends on its etiology and localization. Each variety has its own developmental characteristics, which the physician always takes into account when prescribing treatment. But by the nature of the manifestation they are practically the same.

Thus, depending on the etiology of the disease, the types of acute knee arthrosis are as follows:

• Primary gonarthrosis. This disease develops without any preconditions. The risk group includes the elderly, women and obese patients. Gonarthrosis of the primary type of knee joint can develop over the years without any manifestation. But the sooner it is discovered, the more favorable the prognosis of treatment will be.
Secondary gonarthrosis of the knee
• occurs as a result of trauma, but can also be the result of various infectious pathologies. If the injured joints are treated in time, the patient has every chance to avoid this disease.

There are types of osteoarthritis by localization:

• Right gonarthrosis, which develops in the joint tissues of the right knee. It is common in athletes as well as in people whose work requires frequent physical exertion.
• Left gonarthrosisinvolves the left knee in the pathological process. It occurs in people who play professional sports as well as in patients diagnosed with obesity.
• Bilateral osteoarthritishas a destructive effect on the joint tissues of both knees. This type of disease is considered to be the most severe, both in terms of symptoms and therapeutic approach. In most cases, this type of gonarthrosis of the knee joint develops in the elderly, i. e. , idiopathic.

Anatomy and abnormalities

The knee joint is formed from the joint surfaces of the tibia and femur. On the front is the patella, which glides smoothly along the recess between the condils of the femoral joint.

The femur and tibia, as well as the knee pad, are covered with flexible clay cartilage 5-6 mm thick. It helps reduce friction during human physical activity and has an impact-absorbing function in the event of a fall.

Abnormalities of the joints: intermittent disorders

In the first stage of the development of gonarthrosis of the knee joint, blood circulation is primarily affected. The small intraosseous vessels that carry blood to the hyaline joint become disturbed, leading to a gradual drying of its surface. It becomes less flexible and cracks begin to form on its surface.

As a result, these cartilages touch each other instead of smoothly slipping. Inflammation begins to develop gradually, and the patient’s cartilage, displaced slightly, interferes with each other to fully perform their functions. They gradually lose their padding properties due to the formation of a large number of microcracks in the cartilage-forming tissues.

In the second stage of gonarthrosis progression, compensatory changes appear in the bone area. As a result of the increased loads, the joint platform begins to flatten gradually, leading to compaction of the subchondral zone (the area of ​​bone below the cartilage).

Along the edges, joint surfaces begin to grow with bony processes that appear as sharp thorns on X-ray.

As the lubricant thickens in the joints, it loses most of its function. This leads to accelerated cartilage degeneration. Because of this, it looks like a thin strand on an X-ray or becomes completely invisible.

If something like this is detected, it means that the disease flows smoothly (or quickly - it all depends on the situation) into stage 3 of development.

Bone deformity is noticeable in the third stage of knee joint gonarthrosis. They appear to be pinched together, leading to a decrease in joint mobility. The cartilage tissue dries almost completely.

Causes and predisposing factors

The causes of arthrosis of the knee joint are not isolated - often the doctor determines several factors at once that led to the development of the disease.

The most common and common causes are:

• previous joint injuries (moderate or severe);
• leg fractures, especially if intraarticular damage has occurred;
• violation of the integrity of the meniscus structure;
• ribbon tears or full tears;
• Excessive stress on the knee joints.

Acute knee arthrosis is directly related to a person's age. So it turns out that people over the age of 40 are most susceptible to it, as during this period the elasticity of the cartilage begins to decrease and the lubricating joint gradually "dries out".

To delay the moment, exercise is recommended for patients, but physical activity should be moderate and should not lead to general discomfort.

Being overweight is one of the predisposing factors for gonarthrosis. The fact that excess body is an additional burden on bones and joints that should not affect their health.

In this case, the fact that which foot has a higher load plays an important role. For example, if your left foot is the "support", you are more likely to develop left gonarthrosis.

In obesity, constant pressure on the joints leads to microtrauma and rupture of small blood vessels. Rupture of the meniscus or ligaments is also possible, which is considered a serious manifestation of joint injuries.

This disease is extremely severe in patients with severe symptoms of varicose veins. In this case, the patient is presented with a phlebologist consultation.

People who:

are at high risk of developing pathology

• had previously suffered from different types of arthritis;
• have an unfavorable inheritance;
• has problems with the tape device;
• suffer from metabolic disorders;
• suffered traumatic brain injury;
• injured in an accident;
He had
• spinal injuries.

Many of these factors are often closely related. Determining the exact cause helps to make an accurate diagnosis and requires the patient to treat the arthrosis of the knee joint correctly and effectively.

Clinical manifestations

Symptoms of gonarthrosis do not appear immediately - they begin to appear gradually depending on the stage of the disease. For this reason, the clinical picture should be considered intermittently.

First section

In the early stages of the disease, patients complain of mild knee pain, which is exacerbated by physical exertion. They become especially more intense as the stairs descend and rise.

In addition to the pain, the patient feels a certain stiffness of movement, a "contraction" in the joint area. It is felt in the popliteal part and passes away when the knee muscles relax.

Another characteristic feature is called “initial pain syndrome”. It develops in the first steps of the patient. When the knees get used to the load, this anomaly disappears without a trace.

Second Section

At this time, the symptoms of knee arthrosis become more intense and noticeable. The pain increases, causing significant difficulty and discomfort while walking. The pain syndrome disappears after a long rest, but with intense effort it makes itself felt again.

Inflammation of the joint causes swelling of the knee that is visible to the naked eye. There is a strong, unpleasant crackle while walking. The movements become more and more difficult and limited.

Third Section

The pain becomes very severe and the patient cannot do without pain relief. It is difficult for a person to bend his knee, he feels the rigidity of joint movements. It deforms and increases in size. In severe cases, the patient cannot move without additional support.

The patient should not ignore all of these signs of knee arthrosis. Because of the disease, a person can be hospitalized for a long time and sometimes lead to disability.

Which doctor treats knee gonarthrosis?

An orthopedic traumatologist should be consulted to diagnose and treat knee gonarthrosis. If surgery is needed, you may need the help of a surgeon.

Diagnostic Measures

An integrated approach to patient testing is extremely important in determining the cause of a disease.

The diagnostic scheme consists of several stages:

1. Visual inspection and medical history of the orthopedist. The doctor determines if the patient has symptoms of acute arthrosis of the knee joint, touches the affected area of ​​the foot, measures the bone, and performs an angle measurement — this test can be used to assess joint movement at different angles.
2. Clinical blood test to evaluate ESR.
3. Blood biochemistry.
4. Urine and blood tests for fibrinogen, urea and other substances.
5. Radiography is one of the most common methods of examining arthrosis. In the initial stage, however, the snapshot shows no changes - they can only be noticed in the later stages of development. The x-ray shows narrowing of the joint gap, sclerotic changes in the cartilage area, bone tissue damage, and salt deposits.
6. Ultrasound is the most informative diagnostic procedure. However, full-fledged test results can be obtained when ultrasound is performed in conjunction with radiography.
7. MRI allows you to thoroughly examine all layers of joint, cartilage, and bone tissue and notice the first dystrophic changes in the early stages of arthrosis. However, MRI has one major drawback - the procedure is quite expensive. But its high accuracy contributes to the formulation of 99. 9% of the exact diagnosis.

Management

The treatment and diagnosis of acute knee arthrosis requires an integrated approach. But above all, drug therapy should be used because the diseased joint can become inflamed at any time.

Medication

How to treat knee gonarthrosis with pharmacy drugs and which drugs to choose? Only a traumatologist will tell you about this. Often, the following groups of drugs belong to the therapeutic order:

• Non-steroidal anti-inflammatory drugs, COX-1 or 2. The first group can severely damage the gastrointestinal tract and should not be used for a long time. The same cannot be said for the milder drugs in the COX-2 group. They are administered intramuscularly or intravenously.
• Treatment of osteoarthritis of the knee also involves the use of hormonal medications. They help relieve inflammation and swelling of the knee. Their use is recommended in case of synovitis (inflammation of the synovium).
• Treatment with chondroprotectors.
• Application of ointments, gels, creams. They improve blood circulation, warm up, relieve swelling and inflammation.

First method

How to cure knee arthrosis with this technique? The main elements of the therapeutic regimen are:

• use of drugs (NSAIDs, chondroprotectors, analgesics, ointments, creams, gels);
• light physiotherapy exercises;
• manual therapy;
• physiotherapy;
• warming anti-inflammatory compressions with medicinal solutions.

In addition, the famous rheumatologist says that diet plays an important role in arthrosis. Thanks to a well-designed diet and the application of the above techniques, you can achieve amazing results from therapy in the shortest possible time.

Second method

Often, the treatment of knee arthrosis, like other joint pathologies, is performed by this method.

The development of a famous doctor is based on the following application:

• drugs;
• surgery;
• Adhering to a diet that removes excess fluid from the body;
• kinesitherapy;
• physiotherapy.

Your doctor also recommends that you swim more in the pool, go to the sauna and go for a massage. This helps to improve the patient’s health, especially if the disease has been neglected and untreated for a long time.

Treatment according to the third method

Treatment of knee joint gonarthrosis with this technique completely eliminates dynamic loads, as they can significantly accelerate the deformation process. Exercise should be slow, low amplitude.

Example: Sit on a chair "on top", ie with your back. He spreads his legs wide, but don’t let them touch the floor. Gently wave both legs one after the other. Do the exercise until you feel a little tired. The number of approaches depends on the well-being of the patient.

Surgery

How to treat advanced osteoarthritis of the knee joints? In this case, there is only one way out - operation. There are several types of osteoarthritis of the knee:

• Removal of deformed cartilage and diseased joints (arthrodesis). Extremely rare.
• Removes damaged cartilage without removing the joint. This procedure is called arthroscopic removal. They are performed using a special device - an arthroscope. The procedure is simple, but its effect lasts up to 3 years.
• Sawing and fixing the diseased joint at a different angle. This is called periarticular osteotomy. The technique is quite complicated, but it allows us to forget about the pathology for 3-5 years.

Surgery is rarely used and only in the absence of a method that will cure the disease for at least 1-2 years. In the initial stages of the disease, the operation is almost never performed.

Endoprosthetics

Endoprosthetics are considered the most common treatment for gonarthrosis. It is a type of surgery that allows the mobility of the affected knee to be fully maintained. But despite its effectiveness, this technique requires long-term rehabilitation. In addition, it can have quite serious consequences.

An "artificial" patient is replaced with an artificial joint that can serve for 20 years. Although, of course, it all depends on what material it is made of. The procedure is not cheap, but quite effective, so it has gained particular popularity.

Physiotherapy exercises

Exercise therapy is prescribed by your doctor depending on the stage of the disease. However, the principles for performing the exercises are the same in all cases:

• to avoid intense stress on the knee joint;
• sudden and forced movements are prohibited;
• Do not perform exercises that require a full load on the sore joint.

Permitted Practices:

• a slight tremor in the legs while kneeling on a blanket spread out on the floor;
• nice kneeling movements in the same position;
• in the same position, alternately straighten your legs, trying not to lift the corners off the floor, and then bend it again, avoiding sudden movements.

These exercises combined with medication and physiotherapy produce excellent results.

Physiotherapy

All physiotherapy procedures are prescribed for gonarthrosis in remission. One of the most effective techniques is to note:

• electrophoresis with medical solutions;
• magnetotherapy;
• ultrasound therapy;
• microwave treatment;
• paraffin therapy;
• baths with radon or hydrogen sulfide;
• sludge treatment.

Physiotherapy courses should be taken at least twice a year to prevent recurrence of the disease. This helps to prolong the remission phase.

Massage

A knee massage is performed to improve blood circulation. It is performed along the lymphatic flow in the direction between the peripheral area and the central zone. The popliteal fossa is not involved in this process.

Manual therapy sessions are often performed in conjunction with massage to gradually stretch the patient’s joint. Such procedures stabilize the patient's condition, but can only be performed by a professional.

Is gonarthrosis completely cured?

Is it possible to completely cure osteoarthritis of the knee joint? Perhaps no one, not even the most experienced traumatologist, is able to give a clear answer to this question. It all depends on the severity of the disease. If you continue therapy in the early stages of development, you can stop further deformity of the joints.

However, if a pathology is found in the final stages, even surgery does not guarantee the complete disappearance of the unpleasant symptoms. Surgery only helps with healing for a few years, after which the disease can remind itself again.

Prevention

To prevent gonarthrosis:

• avoid knee injuries;
• practice constantly (squatting, running, raising and lowering legs);
• enrich your diet with foods high in vitamins;
• limits the use of salt, hot spices, fried, smoked, sweet;
• maintaining normal physical form;
• immediate medical attention for the slightest knee injury;
• prophylactic administration of chondroprotectors after the age of 35 years;
• daily water consumption (2 liters).

By following these simple recommendations, you can reliably protect yourself from knee arthrosis and other diseases that can impair your quality of life for a long time.